[Background Material and Data on Programs within the Jurisdiction of the Committee on Ways and Means (Green Book)]
[Program Descriptions]
[Section 4. Supplemental Security Income (SSI)]
[From the U.S. Government Printing Office, www.gpo.gov]






 
[1996 Green Book] SECTION 4. SUPPLEMENTAL SECURITY INCOME (SSI) *
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    * The Personal Responsibility and Work Opportunity Reconciliation 
Act of 1996 changed this program; see appendix L for details.
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                                CONTENTS

Background
Trends
Basic Eligibility
  Categorical Requirements
  Citizenship and Residency Requirements
  Income and Resource Requirements
  Presumptive SSI Eligibility for Persons with AIDS and HIV
  Public Institution Requirement
Application to Other Programs Requirement
  Eligibility for Social Security
  Eligibility for AFDC
  Eligibility for Medicaid
  Eligibility for Food Stamps
Vocational Rehabilitation and Treatment and Monitoring 
        Requirements
SSI Benefits
  Federal SSI Benefit Standard
  Benefits for Persons Living in the Household of Another
  Benefits for Persons Living in a Medicaid Institution
  Benefits of Former Recipients of State Assistance
  Overpayments
  Faster Initial SSI Payments
  State Supplementation
  Maximum SSI and Food Stamp Benefits for Individuals Living 
            Independently
  Comparison of SSI Payment Levels to Poverty Thresholds
Trends in the SSI Caseload
  Number of Recipients
  Characteristics of Adult Disabled and Blind Recipients
  Characteristics of Recipients Receiving Benefits on the Basis 
            of Age
  Characteristics of Children Receiving Benefits
  Overview of Caseload Developments
Eligibility of Drug Addicts and Alcoholics
Eligibility of Legal Immigrants (Aliens) for SSI
Eligibility of the Homeless
Special SSI Provisions for the Working Disabled
  Earned Income Disregards
  Eliminating Work Disincentives
  Overview of Section 1619 Provisions
Measures of SSI Participation
Legislative History
  Legislative Changes Made in the 92d Congress
  Legislative Changes Made in the 93d Congress
  Legislative Changes Made in the 94th Congress
  Legislative Changes Made in the 96th Congress
  Legislative Changes Made in the 97th Congress
  Legislative Changes Made in the 98th Congress
  Legislative Changes Made in the 99th Congress
  Legislative Changes Made in the 100th Congress
  Legislative Changes Made in the 101st Congress
  Legislative Changes Made in the 103d Congress
  Legislative Changes Made in the 104th Congress
References

                               BACKGROUND

    The Supplemental Security Income (SSI) Program is a means 
tested, federally administered income assistance program 
authorized by title XVI of the Social Security Act. Established 
in 1972 (Public Law 92-603) and begun in 1974, SSI provides 
monthly cash payments in accordance with uniform, nationwide 
eligibility requirements to needy aged, blind and disabled 
persons.
    The SSI Program replaced the Federal-State programs of old 
age assistance and aid to the blind established by the original 
Social Security Act of 1935 as well as the program of aid to 
the permanently and totally disabled established by the Social 
Security amendments of 1950. Under the former programs, Federal 
matching funds were offered to the States to enable them to 
give cash relief, ``as far as practicable'' in each State, to 
persons in eligible categories whom the States deemed needy. 
The States set benefit levels and administered these programs. 
The Federal-State adult assistance programs continue to operate 
in Guam, Puerto Rico, and the Virgin Islands. Under the 
Covenant to Establish a Commonwealth of the Northern Mariana 
Islands, enacted as Public Law 94-241 on March 24, 1976, the 
Northern Mariana Islands became the only U.S. jurisdiction 
outside the 50 States and the District of Columbia authorized 
to operate an SSI Program.
    The Congress intended the new SSI Program to be more than 
just a Federal version of the former State adult assistance 
programs which it replaced. In describing the new program, the 
report of the Committee on Finance stated: The Committee bill 
would make a major departure from the traditional concept of 
public assistance as it now applies to the aged, the blind and 
the disabled. Building on the present Social Security Program, 
it would create a new Federal program administered by the 
Social Security Administration (SSA), designed to provide a 
positive assurance that the Nation's aged, blind, and disabled 
people would no longer have to subsist on below poverty-level 
incomes (Senate Report No. 92-1230, 1972, p. 384).
    The SSI Program was envisioned as a basic national income 
maintenance system for the aged, blind, and disabled which 
would differ from the State programs it replaced in a number of 
ways. It would be administered by SSA in a manner as comparable 
as possible to the way in which benefits were administered 
under the Social Security Program. While it was understood that 
modifications would be necessary to make SSA's systems work for 
the new SSI Program, SSI was seen as an add-on rather than a 
new system. SSA had a longstanding reputation for dealing with 
the public on a fair and humane basis, but with scrupulous 
regard for the requirements of law. Thus, it was expected that 
both recipients and taxpayers would be pleased with the 
outcome.
    Under the former adult assistance programs the amount of 
assistance could vary from person to person according to an 
evaluation of the individual's needs. The SSI Program, by 
contrast, represented a ``flat grant'' approach in which there 
would be a uniform Federal income support level.
    In contrast to the former State programs with their 
provisions for liens against property and relative support 
requirements, the SSI Program was intended to have minimal 
barriers to eligibility other than a lack of income. Even here, 
the new SSI Program incorporated more generous provisions for 
disregarding income--particularly earned income--than was 
provided under the old-age assistance program. The report of 
the House Committee on Ways and Means stated that the SSI 
Program was designed to provide incentives and opportunities 
for those able to work or to be rehabilitated that would enable 
them to escape from their dependent situations (House Report 
No. 92-231, 1971, p. 147).
    For the most part, the nature of the SSI Program is 
expressed by its title. It was conceived as a guaranteed 
minimum income for the aged, blind, and disabled which would 
supplement the Social Security Program and act as an income-
related program to provide for those who were not covered or 
minimally covered under Social Security or who had earned only 
a minimal entitlement under the program.
    It should be noted that even though SSA administers the SSI 
Program, SSI is not the same as Social Security. The SSI 
Program is funded by general revenues of the U.S. Treasury--
personal income taxes, corporation taxes, and other taxes. 
Social Security benefits are funded by the Social Security 
taxes paid by workers, employers, and self-employed persons. 
The programs also differ in other areas such as the conditions 
of eligibility and the method of determining payments. In 
addition, States have the option of supplementing the basic 
Federal SSI payment. In some cases, State supplementary 
payments are administered by the State instead of the Federal 
Government (i.e., the Social Security Administration).

                                 TRENDS

    Table 4-1 summarizes the trends in the SSI Program since 
its inception in 1974:
 1. The number of recipients on SSI has risen from nearly 4 
        million in 1974 to 6.5 million in December 1995. The 
        number of SSI recipients declined early in the program 
        as the number of aged individuals on SSI declined, but 
        that trend reversed in the mid-1980s as rapid growth in 
        disabled recipients outstripped the minimal change in 
        the elderly and blind SSI populations.

                                                            TABLE 4-1.--SUPPLEMENTAL SECURITY INCOME SUMMARY, SELECTED YEARS 1974-95                                                            
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                                                                                                                            Year                                                                
                           Item                            -------------------------------------------------------------------------------------------------------------------------------------
                                                               1974       1978       1980       1984        1986        1988       1990       1991       1992       1993       1994       1995  
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Recipients: \1\                                                                                                                                                                                 
      Total...............................................  3,996,064  4,216,925  4,142,017   4,029,333   4,269,184  4,463,869  4,817,127  5,118,470  5,566,189  5,984,300  6,295,786  6,514,134
                                                           -------------------------------------------------------------------------------------------------------------------------------------
    Aged..................................................  2,285,909  1,967,900  1,807,776   1,530,289   1,473,428  1,433,420  1,454,041  1,464,684  1,471,022  1,474,852  1,465,905  1,446,122
    Blind.................................................     74,616     77,135     78,401      80,524      83,115     82,864     83,686     84,549     85,400     85,456     84,911     83,545
    Disabled..............................................  1,635,539  2,171,890  2,255,840   2,418,522   2,712,641  2,947,585  3,279,400  3,569,237  4,009,767  4,424,022  4,744,470  4,984,467
Number with section 1619(a)...............................         NA         NA         NA  406 (8/84)  992 (1/86)     19,920  \2\ 13,99                                                       
                                                                                                                                        4     15,531     17,603     18,597     24,315     28,060
    Number with section 1619(b)...........................         NA         NA         NA       6,804       8,106     15,625     23,517     26,852     31,649     34,293     40,683     47,002
Annual payments (in millions):                                                                                                                                                                  
      Total...............................................     $5,246     $6,552     $7,940     $10,372     $12,081    $13,786    $16,599    $18,534    $22,238    $23,991    $25,870    $27,037
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    Federal benefits......................................      3,833      4,881      5,866       8,281       9,498     10,734     12,894     14,765     18,247     20,722     22,175     23,919
    Federal admin. State supp.............................      1,264      1,491      1,848       1,792       2,243      2,671      3,239      3,231      3,435      3,270      3,116      3,118
    State admin. State supp...............................        149        180        226         299         340        381        466        538    \3\ 556        564        579    \4\ 620
                                                           =====================================================================================================================================
    Annual payments (in millions of 1995 dollars).........    $17,034    $15,535    $15,024     $15,267     $16,740    $17,836    $19,526    $20,755    $24,174    $25,312    $26,596    $27,037
Monthly Federal benefits rates:                                                                                                                                                                 
    Individuals...........................................    $140.00    $177.80    $208.20     $314.00     $336.00    $354.00    $386.00    $407.00    $422.00    $434.00    $446.00    $458.00
    Couples...............................................     210.00     266.70     312.30      472.00      504.00     532.00     579.00     610.00     633.00     652.00     687.00     687.00
Average Federal SSI payments: \1\                                                                                                                                                               
    All Recipients........................................     $95.11    $111.98    $143.35     $196.16     $215.40    $227.49    $261.47    $286.03    $329.74    $317.41    $325.26    $358.40
    Aged individuals......................................      78.48      91.22     112.45      143.24      151.38     159.36     175.29     186.28     195.86     204.45     211.55     219.13
    Aged couples..........................................      93.02     120.48     157.56      221.98      246.07     273.18     322.82     414.26     448.61     478.42     505.64     534.00
Average federally administered: \1\                                                                                                                                                             
    State supplementation.................................     $70.92     $75.00     $99.15      $97.61     $115.41    $122.68    $139.79    $130.55    $118.08    $108.50    $101.46    $105.24
Income of recipients percent with: \1\                                                                                                                                                          
    Social Security benefits..............................       52.7       51.7       51.0        49.6        48.9       47.8       45.9       44.3       41.3       40.1       39.1       37.9
    Other unearned income.................................       10.5       11.5       11.0        11.2        12.1       12.4       13.0       14.1       14.5       13.4       13.1       12.8
    Earnings..............................................        2.8        3.1        3.2         3.5         3.9        4.4        4.7        4.6        4.4        4.3        4.2        4.3
Average amount of: \1\                                                                                                                                                                          
    Social Security benefits..............................    $130.01    $156.50    $196.94     $250.61     $263.29    $286.49    $318.57    $329.19    $335.72    $338.85    $345.20    $354.47
    Other unearned income.................................      61.10      66.93      74.35       84.56       86.40      85.92      98.13      94.71      91.96     100.44     101.13     105.32
    Earnings..............................................      80.00      99.32     106.95      126.47      142.17     173.09     195.64     206.86     207.55     210.22     225.01     234.94
Poverty thresholds (age 65 and over):                                                                                                                                                           
    Individual............................................     $2,364     $3,127     $3,949      $4,979      $5,255     $5,674     $6,268     $6,532     $6,729     $6,930     $7,108     $7,309
    Couple................................................      2,982      3,944      4,983       6,282       6,630      7,158      7,905      8,241      8,489      8,741      8,967      9,221
Federal benefit rate as a percent of poverty:                                                                                                                                                   
    Individual............................................       74.1       72.7       72.3        75.6        76.7       74.9       73.9       74.8       75.3       75.2       75.3       75.2
    Couple................................................       88.1       86.4       86.0        90.2        91.2       89.2       87.9       88.8       89.5       89.5       89.5       89.4
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\1\ December data.                                                                                                                                                                              
\2\ The decrease in 1619(a) participants in 1990 was caused by the increase in the substantial gainful activity level to $500 monthly.                                                          
\3\ Fiscal year 1992 data.                                                                                                                                                                      
\4\ Fiscal year 1995 data.                                                                                                                                                                      
                                                                                                                                                                                                
NA--Not available.                                                                                                                                                                              
                                                                                                                                                                                                
Source: Social Security Administration (1995 and various years) and unpublished data.                                                                                                           

 2. Total annual benefits paid under the SSI Program rose from 
        about $5.2 billion in 1974 to $27.0 billion in 1995.
 3. The monthly Federal benefit rates for individuals and 
        couples rose from $140 and $210 in 1974 to $470 and 
        $705 in 1996 (1996 figures are not in table), 
        respectively. Nearly all of these changes resulted from 
        the statutory indexation of the Federal benefit rates 
        to the Consumer Price Index (CPI).
 4. The proportion of SSI recipients receiving Social Security 
        benefits declined from nearly 53 percent in 1974 to 
        about 38 percent in 1995. The fraction of SSI 
        recipients receiving some other type of unearned income 
        rose from about 11 percent in 1974 to 13 percent in 
        1995, and the fraction with earnings increased from 
        about 3 percent in 1974 to more than 4 percent in 
        December 1995.
 5. The Federal benefit rate as a percent of the appropriate 
        poverty level for individuals has ranged from 72 to 77 
        percent and is currently 75 percent; for couples it has 
        ranged from 86 to 91 percent and is currently at 89 
        percent. Most States supplement the Federal benefit for 
        at least some participants.
 6. The SSI Program pays benefits to children who are blind or 
        have other disabilities. Some of the increases in 
        participation since 1991 reflect the revised definition 
        of disability for children as a result of the Supreme 
        Court's decision in the Sullivan v. Zebley case.

                           BASIC ELIGIBILITY

                        Categorical Requirements

    To qualify for SSI payments, a person must satisfy the 
program criteria for age, blindness or disability. The aged are 
defined as persons 65 years and older. The blind are 
individuals with 20/200 vision or less with the use of a 
correcting lens in the person's better eye, or those with 
tunnel vision of 20 degrees or less. Disabled individuals are 
those unable to engage in any substantial gainful activity by 
reason of a medically determined physical or mental impairment 
expected to result in death or that has lasted, or can be 
expected to last, for a continuous period of at least 12 
months. The test of ``substantial gainful activity'' is to earn 
$500 monthly in counted income, with impairment-related 
expenses subtracted from earnings. Generally, the individual 
must be unable to do any kind of work that exists in the 
national economy, taking into account age, education, and work 
experience.
    Children may qualify for SSI if they are under age 18 (or 
under age 22 if a full-time student), unmarried, and meet the 
applicable SSI disability or blindness, income, and resource 
requirements. The child's impairment must be of severity 
comparable to that of an adult whose disability prevents him 
from working. The Supreme Court ruled in Sullivan v. Zebley 
(1990) that in determining the severity of a child's 
impairment, SSA must consider whether the limitations caused by 
the impairment substantially reduce the child's ability to do 
the things and behave in the ways that children of a similar 
age normally do.
    To be found disabled, children must have a medically 
determinable physical or mental impairment that substantially 
reduces their ability to function independently, and 
effectively engage in ``age-appropriate'' activities. This 
impairment must be expected to result in death or to last for a 
continuous period of not less than 12 months.
    To determine whether an adult is disabled, SSA compares the 
medical evidence to a ``Listing of Impairments'' that are 
presumed to be too severe to allow the individual to perform 
any ``substantial gainful activity'' (this listing also is used 
for Social Security Disability Insurance (DI) cases). If the 
individual has an impairment on the list, she qualifies for SSI 
benefits without further inquiry. If the individual's 
impairment is not on the list, SSA makes an individualized 
assessment to determine whether the person would be able to 
``do his own past work or any other work that exists in the 
national economy given his age, education, and work 
experience.'' If the adult applicant cannot work based on these 
factors, she is eligible for SSI benefits.
    Before the 1990 Supreme Court ruling in Sullivan v. Zebley, 
SSA treated children in a different way. If the child's 
impairment did not match the listed impairment, the child was 
not eligible for SSI benefits. In contrast to adults, there was 
no additional functional assessment done. On February 20, 1990, 
the Supreme Court ruled in Sullivan v. Zebley that SSA's 
refusal to consider the functional limitations of children when 
assessing their SSI eligibility for disability benefits was 
``manifestly contrary to the statute.'' On February 11, 1991, 
SSA published the revised regulations for determining whether a 
child is disabled.
    Under the disability determination process for children, 
individuals whose impairments do not meet or equal the 
``Listing of Impairments'' in Federal regulations are subject 
to an individualized functional assessment (IFA). This 
assessment, established pursuant to the Zebley decision, 
examines whether the child can engage in ``age-appropriate'' 
activities effectively. If not, the child is determined to be 
disabled.

                 Citizenship and Residency Requirements

    To qualify for SSI, a person must (1) be a U.S. citizen or 
an immigrant lawfully admitted for permanent residence or 
otherwise permanently residing in the United States under color 
of law and, (2) be a resident of the United States or the 
Northern Mariana Islands, or a blind or disabled child of 
military personnel stationed outside the United States, or a 
student temporarily abroad.

                    Income and Resource Requirements

Income
    Individuals and couples are eligible for SSI if their 
incomes fall below the Federal maximum monthly SSI benefit, 
currently $470 for an individual and $705 for a couple. If only 
one member of a couple qualifies for SSI, part of the 
ineligible spouse's income is considered to be that of the 
eligible spouse (this procedures is called ``deeming''). If a 
couple has been separated or living apart for over 6 months, 
each person is treated as an individual. If an unmarried child 
living at home is under age 18, some of the parent's income is 
deemed to that child. If an alien/immigrant is sponsored into 
the United States, some of the sponsor's income is deemed to 
that immigrant.
    Income includes cash, checks, and items received ``in-
kind'' such as food and shelter. Wages, net earnings from self-
employment, and income from sheltered workshops are considered 
earned income. Social Security benefits, workers' or veterans' 
compensation annuities, rent, and interest are counted as 
unearned income.
    An individual does not have to be totally without income to 
be eligible for SSI benefits. Maximum SSI benefits are paid 
(assuming the other conditions of eligibility are met) if the 
individual or couple has no ``countable'' income in that 
particular month. If the individual or couple has ``countable'' 
income, a dollar-for-dollar reduction is made against the 
maximum payment. Not all income is counted for SSI purposes. 
Major exclusions include the first $20 of monthly income from 
virtually any source (such as Social Security benefits, but not 
needs-tested income such as veterans' pensions) and the first 
$65 of monthly earned income plus one-half of remaining 
earnings.
    Income received in sheltered workshops and work activity 
centers is considered earned income and qualifies for earned 
income exclusions. Table 4-2 shows the maximum income that an 
individual and couple can have, taking into account these 
income exclusions, and still remain eligible for Federal SSI 
benefits.

                    TABLE 4-2.--MAXIMUM INCOME FOR ELIGIBILITY FOR FEDERAL SSI BENEFITS, 1996                   
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                                                                   Receiving only Social    Receiving only wage 
                                                                         Security                 income        
                                                                 -----------------------------------------------
                                                                    Monthly    Annually     Monthly    Annually 
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Individual......................................................        $490      $5,800      $1,025     $12,300
Couple..........................................................         725       8,700       1,495      17,940
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Source: Office of Supplemental Security Income, Social Security Administration.                                 

    Work-related expenses are disregarded (i.e., subtracted 
from income) in the case of blind applicants or recipients and 
impairment-related work expenses are disregarded in the case of 
disabled applicants or recipients.
    The SSI Program also does not count income and resources 
that are set aside as part of an approved plan for achieving 
self-support (PASS). A PASS is an income and resource exclusion 
that allows an SSI recipient who is blind or disabled to set 
aside income and resources for a work goal. The money set aside 
can be used to pay for such items or services as education, 
vocational training, or starting a business.
    The value of any in-kind assistance is counted as income 
unless such in-kind assistance is specifically excluded by 
statute. Generally, in-kind assistance provided by or under the 
auspices of a federally assisted program, or by a State or 
local government (for example, nutrition, food stamps, housing 
or social services), will not be counted as income. As 
described later, if an SSI applicant or recipient is living in 
the household of another and receiving in-kind support and 
maintenance from her, the SSI benefit standard for such an 
individual is reduced by one-third. By regulation, SSA has also 
ruled that the value of any in-kind support and maintenance 
received (other than in the case of those receiving in-kind 
assistance by reason of living in another's household), is 
presumed to equal one-third of the Federal SSI benefit standard 
plus $20. The individual can rebut this presumption. If it is 
determined that the actual value is less than the one-third 
amount, the lower actual value will be counted as unearned 
income.
    In-kind support and maintenance provided by a private 
nonprofit organization to aged, blind, or disabled individuals 
is excluded under the SSI Program if the State determines that 
the assistance is provided on the basis of need. Certain types 
of assistance provided to help meet home energy needs are also 
excluded from income. Assistance provided to an aged, blind, or 
disabled individual for the purpose of meeting home energy 
costs either in cash or in kind and which is furnished by a 
home heating oil or gas supplier or by a utility company is to 
be excluded. Assistance for home energy costs provided in-kind 
by a private nonprofit organization is also excluded.
    As countable income increases, a recipient's SSI benefit 
amount decreases. Ineligibility for SSI occurs when countable 
income equals the Federal benefit standard plus the amount of 
State supplementation, if any.
Resources
    SSI eligibility is restricted to qualified persons who have 
resources/assets of not more than $2,000, or $3,000 in the case 
of a couple. The resource limit for a couple applies even if 
only one member of a couple is eligible. If the couple has been 
separated or living independently for over 6 months, each 
person is treated as an individual. If an unmarried child 
living at home is under age 18, the parent's assets are 
considered to be the child's (i.e., deemed to the child).
    In determining countable resources, a number of items are 
not included, such as the individual's home; and, within 
reasonable limits set by SSA: household goods, personal 
effects, an automobile, and a burial space for the individual, 
spouse, and members of the immediate family. Regulations place 
a limit of $2,000 in equity value on excluded household goods 
and personal effects and exclude the first $4,500 in current 
market value of an auto (100 percent of the auto's value is 
excluded if it is used to obtain medical treatment or for 
employment or has been modified for use by or transportation of 
a handicapped person or is necessary to perform essential daily 
activities because of distance, climate or terrain). The value 
of property which is used in a person's trade, or business, or 
by the person as an employee is also excluded. The value of 
certain other property that produces income, goods or services 
essential to a person's self-support may be excluded within 
limits set by SSA in regulations. SSI and Social Security 
retroactive benefit payments may not be considered as a 
resource for a period of 6 months after the month in which the 
retroactive benefit is received. Resources set aside under a 
PASS (plan for achieving self support) are also excluded.
    The cash surrender value of life insurance policies if the 
total face value of all policies on an individual's life is 
$1,500 or less are not counted toward the $2,000 or $3,000 
countable resources limit. The entire cash surrender value of 
life insurance policies if the total face value of all policies 
on an individual's life is greater than $1,500 counts toward 
the resources limit, but may be excludable under one of the 
other resource provisions.
    An individual and spouse may have excluded up to $1,500 
each of burial funds. However, the $1,500 maximum amount is 
reduced by the face value of any excluded life insurance 
policies and the value of any irrevocable burial contracts, 
trusts or arrangements. If left to accumulate, interest earned 
on excluded burial funds and burial spaces is not countable as 
either income or resources for SSI purposes.
    Current law provides that as of July 1, 1988, an individual 
who gives away or sells any nonexcludable resource for less 
than fair market value will no longer be subject to a penalty 
for such a transfer. However, such a transfer may make the 
individual ineligible for certain Medicaid covered nursing 
services. SSA must notify individuals of the penalty and 
provide information upon request to the States regarding 
transfers of resources.
    The Deficit Reduction Act of 1984 (Public Law 98-369) 
requires the Internal Revenue Service (IRS) to furnish SSA with 
certain nonwage information about SSI recipients. The IRS 
information consists primarily of reports of interest payments 
submitted to IRS by financial institutions but also includes 
income from dividends, unemployment compensation, etc. The 
purpose of the provision was to assist in alerting SSA of the 
potential ownership by SSI recipients of bank accounts in 
excess of the countable resources limit. In fiscal year 1987, 
computer matches between IRS tax files and SSI records resulted 
in 239,000 such matches. Only cases involving IRS reports of 
interest income of $51 or more were examined. The resulting 
savings to the SSI Program were $64 million. As a result of 
SSA's evaluation of these cases, the tolerance level was 
lowered to $41 beginning with fiscal year 1988 and 398,000 
matches were identified. In fiscal year 1989, the matches 
totaled 508,000. SSA has evaluated and adjusted the tolerance 
levels several times over the years. Effective October 1993, 
the tolerance level for income from resources--e.g., interest 
and dividends--is $60. The tolerance level for other nonwage 
income not from resources--e.g., unemployment compensation and 
pensions--is $1,000. Also, a special tolerance was developed 
for cases that had been matched before; if the current year's 
resources are less than $10 more than the prior year's resource 
indicators, the IRS report is not examined. All match 
information is sent to Social Security offices for verification 
of the information. For fiscal years 1994 and 1995 there were 
297,000 and 181,000 matches, respectively.
    Based on a study of the 1993 matches, SSA decided to apply 
a statistical profiling technique to the IRS matches. 
Statistical profiling increases the cost-effectiveness of the 
IRS process by targeting the more error-prone matches and 
eliminating the less productive matches. The resulting savings 
to the SSI Program were $45 million.
    Prior to the 1984 Deficit Reduction Act, if in any month a 
recipient's assets exceeded the asset limit, the individual was 
ineligible for benefits in that month and the entire amount of 
the benefit paid for that month was considered an overpayment 
subject to recovery. Effective October 1, 1984, SSI law 
provides that in cases where there is an overpayment based 
solely on an excess of assets of $50 or less, the recipient is 
deemed to be without fault for purposes of waiving the 
overpayment and the overpayment is not recovered unless the 
Secretary finds that the failure to accurately and timely 
report the excess was knowing and willful on the part of the 
recipient.
    An individual may receive SSI benefits for a limited time 
even though he has certain nonliquid property that, if counted, 
would make him ineligible. These benefits are conditioned upon 
the disposal of the property, and are subject to recovery as 
overpayments when the property is sold. The 1987 Budget 
Reconciliation Act provides, in addition, for the exclusion of 
real property (if it cannot be sold) because it is jointly 
owned and sale would cause undue hardship to the joint owner 
due to loss of housing, because it has legal impediments to its 
sale, or because reasonable efforts to sell it have been 
unsuccessful.

Deeming of Income and Resources

    The income of an ineligible spouse who lives with an adult 
SSI applicant or recipient is considered in determining the 
eligibility and amount of payment to the individual. The income 
of the parents of a child under the age of 18 who is blind or 
disabled is also considered in determining the eligibility and 
payment for the child. However, since 1990, children with 
disabilities who are eligible for Medicaid at home under State 
home care plans, who previously received SSI personal needs 
allowances while in medical institutions, and who otherwise 
would be ineligible for SSI because of their parents' income or 
resources, have been eligible for the $30 monthly personal 
needs allowance that would be payable if they were 
institutionalized, without regard to their parents' income and 
resources. Effective October 1, 1993, an ineligible parent or 
spouse who is absent from a household due solely to a duty 
assignment as a member of the Armed Forces is considered, 
absent evidence to the contrary, to be living in the same 
household as the SSI applicant or recipient for deeming 
purposes.
    By regulation, the Commissioner of Social Security has 
provided that in determining the amount of the income of an 
ineligible spouse or parent to be deemed to the SSI applicant 
or recipient, the needs of the spouse or parent and other 
children in the household are taken into account. In addition, 
the SSI earned and unearned income exclusions are applied in 
determining the amount of income to be deemed to the SSI 
applicant or recipient. If the combined countable income of an 
SSI applicant and an ineligible spouse does not exceed the SSI 
benefit standard for an eligible couple in that State 
(including any federally administered State supplementary 
payment), the SSI applicant would be eligible to receive an SSI 
and/or State supplementary benefit.
    For example, in 1996 in a State with no supplementation, 
here is how the deeming procedure would work in the case of an 
ineligible spouse earning $550 per month living with an 
eligible individual with $200 of Social Security benefits:


Unearned income of eligible individual.....................      $200.00
Less $20 exclusion.........................................       -20.00
                                                            ------------
      Countable unearned income............................       180.00
                                                            ============
Earned income of ineligible individual.....................       550.00
Less $65 earned income disregard...........................       -65.00
Less one-half of remaining earnings ($485).................      -242.50
                                                            ------------
      Countable earned income..............................       242.50
Plus countable unearned income.............................       180.00
                                                            ------------
      Couple's total countable income......................       422.50
                                                            ============
SSI payment standard for couples...........................       705.00
Less countable income......................................      -422.50
                                                            ------------
      Benefit payable to eligible individual...............       282.50
                                                                        

    Thus, the benefit for the eligible individual will be 
$282.50. Without deeming and as an individual, the recipient 
would have received $290 [$470-($200 less $20 exclusion)]. The 
$20 exclusion can only be used once and is first applied to 
unearned income, which in this example is the $200 of Social 
Security income.
    An individual's resources are deemed to include those of 
the ineligible spouse (or in the case of a child under the age 
of 18, those of the parents) with whom the individual is 
living. Under SSI regulations, in determining the amount of the 
spouse's or parents' resources that can be deemed, all 
applicable exclusions are applied. In the case of a child, only 
the value of the parents' resources that exceeds the applicable 
limits ($2,000 for a single parent, and $3,000 for two parents) 
is deemed to the child. Also, under regulations, pension funds 
of an ineligible spouse or parent are excluded from deeming.
    In December 1995, there were about 109,000 children's cases 
in which deeming reduced benefits. This figure does not take 
into account, however, the number of children who were not 
eligible because of the deeming provision.
    In determining the eligibility of aliens applying for SSI, 
the income and resources of their sponsors are considered. 
After income and resources allowances for the needs of the 
sponsors and income allowances for their dependents, the 
remainder is deemed available for the support of the alien 
applicant. Prior to January 1, 1994, the remainder was deemed 
available for a 3-year period after the alien's entry into the 
United States. Effective January 1, 1994, through September 30, 
1996, the remainder is deemed available for a 5-year period 
after the alien's entry into the United States. Under current 
law, the deeming period will revert to 3 years again on October 
1, 1996. This provision does not apply to those who become 
blind or disabled after admission as a permanent resident, to 
refugees, and to persons granted political asylum.

       Presumptive SSI Eligibility for Persons with AIDS and HIV

    SSI law permits benefits to be paid to a person applying 
for SSI benefits on the basis of disability or blindness before 
a formal determination of disability or blindness has been made 
when available information indicates a high probability that 
the person is disabled or blind and the person is otherwise 
eligible.
    Section 1631(a)(4)(B) of the Social Security Act provides 
that the Commissioner of Social Security may pay up to 6 months 
of SSI benefits to a person applying for SSI based on 
disability or blindness prior to the determination of the 
individual's disability or blindness if the individual is 
presumptively disabled or blind and otherwise eligible. A 
finding of presumptive disability or blindness may be made at 
the Social Security field offices only for specified impairment 
categories (because the field office employees generally are 
not trained disability adjudicators); however, at the State 
agencies (where there are disability adjudicators) they may be 
made for any impairment category.
    On February 11, 1985, Acquired Immunodeficiency Syndrome 
(AIDS), as defined by the Centers for Disease Control, was 
added (pursuant to interim Federal regulations) to the 
impairment categories, thus allowing field offices to find 
presumptive disability for persons claiming they had AIDS. 
These regulations were scheduled to expire February 11, 1988, 
but were extended until December 31, 1989; and in 1989 they 
were extended until December 31, 1991. In December 1991, a new 
more liberal regulation was implemented. Under the new 
procedures, the Social Security field offices may make a 
finding of presumptive disability for any individual with the 
Human Immunodeficiency Virus (HIV) whose disease manifestations 
are of listing-level severity, not only to those who have been 
diagnosed with AIDS.
    The Social Security Administration standards governing 
presumptive SSI eligibility for persons with HIV disease have 
been challenged in court in at least one State on the grounds 
that they discriminate against women. The contention is that 
the listing of impairments reflects the course of HIV disease 
in men, while women tend to have different symptoms and are 
therefore excluded. Others have argued that the Center for 
Disease Control definition and the somewhat broader SSA listing 
have failed to keep pace with changing manifestations of HIV 
disease.

                     Public Institution Requirement

    In general, public institutions are prisons, hospitals, 
nursing homes, or any institution that is operated or 
administered by a governmental unit. This governmental unit 
could be the Federal, State, city, or county government, or 
another political subdivision of the State. Residents of public 
institutions for a full calendar month are ineligible for SSI 
unless one of the following exceptions applies:
 1. The public institution is a medical treatment facility and 
        Medicaid pays more than 50 percent of the cost of care.
 2. The individual is residing in a publicly operated community 
        residence which serves no more than 16 residents. Such 
        a facility must provide an alternative living 
        arrangement to a large institution and be residential 
        (i.e., not a correctional, educational or medical 
        facility).
 3. The public institution is a public emergency shelter for 
        the homeless. Such a facility provides food, a place to 
        sleep, and some services to homeless individuals on a 
        temporary basis. Payments to a resident of a public 
        emergency shelter for the homeless are limited to no 
        more than 6 months in any 9-month period.
 4. The individual is in a public institution primarily to 
        receive educational or vocational training. To qualify, 
        the training must be an approved program and must be 
        designed to prepare an individual for gainful 
        employment.
 5. The individual was eligible for SSI under one of the 
        special provisions of section 1619 of the Social 
        Security Act (see section on ``Special SSI Provisions 
        for the Working Disabled, Overview of Section 1619 
        Provisions'') in the month preceding the first full 
        month of residency in a medical or psychiatric 
        institution which agrees to permit the individual to 
        retain benefit payments. Payment may be made for the 
        first full month of institutionalization and the 
        subsequent month.
 6. A physician certifies that the recipient's stay in a 
        medical facility is likely not to exceed 3 months and 
        the recipient needs to continue to maintain and provide 
        for the expenses of the home to which he may return. 
        Payments may be made for up to the first 3 full months 
        of institutionalization.
    To help institutionalized individuals return to community 
living, the SSI Program includes a prerelease procedure for 
institutionalized individuals. Some individuals are medically 
ready to be released from an institution but are financially 
unable to support themselves. The prerelease procedure allows 
such individuals to apply for SSI payments and food stamps 
several months in advance of their anticipated release so 
benefits can commence quickly after release. A formal 
prerelease agreement can be developed between an institution 
and the local Social Security office. However, an individual 
can file an application for SSI under prerelease without the 
existence of such an agreement.

               APPLICATION TO OTHER PROGRAMS REQUIREMENT

    Since SSI payments are reduced by other income, applicants 
and recipients must apply for any other money benefits due 
them. SSA works with recipients and helps them get any other 
benefits for which they are eligible.

                    Eligibility for Social Security

    As noted, SSI law requires that SSI applicants file for all 
other benefits for which they may be entitled. Since its 
inception SSI has been viewed as the ``program of last 
resort.'' That is, after evaluating all other income, SSI pays 
what is necessary to bring an individual to the statutorily 
prescribed income ``floor.'' As of December 1995, 38 percent of 
all SSI recipients also received Social Security benefits (63 
percent of the aged, 31 percent of the disabled, and 36 percent 
of the blind). Social Security benefits are the single highest 
source of income for SSI recipients. The SSI Program considers 
Social Security benefits unearned income and thus counts all 
but $20 monthly in determining the SSI benefit amount.

     Eligibility for Aid to Families with Dependent Children (AFDC)

    An individual cannot receive both SSI payments and AFDC 
benefits and, if eligible for both, must choose which benefit 
to receive. Generally, the AFDC agency encourages individuals 
to file for SSI and, once the SSI payments start, the 
individual is removed from the AFDC filing unit.

                        Eligibility for Medicaid

    States have three options as to how they treat SSI 
recipients in relation to Medicaid eligibility. Section 1634 of 
SSI law allows SSA to enter into agreements with States to 
cover all SSI recipients with Medicaid eligibility. SSI 
recipients are not required to make a separate application for 
Medicaid under this arrangement. As of January 1, 1996, 32 
States and the District of Columbia chose this option, and SSI 
recipients in these States account for approximately 78 percent 
of all SSI recipients nationwide.
    Under the second option, States elect to provide Medicaid 
eligibility for all SSI recipients, but only if the recipient 
completes a separate application with the State agency which 
administers the Medicaid Program. The seven States of Alaska, 
Idaho, Kansas, Nebraska, Nevada, Oregon, and Utah and the 
Commonwealth of the Northern Mariana Islands affecting about 
2.6 percent of SSI recipients nationwide, have elected this 
option.
    The third and most restrictive option is known as the 
``209(b)'' option, under which States may impose Medicaid 
eligibility criteria which are more restrictive than SSI 
criteria, so long as the criteria chosen are not more 
restrictive than the State's approved Medicaid State plan in 
January 1972. The 209(b) States may be more restrictive in 
defining blindness or disability, and/or more restrictive in 
their financial requirements for eligibility, and/or require a 
Medicaid application with the State. However, aged, blind, and 
disabled SSI recipients who are Medicaid applicants must be 
allowed to spend-down in 209(b) States, regardless of whether 
or not the State has a medically needy program. As of January 
1, 1996, 11 States use the 209(b) option for Medicaid coverage 
of aged, blind, and disabled SSI recipients. About 19.3 percent 
of the SSI recipient population nationwide lives in these 
209(b) States. The 11 States that use this option are:

Connecticut
Hawaii
Illinois
Indiana
Minnesota
Missouri
New Hampshire
North Dakota
Ohio
Oklahoma
Virginia

    An amendment included in the 1986 SSI disability amendments 
(Public Law 99-643) required, effective July 1, 1987, that 
209(b) States continue Medicaid coverage for individuals in 
section 1619 status if they had been eligible for Medicaid for 
the month preceding their becoming eligible under section 1619 
(see special section on ``Special SSI Provisions for the 
Working Disabled, Overview of Section 1619 Provisions'').
    The same legislation required States to provide for 
continued Medicaid coverage for those individuals who lose 
their eligibility for SSI on or after July 1, 1987 when their 
income increases because they become newly eligible for Social 
Security benefits as an adult who became disabled as a child 
(disabled adult child) or because of an increase in their 
benefits as an adult who became disabled as a child. ``Disabled 
adult children'' who otherwise would be eligible for SSI 
continue to be considered SSI recipients for Medicaid purposes. 
Protection against loss of Medicaid also is provided for 
certain blind or disabled individuals who lose their SSI 
benefits when they qualify for Social Security disabled widow 
or widower's benefits beginning as early as age 50. The Omnibus 
Budget Reconciliation Act of 1990 provides that such 
individuals, who otherwise would continue to qualify for SSI on 
the basis of blindness or disability, will be deemed to be SSI 
recipients for purposes of Medicaid eligibility until they 
become eligible for Medicare Hospital Insurance. This provision 
has been effective since January 1, 1991.

                      Eligibility for Food Stamps

    Except in California, which has converted food stamp 
benefits to cash that is included in the State supplementary 
payments, SSI recipients may be eligible to receive food 
stamps. SSI beneficiaries living alone or in a household where 
all other members of the household receive or are applying for 
SSI benefits can file for food stamps at an SSA office. If all 
household members receive SSI, they do not need to meet the 
Food Stamp Program financial eligibility standards to 
participate in the program because they are categorically 
eligible. However, SSI beneficiaries living in households where 
other household members do not receive or are not applying for 
SSI benefits are referred to the local food stamp office to 
file for food stamps. These households must meet the net income 
eligibility standard of the Food Stamp Program to be eligible 
for food stamp benefits.
    The interaction with the Food Stamp Program has important 
financial implications for a State which desires to increase 
the income of its SSI recipients by $1. Because food stamps are 
reduced by $0.30 for each additional $1 of SSI income including 
State supplements, the State must expend $1.43 to obtain an 
effective $1 increase in SSI recipients' total income.

  VOCATIONAL REHABILITATION AND TREATMENT AND MONITORING REQUIREMENTS

    Section 1615(d) of the Social Security Act requires SSA to 
reimburse State vocational rehabilitation agencies for 
reasonable and necessary costs of services which resulted in 
disabled SSI recipients being successfully rehabilitated. The 
objective of vocational rehabilitation for SSI recipients is to 
help disabled individuals achieve and sustain productive, self-
supporting work activity. SSA provides funds to reimburse 
vocational rehabilitation agencies for costs incurred in 
successfully rehabilitating SSI recipients. A successful 
rehabilitation is defined by law as one in which vocational 
rehabilitation services result in performance of substantial 
gainful activity for a continuous period of 9 months.
    Public Law 104-121, enacted in 1996, includes provisions 
which prohibit SSI and disability insurance eligibility for 
individuals whose drug addiction or alcoholism is a 
contributing factor material to the finding of disability. This 
law stipulates that recipients who are disabled due to another 
impairment, and who are determined by the Commissioner of 
Social Security to also have drug or alcohol problems are to be 
paid benefits via a representative payee and are to be referred 
for treatment. Previously, persons who were disabled because of 
drug addiction or alcoholism were required to accept 
appropriate treatment for their conditions as a condition of 
SSI eligibility.

                              SSI BENEFITS

                      Federal SSI Benefit Standard

    The Federal SSI benefit standard for an individual for 1996 
is $470 a month and $705 for a couple. As is discussed later, 
most States supplement the Federal SSI benefit. The result is a 
combined Federal SSI/State supplemented benefit against which 
countable income is compared in determining eligibility and 
benefit amount. However, many States limit their 
supplementation to certain categories of individuals based on 
specific indicators of need--especially special housing needs. 
In September 1995, 321,887 persons, or 5.0 percent of all SSI 
recipients, were eligible for benefits only because (federally 
administered) State supplementation increased the benefit.
    The Federal SSI benefits are indexed to the Consumer Price 
Index (CPI) and by the same percentage as Social Security 
benefits. This occurs through a reference in the SSI law to the 
Social Security cost-of-living adjustment (COLA) provision. 
Prior to the Social Security amendments of 1983 (Public Law 98-
21), the SSI and Social Security cost-of-living increases 
occurred in benefits paid in July. Public law 98-21 delayed the 
Social Security and SSI COLA's from July 1983 to January 1984. 
However, in lieu of a COLA increase in the SSI benefit standard 
in July 1983, the Federal SSI benefit was increased in July, 
1983, by $20 a month for an individual and $30 a month for a 
couple. Table 4-3 shows the Federal SSI benefit from the 
beginning of the SSI Program until the present time.

        Benefits for Persons Living in the Household of Another

    The SSI law provides that if an SSI applicant or recipient 
is ``living in another person's household and receiving support 
and maintenance in-kind from such person,'' the Federal SSI 
benefit applicable to such individual or couple is two-thirds 
of the regular Federal SSI benefit. As shown in table 4-3, the 
Federal SSI benefit in 1996 for those determined to be living 
in the household of another is $313.34 for an individual and 
$470 for a couple.
    Regulations specify the criteria for determining when this 
reduced benefit applies. It does not apply to an individual who 
owns or rents; buys food separately; eats meals out rather than 
eating with the household; or pays a pro rata share of the 
household's food and shelter expenses.
    In September 1995, 4.6 percent, or about 298,800 SSI 
recipients, had their benefits determined on the basis of this 
``one-third reduction'' benefit standard. Sixty-three percent 
of those recipients were receiving benefits on the basis of 
disability (see table 4-4).

                                 TABLE 4-3.--FEDERAL SSI BENEFIT LEVELS, 1974-96                                
                                                  [In dollars]                                                  
----------------------------------------------------------------------------------------------------------------
                                                                     Eligibility status                         
                                          ----------------------------------------------------------------------
                                                               Own household             Household of another   
                   Year                      Medicaid  ---------------------------------------------------------
                                           institution                    Essential                    Essential
                                                         Single   Couple    person    Single   Couple    person 
----------------------------------------------------------------------------------------------------------------
Initial..................................       25.00    130.00   195.00     65.00     86.67   130.00     43.34 
Jan. 1974................................       25.00    140.00   210.00     70.00     93.34   140.00     46.67 
July 1974................................       25.00    146.00   219.00     73.00     97.34   146.00     48.67 
July 1975................................       25.00    157.70   236.60     78.90    105.14   157.74     52.60 
July 1976................................       25.00    167.80   251.80     84.00    111.87   167.87     56.00 
July 1977................................       25.00    177.80   266.70     89.00    118.54   177.80     59.34 
July 1978................................       25.00    189.40   284.10     94.80    126.27   189.40     63.20 
July 1979................................       25.00    208.20   312.30    104.20    138.80   208.20     69.47 
July 1980................................       25.00    238.00   357.00    119.20    158.67   238.00     79.47 
July 1981................................       25.00    264.70   397.00    132.60    176.47   264.67     88.40 
July 1982................................       25.00    284.30   426.40    142.50    189.54   284.27     95.00 
July 1983................................       25.00    304.30   456.40    152.50    202.87   304.27    101.67 
Jan. 1984 \1\............................       25.00    314.00   472.00    157.00    209.34   314.67    104.67 
Jan. 1985................................       25.00    325.00   488.00    163.00    216.67   325.34    108.67 
Jan. 1986................................       25.00    336.00   504.00    168.00    224.00   336.00    112.00 
Jan. 1987................................       25.00    340.00   510.00    170.00    226.67   340.00    113.34 
Jan. 1988................................       25.00    354.00   532.00    177.00    236.00   354.67    118.00 
Jan. 1989................................       30.00    368.00   553.00    184.00    245.34   368.67    122.67 
Jan. 1990................................       30.00    386.00   579.00    193.00    257.34   386.00    128.67 
Jan. 1991................................       30.00    407.00   610.00    204.00    271.34   406.67    136.00 
Jan. 1992................................       30.00    422.00   633.00    211.00    281.34   422.00    140.67 
Jan. 1993................................       30.00    434.00   652.00    217.00    289.34   434.67    144.67 
Jan. 1994................................       30.00    446.00   669.00    223.00    297.34   446.00    148.67 
Jan. 1995................................       30.00    458.00   687.00    229.00    305.34   458.00    152.66 
Jan. 1996................................       30.00    470.00   705.00    235.00    313.34   470.00    152.57 
----------------------------------------------------------------------------------------------------------------
\1\ Cost-of-living adjustments to Federal SSI benefit levels are rounded to the next lower whole dollar         
  beginning with the increase effective January 1984.                                                           
                                                                                                                
Source: Office of Research and Statistics, Social Security Administration.                                      

    Of the 25 States and the District of Columbia that provide 
optional supplements to the Federal SSI benefit, 9 States and 
the District of Columbia provide the same amount of 
supplementation for those whose Federal SSI benefit amount is 
determined on the basis of the ``one-third reduction.'' Eight 
States provide a higher State supplementation for such 
recipients; in six States the amount of State supplementation 
is less; two States provide no supplementation for those 
recipients; and one State's supplementation varies depending 
upon need.

         Benefits for Persons Living in a Medicaid Institution

    When individuals enter a hospital or other medical 
institution in which more than half of the bill is paid by the 
Medicaid Program, their monthly SSI benefit standard is reduced 
to $30, beginning with the first full calendar month of 
residence. This Personal Needs Allowance (PNA) is intended to 
take care of small personal expenses, with the cost of 
maintenance and medical care being provided through Medicaid. 
The Federal PNA benefit of $25 was increased to $30 a month on 
July 1, 1988--the first increase since the SSI Program began in 
1974. The annual cost-of-living increase for SSI does not apply 
to the personal needs allowance. The 1987 Budget Reconciliation 
Act does, however, provide that if a physician certifies that 
the recipient's stay in such a medical institution is not 
likely to exceed 3 months and they need to continue to maintain 
a home to which they may return, SSI benefits will not be 
reduced and recipients will continue to receive full SSI 
benefits for up to the first 3 months of institutionalization.

   TABLE 4-4.--NUMBER AND PERCENTAGE DISTRIBUTION OF PERSONS RECEIVING  
  FEDERALLY ADMINISTERED PAYMENTS, BY LIVING ARRANGEMENT AND CATEGORY,  
                             SEPTEMBER 1995                             
------------------------------------------------------------------------
                                               Reason for eligibility   
    Living arrangement \1\        Total   ------------------------------
                                              Aged     Blind    Disabled
------------------------------------------------------------------------
Own household.................       93.0       90.2     92.2       93.8
Another's household...........        4.6        7.4      4.9        3.8
Institutional care covered by                                           
 Medicaid.....................        2.4        2.4      2.9        2.4
                               -----------------------------------------
Total percent.................      100.0      100.0    100.0      100.0
                               =========================================
    Total number..............  6,495,422  1,454,554   84,553  4,956,315
------------------------------------------------------------------------
\1\ As used for determination of Federal SSI payment standard.          
                                                                        
Source: Office of Research and Statistics, Social Security              
  Administration.                                                       

    Approximately 155,890 or 2.4 percent of SSI recipients 
received benefits in September, 1995, on the basis of this 
personal needs allowance. For those individuals whose income 
from non-SSI sources exceeds the $30 benefit standard 
(including those who were receiving both Social Security and 
SSI before entering an institution), Medicaid regulations 
require States to allow them (and other non-SSI Medicaid 
eligibles) to retain no less than $30 a month of their income 
as a ``personal needs allowance'' when their income is applied, 
along with Medicaid reimbursement, to pay for their 
institutional medical care.
    Sixteen State programs have exercised their option to 
supplement the PNA. Prior to the 1985 Budget Reconciliation 
Act, SSI regulations would not allow for Federal administration 
of State PNA supplements. An amendment included in that 
legislation now requires SSA, at the request of a State, to 
administer such State supplementary payments. As of December 
1995, California, the District of Columbia, Maine, 
Massachusetts, Michigan, New Jersey, New York, Rhode Island, 
Vermont, and Washington had opted for Federal administration. 
Approximately 28 States allow some or all of those individuals 
affected by the Medicaid personal needs allowance regulations 
to retain more than $30 a month.

           Benefits of Former Recipients of State Assistance

    Another benefit affecting some persons involves Federal 
payments to an individual who was transferred to SSI from a 
former State program of aid to the aged, blind or disabled. The 
Federal benefits of these persons are increased by up to $235 
monthly in 1996 to take into account an ``essential person'' 
living in the household.
    Essential persons are persons (generally an ineligible 
spouse or relative) who live with the eligible individual and 
who are considered necessary to provide essential care and 
services for the eligible individual and whose needs were taken 
into account in December 1973 in determining the need of the 
individual. Essential persons do not themselves receive SSI 
payments; rather, the standard of payment to which an eligible 
individual or couple is entitled is increased, and any income 
and resources of the essential persons are combined with those 
of the eligible individual or couple in calculating the amount 
to which the individual or couple is eligible.
    Eligibility for such increased payments apply only to a 
person included as an essential person in December 1973 and 
ends when the person no longer lives with the eligible 
individual, becomes eligible for SSI in his own right, or 
becomes the eligible spouse of an eligible individual.
    Some States have categories of State supplementation 
similar to the ``essential persons'' category for individuals 
transferred from the pre-SSI Program.

                              Overpayments

    A provision in the 1984 Deficit Reduction Act established a 
limit on the rate that overpayments made to SSI recipients can 
be recovered. The amount of recovery in any month is now 
limited to the lesser of: (1) the amount of the benefit for 
that month; or (2) an amount equal to 10 percent of the 
countable income (plus the SSI payment) of the individual (or 
couple) for that month. This limitation does not apply if there 
is fraud, willful misrepresentation, or concealment of 
information in connection with the overpayment. The recipient 
may request a higher or lower rate at which benefits may be 
withheld to recover the overpayment.

                      Faster Initial SSI Payments

    Making initial payments faster for those who are 
presumptively or proven eligible is a goal of the SSI Program. 
The provisions for a one-time emergency advance payment 
continues to permit a faster response to presumptive or proven 
eligibility in new claims with critical needs. In fiscal year 
1995, Social Security offices made 6,212 emergency advance 
payments in these new claims situations totaling $2,745,349 
with an average payment amount of $441.
    Beginning in October 1985, local Social Security offices 
were given the authority to make ``immediate payments'' for 
certain Social Security and SSI cases when it is found that 
benefits are due but unpaid and an expedited Treasury payment 
would be too slow. ``Immediate'' usually means while the 
beneficiary waits or the next day at the latest. Payments are 
made using bank drafts prepared by the local field office. 
Payments are limited to the maximum per beneficiary of $400 or 
the amount due, whichever is less, once in a 30-day period. The 
person's eligibility for benefits must be verified by the local 
office and payment approved by the office manager. During 
fiscal year 1995, 55,671 Social Security and 42,123 SSI 
immediate payments were issued under this procedure. The total 
amount of these payments equalled $34,114,510 for an average of 
$348 per payment.

                         State Supplementation

Mandatory State supplementation

    State supplementary payments are required by law to 
maintain income levels of former public assistance recipients 
transferred to the Federal SSI Program. The purpose of these 
mandatory State supplements is to assure that no person suffers 
a reduction in income as a result of the change from former 
State adult assistance programs to the SSI Program. Under 
mandatory supplementation rules, States are to maintain 
recipients of the programs of old age assistance, aid to the 
blind, and aid to the permanently and totally disabled at their 
December 1973 income level. That level is the amount an 
individual received in December 1973 under the terms and 
conditions of the State plan in effect for the month of June 
1973, plus his or her other income. Thus, States must provide a 
supplementary payment to any individual who, because of special 
needs or other reasons, had a December 1973 payment higher than 
the amount she received under the basic Federal SSI Program.
    To remain eligible for Medicaid Federal matching funds, 
States were required to adopt a mandatory State supplementation 
program. In December 1995, approximately 3,200 recipients or 
less than 0.1 percent of all recipients were receiving payments 
based in part or solely because of the mandatory 
supplementation rule.

Optional State supplementation

    In addition to any mandatory supplementation States must 
provide, a State (or political subdivision) may choose to 
provide an optional supplement to Federal SSI payments. This 
optional supplement also is intended to help individuals meet 
needs which are not fully met by the Federal payment. The State 
determines whether it will make such a payment, to whom, and in 
what amount. States have the option of covering recipients of 
mandatory supplementation under their program of optional 
supplementation.
    At the present time, all but eight States and jurisdictions 
provide some form of optional State supplementation. States 
that provide no supplement are: Arkansas, Georgia, Kansas, 
Mississippi, Commonwealth of the Northern Mariana Islands, 
Tennessee, Texas, and West Virginia. States (or local 
jurisdictions) may elect to administer their supplementary 
payments themselves or may contract with SSA for Federal 
administration. Sixteen States and the District of Columbia 
have contracted with SSA to administer the State optional 
supplementation program. Since the SSI Program began in 1974, 
seven States have shifted from Federal to State administration 
of their optional State supplementation program.

Variation in payment amount

    In addition to categorical variations which may apply 
(i.e., aged, blind, disabled), a State may elect a number of 
variations in optional supplementary payments to account for 
specific differences in living costs to a recipient. The type 
and amount of the variations selected must be specified in the 
Federal-State agreement. A State may make variations in its 
payments to account for both geographic and living arrangement 
cost differences.
    A significant number of the aged, disabled and blind 
population receiving SSI cannot live alone because of mental or 
physical limitations and have a need for housing which includes 
services beyond room and board. These services often include 
supervision for daily living and protective services for the 
mentally retarded, chronically mentally ill, or the frail or 
confused elderly. Such nonmedical supervised and/or group 
living arrangements generally cost more than the Federal SSI 
benefit needs standard of $458 and $470 a month in 1995 and 
1996, respectively, and often more than the combined Federal 
and SSI State supplementation for those classified as living 
independently.
    All but 10 of the 50 States and the District of Columbia 
have Federal or State administered State supplementation which 
is specifically directed at covering the additional cost of 
providing housing in a protective, supervised, or group living 
arrangement.
    These living arrangements are identified by a variety of 
terms including: adult foster care homes; domiciliary care 
homes; congregate care; group homes for the mentally retarded, 
and a variety of other terms. The amount of supplementation by 
the State also varies a great deal. For example, in the State 
of Maryland under a State-administered supplementation program, 
a ``specialized and intensive supervision'' group living 
facility has a State supplementation of $666 a month in 
addition to the Federal benefit level of $470. The total 
Federal and State SSI payment in a month is $1,136. In one 
State, the State supplementation is less than $2 a month for 
those who need little supervision and care. However, in some 
States, the cost of supervised group living care is also 
partially met by direct State funding of the staff. In a number 
of States, the State makes payments for nonmedical group care 
directly to private residential facilities based on a rate 
negotiated by the State with each facility. In such cases, 
there is often a ``personal needs allowance'' payment made 
directly to or on behalf of the residents of the facility.

Administrative fees

    The Omnibus Budget Reconciliation Act of 1993 amended the 
State supplementation provision to provide for State payment 
for Federal administration of State supplementary payments. For 
fiscal year 1994 (i.e., from October 1, 1993 through September 
30, 1994), a State with federally administered supplementary 
payments pays the Commissioner an administration fee of $1.67 
per payment. The rate per payment changes to $3.33 for fiscal 
year 1995, and $5.00 for fiscal year 1996 and each succeeding 
year, or a different rate deemed appropriate for the State by 
the Commissioner.

State SSI supplement levels over time

    Throughout the entire period from July 1975 to January 
1996, 23 States have continuously provided supplemental SSI 
payments to aged individuals living independently, and 21 
States continuously supplemented SSI payments to aged couples 
living independently.
    During the period from July 1975 to January 1996, no State 
increased supplements faster than inflation for aged 
individuals living independently (see table 4-5).
    Among the States which have supplemented SSI payments for 
aged couples living independently, only Alaska and Minnesota 
have kept their supplemental increases equivalent to or higher 
than inflation (see table 4-6). Other States have allowed 
inflation to erode the purchasing power of supplements or have 
reduced them in the face of State fiscal problems.
    Approximately 45 percent of SSI recipients receive a State 
supplement. For those SSI recipients, other than those 
receiving a State supplement because they are living in some 
type of group living arrangement, the amount of State 
supplement ranges from $2 a month to $362 a month for an 
individual. At present, 25 States and the District of Columbia 
supplement the Federal standard for individuals living 
independently.
    The District of Columbia, South Dakota, Utah, and Wyoming 
all began supplementing SSI payments to individuals between 
1975 and 1980.

              TABLE 4-5.--STATE SSI SUPPLEMENTS FOR AGED INDIVIDUALS WITHOUT COUNTABLE INCOME LIVING INDEPENDENTLY, SELECTED YEARS 1975-96              
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                                               Percent  
                                                                                                                                               change   
                            State                               July   July   Jan.   Jan.   Jan.   Jan.   Jan.   Jan.   Jan.   Jan.   Jan.    (constant 
                                                                1975   1980   1985   1988   1990   1991   1992   1993   1994   1995   1996    dollars)  
                                                                                                                                             1975-96 \1\
--------------------------------------------------------------------------------------------------------------------------------------------------------
Alaska \2\...................................................   $142   $235   $261   $305   $331   $349   $362   $374   $362   $362   $362           -11
California...................................................    101    182    179    221    244    223    223    186    157    157    156           -46
Colorado.....................................................     27     55     58     58     54     45     56     56     56     56     56           -27
Connecticut \3\..............................................     NA    102    141    403    366    359    325    313    301     NA  \3\ N              
                                                                                                                                         A            NA
District of Columbia.........................................      0     15     15     15     15     15     15     15     15      5      5            NA
Hawaii.......................................................     17     15      5      5      5      5      5      5      5      5      5           -90
Idaho........................................................     63     74     78     73     73     70     70     65     45     37     37           -79
Illinois \3\.................................................     NA     NA     NA     NA     NA     NA     NA     NA     NA     NA     NA            NA
Maine........................................................     10     10     10     10     10     10     10     10     10     10     10           -65
Massachusetts................................................    111    137    129    129    129    129    129    129    129    129    126           -60
Michigan.....................................................     12     24     27     30     30     31     14     14     14     14     14           -59
Minnesota \4\................................................     31     34     35     35     75     81     81     81     81     81     81            -8
Nebraska.....................................................     67     75     69     43     38     24     30     28     21     19     12           -94
Nevada.......................................................     55     47     36     36     36     36     36     36     36     36     36           -77
New Hampshire................................................     12     46     27     27     27     27     27     27     27     27     27           -21
New Jersey...................................................     24     23     31     31     31     31     31     31     31     31     31           -55
New York.....................................................     61     63     61     72     86     86     86     86     86     86     86           -51
Oklahoma.....................................................     27     79     60     64     64     64     64     60     57     55     54           -30
Oregon.......................................................     17     12      2      2      2      2      2      2      2      2      2           -96
Pennsylvania.................................................     20     32     32     32     32     32     32     32     32     32     27           -53
Rhode Island.................................................     31     42     54     58     64     64     67     64     64     64     64           -28
South Dakota.................................................      0     15     15     15     15     15     15     15     15     15     15            NA
Utah.........................................................      0     10     10      9      6      6      5      5      1      0      0            NA
Vermont......................................................     29     41     53     59     63     65     65     57     55     59     47           -43
Washington \5\...............................................     36     43     38     28     28     28     28     28     28     28     25           -76
Wisconsin....................................................     70    100    100    103    103    103     93     93     85     84     84           -58
Wyoming......................................................      0     20     20     20     20     20     20     10     10     10     10            NA
                                                              ------------------------------------------------------------------------------------------
  Median.....................................................     31     43     36     36     37     36     32     31     31     32     27           -69
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ The percentage change in constant dollars was computed by inflating July 1975 to January 1996 by the CPI-U price index. The July 1975 index value is
  54.2 and the January 1996 value is 154.4.                                                                                                             
\2\ 1975 and 1980--less if shelter costs less than $35 monthly.                                                                                         
\3\ State decides benefit on a case-by-case basis.                                                                                                      
\4\ State has two geographic payment levels--Hennepin County and the remainder of Minnesota. Level shown is for Hennepin County, the area with the      
  largest number of SSI recipients.                                                                                                                     
\5\ State has two geographic payment levels--highest levels are shown in table. Sum paid in King, Pierce, Kitsap, Snohomish, and Thurston Counties.     
                                                                                                                                                        
NA--Not available.                                                                                                                                      
                                                                                                                                                        
Source: Office of Supplemental Security Income, Social Security Administration, and Committee on Ways and Means staff calculations.                     


                TABLE 4-6.--STATE SSI SUPPLEMENTS FOR AGED COUPLES WITHOUT COUNTABLE INCOME LIVING INDEPENDENTLY, SELECTED YEARS 1975-96                
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                                               Percent  
                                                                                                                                               change   
                            State                               July   July   Jan.   Jan.   Jan.   Jan.   Jan.   Jan.   Jan.   Jan.   Jan.    (constant 
                                                                1975   1980   1985   1988   1990   1991   1992   1993   1994   1995   1996    dollars)  
                                                                                                                                             1975-96 \1\
--------------------------------------------------------------------------------------------------------------------------------------------------------
Alabama......................................................     $9      0      0      0      0      0      0      0      0      0      0          -100
Alaska \2\...................................................    183   $338   $371   $444   $484   $510   $528   $544   $528   $528    528             1
California...................................................    251    389    448    534    588    557    557    488    440    415    396           -45
Colorado.....................................................    133    229    278    292    309    293    323    328    323    323    323           -15
Connecticut \3\..............................................     NA     NA     86    602    525    522    461    442    425     NA  \3\ N              
                                                                                                                                         A            NA
District of Columbia.........................................      0     30     30     30     30     30     30     30     30     15     15            NA
Hawaii.......................................................     28     24      9      9      9      9      9      9      9      9      9           -89
Idaho........................................................     49     80     46     44     45     44     45     40     21      9      9           -94
Illinois \3\.................................................     NA     NA     NA     NA     NA     NA     NA     NA     NA     NA     NA            NA
Maine........................................................     15     15     15     15     15     15     15     15     15     15     15           -65
Massachusetts................................................    173    214    202    202    202    202    202    202    202    202    197           -60
Michigan.....................................................     18     36     40     45     45     46     21     21     21     28     28           -45
Minnesota \4\................................................     38     44     66     66     88    132    129    126    126    126    111             3
Nebraska.....................................................     67    114    100     66     65     34     48     39     40     22     14           -93
Nevada.......................................................    106     90     74     74     74     74     74     74     74     74     74           -76
New Hampshire................................................      0     42     21     21     21     21     21     21     21     21     22            NA
New Jersey...................................................     13     12     25     25     25     25     25     25     25     25     25           -33
New York.....................................................     76     79     76     93    102    103    103    102    102    102    103           -52
Oklahoma.....................................................     54    158    120    128    128    128    128    120    114    110    108           -30
Oregon.......................................................     17     10      0      0      0      0      0      0      0      0      0          -100
Pennsylvania.................................................     30     49     49     49     49     49     49     49     49     49     44           -49
Rhode Island.................................................     59     79    102    111    120    121    127    120    120    120    121           -28
South Dakota.................................................      0     15     15     15     15     15     15     15     15     15     15            NA
Utah.........................................................      0     20     20     18     12     12     11     10      5      5      5            NA
Vermont......................................................     61     76     96    106    115    118    118    110    103    110     92           -47
Washington \5\...............................................     40     44     37     22     22     22     22     22     22     22     20           -82
Wisconsin....................................................    105    161    161    166    166    166    146    146    134    132    132           -56
Wyoming......................................................      0     40     40     40     40     40     40     19     19     25     25            NA
                                                              ------------------------------------------------------------------------------------------
  Median.....................................................     57     63     66     66     65     49     49     30     39     28     25           -85
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ The percentage change in constant dollars was computed by inflating July 1975 to January 1996 by the CPI-U price index. The July 1975 index value is
  54.2 and the January 1996 value is 154.4.                                                                                                             
\2\ 1975 and 1980--less if shelter costs less than $35 monthly.                                                                                         
\3\ State decides benefit on a case-by-case basis.                                                                                                      
\4\ State has various geographic payment levels. Level shown is for Hennepin County, the area with the largest number of SSI recipients.                
\5\ State has two geographic payment levels--highest levels are shown in table. Sum paid in King, Pierce, Kitsap, Snohomish, and Thurston Counties.     
                                                                                                                                                        
NA--Not available.                                                                                                                                      
                                                                                                                                                        
Source: Office of Supplemental Security Income, Social Security Administration.                                                                         

      Maximum SSI and Food Stamp Benefits For Individuals Living 
                             Independently

    Table 4-7 for individuals and table 4-8 for couples 
illustrate the maximum potential payment from Federal SSI, 
State supplements, and food stamps for persons with no income, 
by State. These tables assume that the elderly individual or 
couple receive an excess shelter deduction of $247 (the maximum 
for nonelderly) and an excess medical cost deduction of $14 in 
the Food Stamp Program. Approximately 62 percent of SSI 
households in the Food Stamp Program claim a shelter deduction; 
it is estimated that approximately 17 percent of them are 
allowed a deduction that exceeds the excess shelter expense 
ceiling for nonelderly or nondisabled households ($247 per 
month). About 4 percent of SSI households claim a medical cost 
deduction.

  TABLE 4-7.--MAXIMUM POTENTIAL SSI AND FOOD STAMP BENEFITS FOR AGED INDIVIDUALS LIVING INDEPENDENTLY, JANUARY  
                                                    1996 \1\                                                    
----------------------------------------------------------------------------------------------------------------
                                                                                               Combined benefits
                              State                                 Maximum SSI   Food stamp -------------------
                                                                      benefit    benefit \2\  Monthly    Annual 
----------------------------------------------------------------------------------------------------------------
Alabama..........................................................          $470        $93       $563     $6,756
Alaska...........................................................           832        102        934     11,208
Arizona..........................................................           470         93        563      6,756
Arkansas.........................................................           470         93        563      6,756
California.......................................................           626      \3\ 0        626      7,512
                                                                                                                
Colorado.........................................................           526         76        602      7,224
Connecticut......................................................        \4\ NA         NA         NA         NA
Delaware.........................................................           470         93        563      6,756
District of Columbia.............................................           475         92        567      6,804
Florida..........................................................           470         93        563      6,756
                                                                                                                
Georgia..........................................................           470         93        563      6,756
Hawaii...........................................................           475        198        673      8,076
Idaho............................................................       \5\ 507         88        595      7,140
Illinois.........................................................        \6\ NA         NA         NA         NA
Indiana..........................................................           470         93        563      6,756
                                                                                                                
Iowa.............................................................           470         93        563      6,756
Kansas...........................................................           470         93        563      6,756
Kentucky.........................................................           470         93        563      6,756
Louisiana........................................................           470         93        563      6,756
Maine............................................................           480         90        570      6,840
                                                                                                                
Maryland.........................................................           470         93        563      6,756
Massachusetts....................................................           596         55        651      7,812
Michigan.........................................................           484         89        573      6,876
Minnesota........................................................       \7\ 551         69        620      7,440
Mississippi......................................................           470         93        563      6,756
                                                                                                                
Missouri.........................................................           470         93        563      6,756
Montana..........................................................           470         93        563      6,756
Nebraska.........................................................           482         89        571      6,852
Nevada...........................................................           506         82        588      7,056
                                                                                                                
New Hampshire....................................................           497         85        582      6,984
New Jersey.......................................................           501         84        585      7,020
New Mexico.......................................................           470         93        563      6,756
New York.........................................................           556         67        623      7,476
North Carolina...................................................           470         93        563      6,756
                                                                                                                
North Dakota.....................................................           470         93        563      6,756
Ohio.............................................................           470         93        563      6,756
Oklahoma.........................................................           524         77        601      7,212
Oregon...........................................................           472         92        564      6,768
Pennsylvania.....................................................           497         85        582      6,984
                                                                                                                
Rhode Island.....................................................           534         74        608      7,296
South Carolina...................................................           470         93        563      6,756
South Dakota.....................................................           485         89        574      6,888
Tennessee........................................................           470         93        563      6,756
Texas............................................................           470         93        563      6,756
                                                                                                                
Utah.............................................................           470         93        563      6,756
Vermont..........................................................       \8\ 517         79        596      7,152
Virginia.........................................................           470         93        563      6,756
Washington.......................................................       \9\ 495         86        581      6,972
West Virginia....................................................           470         93        563      6,756
                                                                                                                
Wisconsin........................................................           554         68        622      7,464
Wyoming..........................................................           480         90        570      6,840
----------------------------------------------------------------------------------------------------------------
\1\ In most States these maximums apply also to blind or disabled SSI recipients who are living in their own    
  households; but some States provide different benefit schedules for each category.                            
\2\ For one-person households, maximum food stamp benefits from October 1995 through September 1996 are $119 in 
  the 48 contiguous States and the District of Columbia, $153 in Alaska (urban areas, benefit levels in rural   
  Alaska are increased by about 50 percent to account for higher food prices in such areas), and $198 in Hawaii.
For the 48 contiguous States and the District of Columbia, the calculation of benefits assumes: (1) a           
  ``standard'' deduction of $134 per month; (2) an excess shelter deduction of $247 per month (the maximum      
  allowable for nonelderly, nondisabled households); and (3) an excess medical expense deduction of $4 monthly  
  (estimated from 1993 medical expense information). If smaller excess shelter costs were assumed, food stamp   
  benefits would be smaller. For Alaska and Hawaii, higher deduction levels were used, as provided by law ($662 
  and $546, respectively, for combined standard and excess shelter allowance).                                  
\3\ SSI recipients in California are ineligible for food stamps. California provides increased cash aid in lieu 
  of stamps.                                                                                                    
\4\ Individual budget process.                                                                                  
\5\ State disregards $20 of SSI payment in determining the State supplementary payment.                         
\6\ State decides benefits on case-by-case basis.                                                               
\7\ Payment level for Hennepin County. State has two geographic payment levels--one for Hennepin County and the 
  other for the remainder of the State.                                                                         
\8\ State has two geographic payment levels--highest are shown in table.                                        
\9\ Sum paid in King, Pierce, Kitsap, Snohomish, and Thurston Counties.                                         
                                                                                                                
NA--Not available.                                                                                              
                                                                                                                
Source: Table prepared by the Congressional Research Service (CRS) based on data from the Social Security       
  Administration.                                                                                               


  TABLE 4-8.--MAXIMUM POTENTIAL SSI AND FOOD STAMP BENEFITS FOR AGED COUPLES LIVING INDEPENDENTLY, JANUARY 1996 
                                                       \1\                                                      
----------------------------------------------------------------------------------------------------------------
                                                                                               Combined benefits
                              State                                 Maximum SSI   Food stamp -------------------
                                                                      benefit    benefit \2\  Monthly    Annual 
----------------------------------------------------------------------------------------------------------------
Alabama..........................................................          $705       $122       $827     $9,924
Alaska...........................................................         1,233        108      1,341     16,092
Arizona..........................................................           705        122        827      9,924
Arkansas.........................................................           705        122        827      9,924
California.......................................................         1,101      \3\ 0      1,101     13,212
                                                                                                                
Colorado.........................................................         1,028         25      1,053     12,636
Connecticut......................................................        \4\ NA         NA         NA         NA
Delaware.........................................................           705        122        827      9,924
District of Columbia.............................................           720        117        837     10,044
Florida..........................................................           705        122        827      9,924
                                                                                                                
Georgia..........................................................           705        122        827      9,924
Hawaii...........................................................           714        313      1,027     12,324
Idaho............................................................       \5\ 714        125        839     10,068
Illinois.........................................................        \6\ NA         NA         NA         NA
Indiana..........................................................           705        122        827      9,924
                                                                                                                
Iowa.............................................................           705        122        827      9,924
Kansas...........................................................           705        122        827      9,924
Kentucky.........................................................           705        122        827      9,924
Louisiana........................................................           705        122        827      9,924
Maine............................................................           720        117        837     10,044
                                                                                                                
Maryland.........................................................           705        122        827      9,924
Massachusetts....................................................           902         62        964     11,568
Michigan.........................................................           733        113        846     10,152
Minnesota........................................................       \7\ 816         88        904     10,848
Mississippi......................................................           705        122        827      9,924
                                                                                                                
Missouri.........................................................           705        122        827      9,924
Montana..........................................................           705        122        827      9,924
Nebraska.........................................................           719        117        836     10,032
Nevada...........................................................           779         99        878     10,536
New Hampshire....................................................           727        115        842     10,104
                                                                                                                
New Jersey.......................................................           730        114        844     10,128
New Mexico.......................................................           705        122        827      9,924
New York.........................................................           808         91        899     10,788
North Carolina...................................................           705        122        827      9,924
North Dakota.....................................................           705        122        827      9,924
                                                                                                                
Ohio.............................................................           705        122        827      9,924
Oklahoma.........................................................           813         89        902     10,824
Oregon...........................................................           705        122        827      9,924
Pennsylvania.....................................................           749        108        857     10,284
Rhode Island.....................................................           826         85        911     10,932
                                                                                                                
South Carolina...................................................           705        122        827      9,924
South Dakota.....................................................           720        117        837     10,044
Tennessee........................................................           705        122        827      9,924
Texas............................................................           705        122        827      9,924
Utah.............................................................           710        120        830      9,960
                                                                                                                
Vermont..........................................................       \8\ 797         94        891     10,692
Virginia.........................................................           705        122        827      9,924
Washington.......................................................       \9\ 725        115        840     10,080
West Virginia....................................................           705        122        827      9,924
Wisconsin........................................................           837         82        919     11,028
Wyoming..........................................................           730        114        844     10,128
----------------------------------------------------------------------------------------------------------------
\1\ In most States these maximums apply also to blind or disabled SSI recipients who are living in their own    
  households; but some States provide different benefit schedules for each category.                            
\2\ For two-person households, maximum food stamp benefits from October 1995 through September 1996 are $218 in 
  the 48 contiguous States and the District of Columbia, $280 in Alaska (urban areas, benefit levels for rural  
  Alaska are about 50 percent higher to account for high food prices in such areas), and $364 in Hawaii.        
For the 48 contiguous States and the District of Columbia, the calculation of benefits assumes: (1) a           
  ``standard'' deduction of $134 per month, (2) an excess shelter deduction of $247 per month (the maximum      
  allowable for nonelderly, nondisabled households); and (3) an excess medical expense deduction of $4 monthly  
  (estimated from 1993 medical expense information). If smaller excess shelter costs were assumed, food stamp   
  benefits would be smaller. For Alaska and Hawaii, higher deduction levels were used, as provided by law ($662 
  and $546, respectively, for combined standard and excess shelter allowance).                                  
\3\ SSI recipients in California are ineligible for food stamps. California provides increased cash aid in lieu 
  of stamps.                                                                                                    
\4\ Individual budget process.                                                                                  
\5\ State disregards $20 monthly of SSI income in determining the State supplementary payment amounts.          
\6\ State decides benefits on case-by-case basis.                                                               
\7\ Payment level for Hennepin County. State has two geographic payment levels--one for Hennepin County and one 
  for the remainder of the State.                                                                               
\8\ State has two geographic payment levels--highest levels are shown in table.                                 
\9\ Sum paid in King, Pierce, Kitsap, Snohomish, and Thurston Counties.                                         
                                                                                                                
NA--Not available.                                                                                              
                                                                                                                
Source: Table prepared by the Congressional Research Service (CRS) based on data from the Social Security       
  Administration.                                                                                               

         Comparison of SSI Payment Levels to Poverty Thresholds

    Table 4-9 compares the Federal SSI benefit for a single 
individual to the Bureau of the Census poverty threshold. Both 
the poverty threshold and the benefit level are indexed to the 
Consumer Price Index. (The percentage increase for the poverty 
threshold and the SSI benefit increase varies slightly because 
of a difference in the method of calculation.) As a result of 
Public Law 98-21, the SSI benefit levels were increased by $20 
per month for individuals and $30 per month for couples in July 
1983. They were further increased by 3.5 percent in January 
1984. This explains why SSI benefits, in relation to the 
poverty level, increased to approximately 75 percent in 1984 
and 1985 compared to 71 percent in the 1975 to 1982 period. In 
1996, benefit levels were 77.2 percent of the poverty level.

   TABLE 4-9.--COMPARISON OF COMBINED BENEFITS TO POVERTY THRESHOLDS FOR ELIGIBLE INDIVIDUALS RECEIVING SSI; SSI AND SOCIAL SECURITY; AND SSI, SOCIAL   
                                                    SECURITY, AND FOOD STAMPS; SELECTED YEARS 1975-96                                                   
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                 Calendar year                                          
            Poverty threshold and benefits            --------------------------------------------------------------------------------------------------
                                                         1975     1980     1984     1986     1988     1990     1991     1992     1993     1994     1996 
--------------------------------------------------------------------------------------------------------------------------------------------------------
Poverty threshold....................................    2,572    3,941    4,980    5,255    5,672    6,268    6,532    6,729    6,930    7,107    7,309
Federal SSI benefits:                                                                                                                                   
    Dollars per year.................................    1,822    2,677    3,768    4,032    4,248    4,632    4,884    5,064    5,208    5,352    5,640
    Percent of poverty...............................     70.8     72.3     75.6     76.7     74.9     73.9     74.8     75.3     75.2     75.3     77.2
Federal SSI and Social Security:                                                                                                                        
    Dollars per year.................................    2,062    2,917    4,008    4,272    4,488    4,872    5,124    5,304    5,448    5,592    5,880
    Percent of poverty...............................     80.2     74.0     80.5     81.3     79.1     77.7     78.4     78.8     78.6     78.7     80.4
Federal SSI, Social Security, and food stamps: \1\                                                                                                      
    Dollars per year.................................    2,350    3,345    4,294    4,488    4,848    5,318    5,580    5,820    5,952    6,072    6,372
    Percent of poverty...............................     91.4     84.9     86.2     85.4     85.5     84.8     85.4     86.5     85.9     85.4    87.2 
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ In computing the food stamp benefit for 1975, average deductions among all elderly households are assumed. For later years (except 1996), the       
  applicable standard deduction plus average shelter and medical deductions among all elderly households is assumed. For 1996, the applicable standard  
  deduction plus average shelter and medical deductions among all SSI households is assumed.                                                            
                                                                                                                                                        
Source: Congressional Research Service.                                                                                                                 

    Table 4-10 presents the same information for a couple. The 
SSI benefit for a couple is 91.7 percent of the poverty 
threshold in 1996.

                       TRENDS IN THE SSI CASELOAD

                          Number of Recipients

    As shown in table 4-11, in September 1995, 6.495 million 
persons received federally administered SSI payments. Of these, 
1.455 million received federally administered payments on the 
basis of being aged, 4.956 million on the basis of being 
disabled, and 84,553 on the basis of blindness. However, 
666,890 of those receiving benefits on the basis of disability 
or blindness were over the age of 65. Table 4-11 also indicates 
that approximately 4 million of those receiving federally 
administered SSI payments received only Federal SSI payments, 
2.2 million received a combination of Federal and State 
payments, and 321,887 received State supplements only.
    Table 4-12 shows the trends in the numbers of persons 
receiving federally administered SSI payments from December, 
1975, through September, 1995, both by reason for eligibility 
and by age categories. There was a steady decline in the number 
of SSI recipients from 1975 until 1983. However, in the last 12 
years the number of SSI recipients has increased from about 3.9 
million to more than 6.5 million, an increase of over 65 
percent.

         Characteristics of Adult Disabled and Blind Recipients

    Major disabling diagnosis.--As shown in table 4-13, of the 
SSI disabled ages 18-64, 28.2 percent were eligible on the 
basis of mental retardation and 31 percent on the basis of 
other mental disorders. Therefore, over one-half of all SSI 
disabled recipients are eligible on the basis of a mental 
disability. The next three largest categories are: diseases of 
the nervous system and sense organs--10.0 percent; diseases of 
musculoskeletal and connective tissues--7.1 percent; and 
diseases of the circulatory system--5.0 percent. In December 
1994, 1.3 million or 23.6 percent of the adult disabled or 
blind receiving SSI benefits had a representative payee. 
Representative payees are individuals, agencies, or 
institutions selected by SSA to receive and use SSI payments on 
behalf of the SSI recipient when it has been found necessary by 
reason of the mental or physical limitations of the recipient.
    Age.--When a person who is receiving SSI on the basis of 
blindness or disability becomes age 65, SSA does not convert 
the individual to eligibility on the basis of age. As shown in 
table 4-14, 16.2 percent of the SSI adult population receiving 
benefits on the basis of disability are age 65 or over (27.5 
percent of the blind were age 65 or over).

     TABLE 4-10.--COMPARISON OF COMBINED BENEFITS TO POVERTY THRESHOLDS FOR ELIGIBLE COUPLES RECEIVING SSI; SSI AND SOCIAL SECURITY; AND SSI, SOCIAL    
                                                   SECURITY, AND FOOD STAMPS; SELECTED YEARS: 1975-96                                                   
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                 Calendar year                                          
            Poverty threshold and benefits            --------------------------------------------------------------------------------------------------
                                                         1975     1980     1984     1986     1988     1990     1991     1992     1993     1994     1996 
--------------------------------------------------------------------------------------------------------------------------------------------------------
Poverty threshold....................................    3,232    4,954    6,280    6,628    7,156    7,906    8,238    8,489    8,741    8,964    9,221
Federal SSI benefits:                                                                                                                                   
    Dollars per year.................................    2,734    4,016    5,664    6,048    6,384    6,948    7,320    7,596    7,824    8,028    8,460
    Percent of poverty...............................     84.6     81.1     90.2     91.2     89.2     87.9     88.9     89.5     89.5     89.6     91.7
Federal SSI and Social Security:                                                                                                                        
    Dollars per year.................................    2,974    4,256    5,904    6,288    6,624    7,188    7,560    7,836    8,064    8,268    8,700
    Percent of poverty...............................     92.0     86.0     94.0     94.9     92.6     90.9     91.8     92.3     92.3     92.2     94.3
Federal SSI, Social Security, and food stamps: \1\                                                                                                      
    Dollars per year.................................    3,430    4,906    6,393    6,696    7,200    7,935    8,340    8,700    8,880    9,084    9,540
    Percent of poverty...............................    106.1     99.0    101.8    101.0    100.6    100.4    101.2    102.5    101.6    101.3    103.5
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ In computing the food stamp benefit for 1975, average deductions among all elderly households are assumed. For later years (except 1996), the       
  applicable standard deduction plus average shelter and medical deductions among all elderly households is assumed. For 1996, the applicable standard  
  deduction plus average shelter and medical deductions among all SSI households is assumed.                                                            
                                                                                                                                                        
Source: Congressional Research Service.                                                                                                                 


   TABLE 4-11.--NUMBER OF PERSONS RECEIVING FEDERALLY ADMINISTERED PAYMENTS, TOTAL AMOUNT AND AVERAGE MONTHLY   
                            AMOUNT, BY SOURCE OF PAYMENT AND CATEGORY, SEPTEMBER 1995                           
----------------------------------------------------------------------------------------------------------------
                        Source of payment                             Total       Aged      Blind      Disabled 
----------------------------------------------------------------------------------------------------------------
                                                                                 Number of persons              
                                                                                                                
                                                                  ----------------------------------------------
With--                                                                                                          
    Federally administered payments \1\..........................   6,495,422  1,454,554  \2\ 84,55             
                                                                                                  3  \3\ 4,956,3
                                                                                                              15
        Federal payment only.....................................   3,984,722    790,120     45,489    3,149,113
        Both Federal and State supplementation...................   2,188,813    531,466     32,475    1,624,872
        State supplementation only...............................     321,887    132,968      6,589      182,330
Total with--                                                                                                    
    Federal payment \4\..........................................   6,173,535  1,321,586     77,964    4,773,985
    State supplementation \5\....................................   2,510,700    664,434     39,064    1,807,202
                                                                                                                
                                                                  ----------------------------------------------
                                                                         Amount of payments [in thousands]      
                                                                                                                
                                                                  ----------------------------------------------
      Total......................................................   2,329,284    363,944     31,456    1,933,884
Federal payments.................................................   2,060,757    289,414     25,531    1,745,812
State supplementation............................................     268,526     74,530      5,925      188,072
                                                                                                                
                                                                  ----------------------------------------------
                                                                               Average monthly amount           
                                                                                                                
                                                                  ----------------------------------------------
      Total......................................................     $358.60    $250.21    $372.02      $390.19
Federal payments.................................................      333.81     218.99     327.47       365.69
State supplementation............................................      106.95     112.17     151.67       104.07
----------------------------------------------------------------------------------------------------------------
\1\ All persons with Federal SSI payments and/or federally administered State supplementation.                  
\2\ Includes an estimated 20,747 persons age 65 or older.                                                       
\3\ Includes an estimated 646,149 persons age 65 or older.                                                      
\4\ All persons with a Federal SSI payment whether receiving a Federal payment only or both a Federal and State 
  supplementation.                                                                                              
\5\ All persons with federally administered State supplementation whether receiving State supplementation only  
  or both a Federal SSI payment and a State supplementation.                                                    
                                                                                                                
Source: Office of Research and Statistics, Social Security Administration.                                      


                TABLE 4-12.--NUMBER OF PERSONS RECEIVING FEDERALLY ADMINISTERED SSI PAYMENTS BY CATEGORY AND AGE, SELECTED YEARS 1975-95                
                                                                     [In thousands]                                                                     
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                           Year                                         
                                                                 ---------------------------------------------------------------------------------------
                 Reason for eligibility and age                    Dec.    Sept.   Sept.   Sept.   Sept.   Sept.   Sept.   Sept.   Sept.   Sept.   Sept.
                                                                   1975    1983    1986    1988    1989    1990    1991    1992    1993    1994    1995 
--------------------------------------------------------------------------------------------------------------------------------------------------------
Reason for eligibility:                                                                                                                                 
  Aged..........................................................   2,307   1,528   1,476   1,434   1,439   1,452   1,463   1,478   1,474   1,470   1,455
  Blind.........................................................      74      79      83      83      83      84      85      86      86      85      85
    Under 18....................................................       3       6       7       7       7       7       7       8       8       8       8
    18-21.......................................................       4       5       5       4       4       4       4       4       4       4       4
    22-64.......................................................      46      45      48      49      49      50      51      52      52      52      52
    65 or older.................................................      22      23      23      22      22      22      22      22      22      21      21
  Disabled......................................................   1,933   2,292   2,673   2,917   3,048   3,229   3,502   3,921   4,348   4,692   4,956
    Under 18....................................................     104     191     231     247     256     287     366     511     683     812     898
    18-21.......................................................      90     122     138     136     139     143     150     167     186     202     219
    22-64.......................................................   1,559   1,517   1,787   1,987   2,091   2,218   2,393   2,637   2,864   3,049   3,193
    65 or older.................................................     179     462     517     548     563     579     592     606     615     629     646
Age:                                                                                                                                                    
  Under 18......................................................     107     197     238     254     263     294     373     518     691     820     906
  18-21.........................................................      93     127     143     140     143     147     154     171     190     206     223
  22-64.........................................................   1,605   1,562   1,835   2,036   2,140   2,269   2,445   2,690   2,917   3,101   3,245
  65 or older...................................................   2,508   2,013   2,016   2,003   2,023   2,051   2,078   2,107   2,110   2,120   2,121
                                                                 ---------------------------------------------------------------------------------------
    Total.......................................................   4,314   3,898   4,232   4,434   4,570   4,764   5,050   5,486   5,908   6,247   6,495
--------------------------------------------------------------------------------------------------------------------------------------------------------
Source: Office of Research and Statistics, Social Security Administration.                                                                              

    Sex.--In January 1996, 54.3 percent of those receiving SSI 
benefits on the basis of disability and 56.3 percent on the 
basis of blindness were women (table 4-15).
    Race.--In January 1996, 52.8 percent of those receiving SSI 
on the basis of disability were white; 31.3 percent were black; 
12.3 percent were other races; and in 3.5 percent of the cases, 
race was not reported (table 4-15).

  TABLE 4-13.--DISABILITY DIAGNOSIS OF SSI AND SECTION 1619 DISABILITY  
                     RECIPIENTS, SEPTEMBER 1995 \1\                     
              [Percentage distribution by diagnostic group]             
------------------------------------------------------------------------
                                    Supplemental Security Income--SSI   
                                ----------------------------------------
        Diagnostic group           All SSI      SSI sec.      SSI sec.  
                                 disabled 18-    1619(a)       1619(b)  
                                   64 yrs.    participants  participants
------------------------------------------------------------------------
Individuals \2\................    4,345,820        20,309        31,110
                                ========================================
      Total percent............        100.0         100.0         100.0
                                ----------------------------------------
Infectious and parasitic                                                
 diseases......................          1.7           1.0           1.5
Neoplasms......................          1.5           1.4           1.7
Endocrine, nutritional, and                                             
 metabolic disorders...........          4.1           2.1           2.5
Mental disorders (other than                                            
 mental retardation)...........         31.2          29.6          32.5
Mental retardation.............         28.2          45.3          37.8
Diseases of:                                                            
    Nervous system and sense                                            
     organs \3\................         10.1          12.7          13.5
    Circulatory system.........          5.0           1.6           2.4
    Respiratory system.........          2.6           0.9           0.9
    Digestive system...........          0.6           0.4           0.6
    Musculoskeletal system.....          7.1           2.8           4.3
Congenital anomalies...........          1.6           0.9           0.8
Injuries.......................          2.8           2.4           3.1
Other..........................          3.4           2.5           2.8
------------------------------------------------------------------------
\1\ Information on diagnosis of SSI disabled recipients under age 65 is 
  from the December 1995 SSI 10-percent disability file. Information on 
  diagnosis for section 1619 recipients is available from SSI source    
  files.                                                                
\2\ Includes only recipients whose diagnosis information is specifically
  identified on the source files.                                       
\3\ Most of the section 1619(b) participants who are classified as blind
  individuals are included in this category. A few section 1619(b) blind
  participants have a primary impairment other than diseases of the eye 
  and are coded in other categories in this table. Also, there are a few
  participants classified as having diseases of the eye who are not     
  blind, whose impairment does not meet the definition of blindness, and
  are classified as disabled.                                           
                                                                        
Source: Office of Supplemental Security Income, Social Security         
  Administration.                                                       

    Other income.--In September 1995, 31.0 percent of the 
disabled and 36.3 percent of the blind received Social Security 
benefits. Table 4-16 shows the number of SSI recipients with 
other sources of unearned income.

  Characteristics of Recipients Receiving Benefits on the Basis of Age

    Age.--In September 1995, of SSI recipients receiving 
benefits on the basis of age (65 or older) 34.5 percent were 80 
years of age or older (table 4-14).
    Sex.--In January 1996, 73.2 percent of those receiving 
benefits on the basis of age were women (table 4-15).

    TABLE 4-14.--NUMBER AND PERCENTAGE DISTRIBUTION OF SSI RECIPIENTS   
  RECEIVING FEDERALLY ADMINISTERED PAYMENTS BY CATEGORY AND AGE GROUP,  
                             SEPTEMBER 1995                             
------------------------------------------------------------------------
          Age group             Total       Aged      Blind     Disabled
------------------------------------------------------------------------
Children:                                                               
    Total number............    960,009  .........      9,108    950,901
                             ===========================================
    Total percent...........      100.0  .........      100.0      100.0
                             -------------------------------------------
Under 5.....................       15.4  .........       14.6       15.4
5-9.........................       28.5  .........       27.2       28.5
10-14.......................       32.8  .........       29.6       32.8
15-17.......................       17.7  .........       16.6       17.7
18-21 \1\...................        5.6  .........       12.0        5.6
Adults:                                                                 
    Total number............  5,535,413  1,454,554     75,445  4,005,414
                             ===========================================
    Total percent...........      100.0      100.0      100.0      100.0
                             -------------------------------------------
18-21 \1\...................        3.1  .........        3.9        4.2
22-29.......................        8.7  .........       12.9       11.8
30-39.......................       14.6  .........       16.9       19.8
40-49.......................       14.0  .........       15.8       19.1
50-59.......................       14.0  .........       14.6       19.1
60-64.......................        7.4  .........        8.4       10.0
65-69.......................       10.6       20.2        8.2        7.2
70-74.......................        9.7       25.3        6.5        4.2
75-79.......................        7.2       19.9        4.8        2.6
80 or older.................       10.8       34.5        8.0        2.2
------------------------------------------------------------------------
\1\ Persons aged 18-21 can be classified as either children or adults   
  depending on their student status.                                    
                                                                        
Source: Office of Research and Statistics, Social Security              
  Administration.                                                       

    Race.--In January 1996, 49.9 percent of those receiving SSI 
on the basis of age were white; 21.0 percent were black; 25.6 
percent were other races; and in 3.5 percent of the cases, race 
was not reported (table 4-15).
    Other income.--In September 1995, 63.2 percent of SSI 
recipients receiving benefits on the basis of age also received 
Social Security benefits. Only 1.9 percent had earned income 
(table 4-16).
    The number of persons receiving federally administered SSI 
payment and unearned income, by type of income, is included in 
table 4-17.

TABLE 4-15.--NUMBER AND PERCENTAGE DISTRIBUTION OF ALL PERSONS RECEIVING
FEDERALLY ADMINISTERED PAYMENTS BY CATEGORY, RACE, AND SEX, JANUARY 1996
------------------------------------------------------------------------
        Race and sex            Total       Aged      Blind     Disabled
------------------------------------------------------------------------
Total number................  6,475,500  1,444,300     87,100  4,944,100
                             ===========================================
    Total percent...........      100.0      100.0      100.0      100.0
                             -------------------------------------------
Race:                                                                   
  White.....................       52.2       49.9       54.5       52.8
  Black.....................       29.0       21.0       25.7       31.3
  Other.....................       15.3       25.6       15.4       12.3
  Not reported..............        3.5        3.5        4.4        3.5
Sex and race:                                                           
  Men.......................       41.5       26.8       43.7       45.7
    White...................       21.0       12.2       23.4       23.5
    Black...................       12.1        4.4       10.9       14.4
    Other...................        6.6        9.2        7.1        5.9
    Not reported............        1.8        1.0        2.3        2.0
  Women.....................       58.5       73.2       56.3       54.3
    White...................       31.2       37.7       31.1       29.3
    Black...................       16.9       16.7       14.8       16.9
    Other...................        8.7       16.5        8.3        6.5
    Not reported............        1.8        2.5        2.1        1.5
------------------------------------------------------------------------
Source: Office of Research and Statistics, Social Security              
  Administration.                                                       


    TABLE 4-16.--PERSONS RECEIVING FEDERALLY ADMINISTERED PAYMENTS AND INCOME AND AVERAGE MONTHLY AMOUNT, BY    
                                   CATEGORY AND TYPE OF INCOME, SEPTEMBER 1995                                  
----------------------------------------------------------------------------------------------------------------
                                                                                    Reason for eligibility      
                          Type of income                             Total   -----------------------------------
                                                                                 Aged      Blind      Disabled  
----------------------------------------------------------------------------------------------------------------
      Total number...............................................  6,495,422  1,454,554        \1\              
                                                                                            84,553           \2\
                                                                                                       4,956,315
                                                                                                                
                                                                  ----------------------------------------------
                                                                                       Number                   
                                                                                                                
                                                                  ----------------------------------------------
Social Security benefits.........................................  2,489,246    919,797     30,688     1,538,761
Other unearned income............................................    849,487    300,893     10,349       538,245
Earned income....................................................    284,912     27,328      6,198       251,386
                                                                  ----------------------------------------------
                                                                               Average monthly income           
                                                                                                                
                                                                  ----------------------------------------------
Social Security benefits.........................................    $345.58    $351.40    $360.79       $341.80
Other unearned income............................................     105.32      84.22      97.52        117.26
Earned income....................................................     237.92     237.64     506.31        231.34
----------------------------------------------------------------------------------------------------------------
\1\ Includes 20,747 persons aged 65 or over.                                                                    
\2\ Includes 646,149 persons aged 65 or older.                                                                  
                                                                                                                
Source: Office of Research and Statistics, Social Security Administration.                                      


   TABLE 4-17.--NUMBER OF PERSONS RECEIVING FEDERALLY ADMINISTERED SSI  
  PAYMENTS AND UNEARNED INCOME (OTHER THAN SOCIAL SECURITY) AND AVERAGE 
        MONTHLY UNEARNED INCOME BY TYPE OF INCOME, SEPTEMBER 1995       
------------------------------------------------------------------------
                Type of income                   Number \1\  Average \2\
------------------------------------------------------------------------
Veterans' benefits............................      115,967      155.50 
Railroad retirement...........................        4,842      325.93 
Black lung benefits...........................        1,685      310.91 
Employment pensions...........................       50,096      112.27 
Worker's compensation.........................        4,590      293.92 
Support and maintenance in kind...............      236,700      102.40 
Support from absent parents...................       79,531      152.61 
Asset income..................................      247,072        9.25 
Assistance based on need......................       40,596       94.86 
Other \3\.....................................       69,408      290.10 
                                               -------------------------
      Total...................................      849,487     $105.32 
------------------------------------------------------------------------
\1\ With unearned income other than social security benefits.           
\2\ Monthly amount of unearned income.                                  
\3\ Includes military, civil service pension, and demonstration         
  projects.                                                             
                                                                        
Source: Office of Research and Statistics, Social Security              
  Administration.                                                       

             Characteristics of Children Receiving Benefits

    At the end of its first year (December 1974), the SSI 
Program paid benefits to 71,000 disabled and blind children, 
less than 2 percent of the SSI caseload. By comparison, in 
December 1980 payments were made to almost 229,000 blind and 
disabled children, 5.5 percent of the 4.1 million recipients in 
that month.
    In December 1995, 974,000 blind and disabled children were 
eligible for SSI payments, nearly a fourteenfold increase. 
These children made up 15.0 percent of the over 6.5 million SSI 
recipients, and represent a fast growing segment of the SSI 
population.
    Most notable has been the growth since 1989. Many analysts 
attribute the growth to outreach activities, the Supreme Court 
decision in the Zebley case (see below), expansion of the 
mental impairment category, and reduction in reviews of 
continuing disability.
    To be eligible for SSI payments as a child, an individual 
must be under age 18 (or under 22 if a full time student), be 
unmarried, and meet the SSI disability or blindness, 
citizenship/residency, and income and resources criteria.
    In December 1995, almost 63 percent of the SSI children 
were 12 years old or less, and an estimated 20 percent of the 
children were under age 6. About 31 percent, an estimated 
300,000 children, were between the ages of 13 and 17. Child 
recipients were more likely to be boys than girls, by about 3 
to 2. Approximately 46 percent were nonwhite.
    Eighty percent of the children live in their parents' home. 
Less than two percent are patients in a medical facility where 
more than half of the cost of their care is covered by the 
Medicaid Program. Another 16 percent live in other hospitals, 
nursing homes, residential schools, foster care, or 
independently.
    About 25 percent of the children had some type of unearned 
income. The three major types of unearned income were: in-kind 
support and maintenance (7 percent), Social Security benefits 
(8.1 percent), and support from absent parents (8 percent). In 
addition, about 11 percent of children had income ``deemed'' 
from their parents.
    Given the rapid growth in the number of children receiving 
SSI, as well as a growing debate over the procedures by which 
children's eligibility should be judged, Congress established 
the National Commission on Childhood Disability to review the 
definition of childhood disability and examine several related 
issues, and report its findings to Congress by November 30, 
1995 (Public Law 103-296). The Commission, which reported in 
October of 1995, recommended that the SSI statute be amended to 
state that the purpose of the SSI Childhood Disability Program 
is to: help low-income families (and other individuals and 
organizations) who care for eligible children with disabilities 
in providing basic necessities to maintain the child at home or 
in another appropriate setting; cover the additional costs of 
caring for and raising a child with a disability; enhance the 
child's opportunity to develop; and offset lost family income 
because a parent remains out of the labor force or 
underemployed to care for the child. The Commission also 
recommended that the SSI definition of childhood disability be 
strengthened; that a benefit scale be created which reduces SSI 
benefits for multiple children in the same family to reflect 
economies of scale in the consumption of food, clothing, and 
shelter; that continuing disability reviews be performed at 
least every 2 years for children whose impairment is likely to 
improve; that appropriate health care treatment be required as 
a condition of continuing eligibility for SSI children; that 
parents or the child's representative payee be required to 
report financial expenditures on a periodic random basis; and 
that categorical eligibility for Medicaid be afforded all SSI 
children.
    In May 1995, another report on the children's SSI Program 
was released. This report conducted by the Committee on 
Childhood Disability of the National Academy of Social 
Insurance (responding to a study request from the House 
Committee on Ways and Means in the 102d Congress), was entitled 
``Restructuring the SSI Disability Program for Children and 
Adolescents.'' The Academy's expert group contended that the 
basic purpose of SSI cash benefits for children is to support 
and preserve the capacity of families to care for their 
disabled children in their own homes. Thus, the SSI benefit was 
intended to provide for some of the additional, nonmedical, but 
disability-related, costs of raising a disabled child; to 
compensate for some of the income lost because of the everyday 
necessities of caring for a disabled child; and to meet the 
child's basic needs for food, clothing, and shelter. The 
Committee also urged that SSI childhood eligibility criteria be 
strengthened, that family benefits in cases where there are 
multiple eligible children in the household be limited, that 
disabled teens be encouraged to work, and that children be 
periodically reviewed (National Academy of Social Insurance, 
1995).
    The General Accounting Office (GAO) also examined the 
growing children's caseload and attempted to understand why the 
caseload was growing so rapidly. GAO compared the results of 
SSA's decisions regarding children by type of disability and 
basis of award 2 years before and 2 years after the medical 
listings were expanded and a new procedure for determining 
disability called the Individualized Functional Assessment had 
been initiated. The study found that the number of children 
receiving SSI disability benefits more than doubled between 
1989 and 1992, from almost 300,000 to 770,500. According to the 
report, although the new individualized functional assessment 
(IFA) process mandated by the Supreme Court in Sullivan v. 
Zebley added 87,900 children to the rolls, most of the children 
who received new awards during the 2 years after the IFA went 
into effect in 1991 met the medical listing. The report 
indicated that the huge increases in the diagnosis of mental 
impairments--including mental retardation and attention deficit 
hyperactivity disorder--accounted for more than two-thirds of 
the growth in awards.
    Given the rapidly growing number of children in SSI, GAO 
assessed the implementation of the IFA process. The GAO study 
found that from 1991 to 1994, SSA made about 219,000 IFA awards 
to children who did not meet SSA's more restrictive listing of 
impairments. These awards accounted for one-third of all awards 
made during this period and about $1 billion a year in benefit 
payments. GAO also found that the IFA process relies too 
heavily on adjudicator's judgments, rather than on objective 
criteria. The study found little evidence, however, that 
parents' coaching their children to act out in disruptive 
behaviors to improve chances of obtaining SSI was widespread, 
but could not rule out its existence.

                   Overview of Caseload Developments

    In summary, the trends in the nature of the SSI population 
show the following:
  --A steady decline in the number of persons receiving SSI 
        benefits on the basis of old age.
  --An increase from 107,000 in December 1975 to 906,000 in 
        September 1995 of the number of disabled and blind 
        children under 18 receiving SSI benefits.
  --A sharp increase of 1,683,000 between 1983 and 1995 in the 
        number of persons ages 22-64 receiving benefits on the 
        basis of disability or blindness.

               ELIGIBILITY OF DRUG ADDICTS AND ALCOHOLICS

    Under both the SSI and the Social Security Disability 
Insurance (DI) Programs, disability is defined as a mental or 
physical impairment that is so severe that it prevents an 
individual from doing any kind of work that exists in the 
national economy, taking into account age, education, and work 
experience. Until recently, drug addiction and alcoholism were 
qualifying medical impairments under both SSI and DI. Thus, a 
person whose drug addiction or alcoholism was a contributing 
factor material to his disability was eligible for SSI. The SSI 
Program required that payments for drug addicts and alcoholics 
be made to a representative payee (i.e., a person or agency 
responsible for managing the recipient's finances), that 
recipients participate in treatment if available, and that the 
treatment be monitored.
    SSI provisions relating to drug addicts and alcoholics were 
contained in the original SSI law (Public Law 92-603). 
Initially, the Senate sought to exclude these individuals from 
SSI by putting them in a separate services program. During 
debate on the 1972 legislation, Members of the Senate argued 
that these drug addicts and alcoholics would need treatment, 
case management, and close monitoring so that they would not 
use the SSI benefits to ``support their alcoholism or 
addiction.'' The Senate provision that excluded drug addicts 
and alcoholics from the SSI Program was deleted in favor of the 
House provision that required recipients to undergo treatment. 
The Senate's concern about providing direct payments to 
substance abusers was accommodated by the provision requiring 
that benefits be provided through representative payees. 
Although virtually all SSI recipients diagnosed as drug addicts 
or alcoholics received their payments via a representative 
payee, most representative payees were family members or 
friends of recipients, and it is suspected that they were 
likely to give in to threats, coercion, or persuasion of the 
recipient, thereby enabling recipients to obtain direct control 
of their SSI payments.
    In 1994, Congress responded to concerns that significant 
numbers of SSI and DI recipients were using their Federal cash 
payments to support their addictions by passing legislation 
(Public Law 103-296) that placed a 3-year time limit on program 
benefits to persons disabled solely because of their addiction 
to drugs or alcohol, extended requirements on treatment and 
monitoring to DI recipients, required DI recipients classified 
as substance abusers to receive their benefits through 
representative payees, encouraged organizations and agencies to 
act as representative payees for recipients classified as 
substance abusers, and temporarily or permanently ended 
benefits of recipients who failed to comply with treatment 
requirements.
    By August 1995, there were about 135,000 SSI recipients 
whose disability was based solely on their drug addiction or 
alcoholism, although the Congressional Budget Office (CBO) 
estimates that perhaps as many of 75 percent of them would be 
eligible for SSI based on another sufficiently disabling 
condition.
    In March 1996, Congress passed legislation that ended drug 
and alcohol addiction as conditions that qualify individuals 
for SSI benefits. Under Public Law 104-121, individuals would 
not be considered disabled for either SSI or DI if drug 
addiction or alcoholism were the contributing factor material 
to their disability. Thus, eligibility for SSI and DI benefits 
ended for persons classified as substance abusers. The bill 
mandates the Commissioner of Social Security to require that 
persons who qualify for SSI or DI based on some other disabling 
condition, but who are determined to have a drug or alcohol 
condition receive their SSI or DI benefits through a 
representative payee and are referred to treatment. Public Law 
104-121 also authorizes $50 million for fiscal year 1997 and 
$50 million for fiscal year 1998 for drug treatment services. 
Recipients classified as drug addicts or alcoholics will no 
longer be eligible for SSI beginning January 1, 1997. 
Applicants were no longer eligible for SSI beginning March 29, 
1996 if they were disabled solely on the basis of drug or 
alcohol addiction.

            ELIGIBILITY OF LEGAL IMMIGRANTS (ALIENS) FOR SSI

    In addition to meeting the categorical requirements (aged, 
blind, or disabled) and the income and resource requirements, 
to qualify for SSI a person must be a citizen of the United 
States or an alien lawfully admitted to the United States for 
permanent residence or otherwise residing in the United States 
under color of law. For 5 years after entry into the United 
States, aliens are deemed to have available a portion of the 
income and resources of their immigration sponsors. (The 
deeming period was extended from 3 years to 5 years, effective 
January 1, 1994 through September 30, 1996.)

                      ELIGIBILITY OF THE HOMELESS

    SSA has implemented specific legislation and developed 
outreach programs and administrative initiatives to better meet 
the needs of the homeless, who may be eligible for SSI. This 
action was prompted by evidence that approximately 30 to 40 
percent of the residents of emergency homeless shelters are 
chronically mentally ill, and are former residents of mental 
institutions.
    These initiatives address the special problems related to 
the homeless: they are often difficult to locate and contact; 
they have limited ability to find information needed to apply 
for benefits; and they are often reluctant to follow through 
with the claims process or are incapable of doing so. While 
many of the chronically mentally ill live with family members 
or have other ongoing contact with those who can assist them 
with daily living activities, the homeless, mentally ill are 
more likely to have very limited contact with family or others 
who could assist them in obtaining housing or applying for 
benefits.
    SSA has identified homelessness as one barrier to filing 
for SSI benefits and, in response, has initiated a wide range 
of outreach activities aimed at this population. For example, 
local field offices have established ongoing programs in which 
local social service agencies, soup kitchens, shelters, and 
churches screen homeless people for possible SSI eligibility, 
refer them to SSA, and help them through the application 
process. Many of SSA's outreach demonstration programs deal 
specifically with the homeless or concentrate on the homeless 
in addition to other target populations, especially individuals 
who suffer from mental illness or AIDS.
    SSA is also participating in the Interagency Council on 
Homelessness (ICH) established by the Congress in 1987 to 
assist homeless individuals and families.

            SPECIAL SSI PROVISIONS FOR THE WORKING DISABLED

                        Earned Income Disregards

    Since SSI began in 1974, the law has required that a 
portion of the earned income of SSI recipients be disregarded 
in determining the eligibility for and the amount of SSI 
benefits. In determining SSI eligibility and benefits, the 
first $65 of monthly earned income (or, up to the first $85 if 
the recipient has no unearned income) plus one-half of the 
remaining earnings are disregarded. In addition, any work-
related expenses are disregarded in the case of blind persons 
and impairment-related work expenses are disregarded in the 
case of disabled persons. Also, income and resources set aside 
under a plan for achieving self-support are excluded.

                     Eliminating Work Disincentives

    Prior to enactment of the section 1619 program in 1980, on 
a temporary 3-year basis, a disabled SSI recipient who worked 
faced a substantial risk of losing SSI benefits and frequently, 
Medicaid. Work was treated the same way it was under the Social 
Security Disability Insurance (SSDI) Program: after a trial 
work period, work at the level of substantial gainful activity 
($500 or more of earnings per month; $300 per month before 
January 1990) led to the loss of disability status even if the 
individual's total income and resources were within SSI Program 
limits. Loss of SSI disability status caused loss of 
categorical Medicaid eligibility as well. (Many States provide 
automatic Medicaid coverage to all recipients of Federal SSI 
payments. Nearly all States follow the SSI definition of 
disability to establish Medicaid eligibility.) Thus, disabled 
individuals had a disincentive to work because of their fear of 
losing SSI benefits and Medicaid.

                  Overview of Section 1619 Provisions

    In response to this work disincentive, in 1986 Congress 
enacted Public Law 99-643 which added section 1619 to the 
Social Security Act. Under this provision, SSI recipients who 
work can continue to receive benefits even if their earnings 
are at or above the level of substantial gainful activity and 
as long as there is not a medical improvement in the disabling 
condition. Under the income disregard formula, the amount of 
their cash benefits is gradually reduced as earnings increase 
until their countable earnings reach the SSI benefit standard 
or what is known as the ``break-even point.'' In a State with 
no supplementation, as shown in table 4-2, this earned income 
eligibility limit is $1,025 per month in 1996 for a person who 
has no unearned income. People who receive section 1619 
benefits continue to be eligible for Medicaid on the same basis 
as regular SSI recipients. If States supplement the Federal 
benefits standard, the ``break-even point'' increases $2 for 
every $1 of State supplementation above the Federal benefit 
standard.
    Under section 1619(b), blind and disabled individuals can 
continue to be eligible for Medicaid even if their earnings 
take them past the SSI income disregard ``break-even point.'' 
In some 209(b) States, workers may lose Medicaid eligibility 
before attaining 1619 (a) or (b) status, if they did not have 
Medicaid coverage the month before section 1619 status began, 
thus making this provision inoperable for those workers. 
Special eligibility status under section 1619(b), under which 
the individual is considered a blind or disabled individual 
receiving SSI benefits for purposes of Medicaid eligibility, 
applies as long as the individual: (1) continues to be blind or 
have a disabling impairment; (2) except for earnings, continues 
to meet all the other requirements for SSI eligibility; (3) 
would be seriously inhibited from continuing to work by the 
termination of eligibility for Medicaid services; and (4) has 
earnings that are not sufficient to provide a reasonable 
equivalent of the benefits (SSI, State supplementary payments, 
Medicaid and publicly funded attendant care) that would have 
been available if he or she did not have those earnings.
    In making an initial determination under the fourth 
criterion, SSA decided to compare the individual's gross 
earnings to a ``threshold'' amount. The threshold amount is the 
amount of gross earnings, after the monthly $20 general income, 
$65 earned income, and one-half of the remainder exclusions are 
applied, that it would take to reduce to zero the Federal SSI 
benefit and State supplementary payment plus the average 
Medicaid expenditures for disabled SSI cash recipients for the 
State of residence. If the individual's earnings exceed the 
threshold, an individualized threshold is calculated which 
considers the person's actual Medicaid use, the State 
supplement rate for the person's actual living arrangement, and 
the value of publicly funded attendant care available to the 
person in the absence of his or her earnings. In determining a 
person's income to compare to the individualized threshold, any 
applicable exclusions are deducted from his earnings, including 
work expenses if the person is blind, impairment-related work 
expenses, and income set aside under a plan for achieving self-
support.
    In other words, Medicaid eligibility continues until the 
individual's earnings reach a higher plateau which takes into 
account the person's ability to afford medical care as well as 
normal living expenses.
    A disabled individual also has the ongoing protection of 
being able to be reinstated to eligibility for cash assistance 
benefits under regular SSI or 1619(a), or Medicaid only 
eligibility under 1619(b) if her work attempt fails or the 
physical or mental disability makes the ability to work 
erratic. This protection is not indefinite, but SSA cannot 
terminate the disability status of an individual for 12 months 
after her most recent eligibility for regular SSI or under 
section 1619 (a) or (b). However, if the individual recovers 
medically, a new application and new disability determination 
would be required to establish a new period of eligibility.

                     MEASURES OF SSI PARTICIPATION

                        SSI Participation Rates

    Table 4-18 shows Federal SSI participation among the 
elderly and the total population using various measures. The 
numerator in the first three columns is the sum of columns two 
and four in table 4-21. Thus, the number of SSI aged 
participants includes the disabled and blind population over 
age 65. Column one simply divides the SSI aged participants by 
the total number of elderly. That rate declined from 11.1 
percent in 1975 to 6.5 percent in 1989, primarily as a result 
of increasing incomes among the aged and decreasing 
participation among low-income elderly. The rate was 6.8 
percent in 1994. Column two presents the number of elderly SSI 
recipients divided by the number of poor elderly. This rate has 
declined from 76 percent in 1975 to 54 percent in 1982. Between 
1982 and 1984, this percentage increased, perhaps as a result 
of outreach efforts mandated by the 1983 Social Security 
amendments (Public Law 98-21). After 1984, the rate declined to 
56.5 percent in 1987, increased to 60.1 percent in 1989, 
declined to 53 percent in 1992, and increased to 57.9 percent 
in 1994. This rate is a gross measure of participation, in that 
it does not control for other SSI eligibility factors such as 
assets or the under counting of income. Column three shows the 
number of SSI aged recipients as a percentage of the number of 
poor elderly before means tested transfers.

                                  TABLE 4-18.--SSI PARTICIPATION RATES, 1975-94                                 
                                                  [In percent]                                                  
----------------------------------------------------------------------------------------------------------------
                                                                                           Among                
                                                               Among all      Among     pretransfer     Among   
                                                                elderly      elderly      elderly       entire  
                                                                               poor         poor      population
----------------------------------------------------------------------------------------------------------------
1975........................................................         11.1         75.6           NA          2.0
1976........................................................         10.3         72.4           NA          1.9
1977........................................................          9.8         74.1           NA          1.9
1978........................................................          9.4         71.5           NA          1.9
1979........................................................          9.0         61.3         68.7          1.8
1980........................................................          8.7         57.5         64.7          1.8
1981........................................................          8.1         55.0         63.3          1.8
1982........................................................          7.5         53.6         62.3          1.7
1983........................................................          7.3         55.2         61.9          1.7
1984........................................................          7.3         61.2         66.3          1.7
1985........................................................          7.1         58.7         64.5          1.7
1986........................................................          6.9         57.9         63.4          1.8
1987........................................................          6.8         56.5         64.7          1.8
1988........................................................          6.6         57.6         64.3          1.8
1989........................................................          6.5         60.1         64.6          1.9
1990........................................................          6.6         56.3         63.3          1.9
1991........................................................          6.8         55.0         61.1          2.0
1992........................................................          6.5         52.7           NA          2.2
1993........................................................          6.7         56.3           NA          2.3
1994........................................................          6.8         57.9           NA          2.4
----------------------------------------------------------------------------------------------------------------
NA--Not available.                                                                                              
                                                                                                                
Note.--The denominator for columns 1 and 4 is in table 15, appendix N, the denominator for column 3 is shown in 
  table 3 of appendix J, and the denominator for column 3 is in table 19 of appendix J.                         
                                                                                                                
Source: Staff of the Committee on Ways and Means.                                                               

    The final column of table 4-18 shows the number of Federal 
SSI participants as a percentage of the total population. The 
numerator for this calculation is the first column of table 21. 
As shown in the table, the percentage of the entire population 
receiving SSI benefits has declined from 2.0 percent in 1975 to 
1.7 percent for the 1982 to 1985 time period. It has since 
increased to 2.4 percent in 1994.
    Table 4-19 shows the percentage of a given State's 
population receiving SSI benefits for selected years.
    As shown in table 4-19, the total percentage of the 
population receiving SSI benefits increased to 2.46 percent in 
1995 from 2 percent in 1975. However, between these years, the 
percentage of the population receiving SSI benefits declined to 
1.74 percent in 1985 (a 13-percent decline) and has since risen 
to 2.46 percent of the population in 1995.

                       TABLE 4-19.--SSI RECIPIENCY RATES BY STATE, SELECTED YEARS 1975-95                       
----------------------------------------------------------------------------------------------------------------
                          State                            1975    1985    1990    1991    1992    1993    1995 
----------------------------------------------------------------------------------------------------------------
Alabama.................................................    3.98    3.29    3.29    3.35    3.43    3.64    3.86
Alaska..................................................    0.81    0.65    0.84    0.87    0.90    0.96    1.09
Arizona.................................................    1.24    1.04    1.22    1.33    1.42    1.54    1.77
Arkansas................................................    4.09    3.14    3.23    3.34    3.47    3.66    3.86
California..............................................    3.09    2.59    2.93    3.03    3.10    3.14    3.17
                                                                                                                
Colorado................................................    1.37    0.93    1.14    1.23    1.29    1.38    1.52
Connecticut.............................................    0.76    0.83    0.98    1.05    1.10    1.19    1.36
Delaware................................................    1.19    1.21    1.21    1.23    1.27    1.34    1.51
District of Columbia....................................    2.23    2.51    2.67    2.83    3.00    3.21    3.63
Florida.................................................    1.86    1.62    1.71    1.82    1.90    2.06    2.34
                                                                                                                
Georgia.................................................    3.27    2.56    2.46    2.51    2.55    2.65    2.80
Hawaii..................................................    1.08    1.08    1.25    1.27    1.30    1.40    1.52
Idaho...................................................    1.06    0.84    1.03    1.10    1.21    1.28    1.44
Illinois................................................    1.22    1.18    1.55    1.67    1.78    2.00    2.25
Indiana.................................................    0.83    0.87    1.09    1.17    1.26    1.39    1.52
                                                                                                                
Iowa....................................................    1.00    0.96    1.18    1.23    1.29    1.37    1.47
Kansas..................................................    1.05    0.87    0.99    1.05    1.14    1.26    1.44
Kentucky................................................    2.83    2.65    3.11    3.27    3.42    3.71    4.23
Louisiana...............................................    3.90    2.87    3.15    3.29    3.49    3.84    4.18
Maine...................................................    2.31    1.89    1.93    1.97    2.03    2.17    2.47
                                                                                                                
Maryland................................................    1.17    1.16    1.25    1.30    1.35    1.44    1.61
Massachusetts...........................................    2.30    1.91    1.98    2.12    2.23    2.40    2.72
Michigan................................................    1.31    1.35    1.54    1.61    1.71    1.93    2.19
Minnesota...............................................    1.00    0.78    0.92    0.99    1.05    1.17    1.84
Mississippi.............................................    5.21    4.28    4.42    4.56    4.68    4.98    5.33
                                                                                                                
Missouri................................................    2.10    1.58    1.66    1.75    1.83    1.96    2.15
Montana.................................................    1.12    0.92    1.25    1.33    1.38    1.44    1.61
Nebraska................................................    1.06    0.88    0.99    1.05    1.09    1.19    1.30
Nevada..................................................    1.00    0.85    0.95    0.98    1.04    1.14    1.37
New Hampshire...........................................    0.67    0.62    0.62    0.68    0.71    0.77    0.92
                                                                                                                
New Jersey..............................................    1.11    1.23    1.36    1.44    1.52    1.66    1.81
New Mexico..............................................    2.29    1.83    2.08    2.19    2.25    2.39    2.65
New York................................................    2.24    2.00    2.31    2.46    2.60    2.85    3.20
North Carolina..........................................    2.71    2.21    2.24    2.33    2.36    2.47    2.65
North Dakota............................................    1.25    0.96    1.17    1.25    1.30    1.34    1.42
                                                                                                                
Ohio....................................................    1.22    1.19    1.44    1.55    1.63    1.84    2.19
Oklahoma................................................    3.03    1.81    1.92    1.97    2.02    2.13    2.27
Oregon..................................................    1.12    0.95    1.11    1.18    1.24    1.35    1.43
Pennsylvania............................................    1.24    1.39    1.60    1.69    1.77    1.90    2.16
Rhode Island............................................    1.72    1.62    1.74    1.83    1.91    2.05    3.27
                                                                                                                
South Carolina..........................................    2.84    2.60    2.59    2.61    2.67    2.80    2.97
South Dakota............................................    1.32    1.19    1.45    1.53    1.62    1.72    1.87
Tennessee...............................................    3.24    2.71    2.87    2.98    3.06    3.22    3.42
Texas...................................................    2.23    1.57    1.73    1.81    1.87    2.00    2.17
Utah....................................................    0.76    0.53    0.73    0.79    0.84    0.94    1.06
                                                                                                                
Vermont.................................................    1.93    1.76    1.79    1.89    1.99    2.08    2.25
Virginia................................................    1.53    1.49    1.54    1.61    1.67    1.76    1.95
Washington..............................................    1.46    1.09    1.27    1.34    1.39    1.50    1.66
West Virginia...........................................    2.37    2.24    2.63    2.78    2.91    3.17    3.66
Wisconsin...............................................    1.44    1.50    1.75    1.83    1.88    2.04    2.17
Wyoming.................................................    0.67    0.45    0.76    0.85    0.92    1.04    1.19
                                                         -------------------------------------------------------
      Total \1\.........................................    2.00    1.74    1.94    2.03    2.11    2.26    2.46
----------------------------------------------------------------------------------------------------------------
\1\ The total number of SSI recipients used to calculate the total recipiency rate includes a certain number of 
  recipients whose State is unknown. For 1975, 1985, 1990, 1991, 1992, and 1993, the numbers of unknown (in     
  thousands) respectively were 256, 14, 0, 96, 71, and 91.                                                      
                                                                                                                
Source: Social Security Administration, Ways and Means Committee staff, and Congressional Research Service.     
  Percentages are calculated as the average number of monthly SSI recipients over the total population of each  
  State in July of the selected year. For 1995, percentages are calculated as the number of SSI recipients in   
  July 1995 divided by the total population of each State in July 1995.                                         

                Changes in Number of Recipients, 1970-95

    SSI is one of the largest cash assistance programs for the 
poor and one of the fastest growing entitlement programs; 
program costs grew 20 percent annually from 1991 through 1994. 
According to GAO, three groups have accounted for nearly 90 
percent of the SSI Program's growth since 1991: adults with 
mental impairments, children, and noncitizens. These groups 
grew at an annual average rate of 11.0, 16.4, and 15.5 percent, 
respectively, from 1986 through 1993, compared with 4.9 percent 
for all SSI recipients. The SSI recipient population has also 
changed dramatically: disabled recipients now account for 
nearly 80 percent of recipients. The GAO report found that SSI 
recipients now tend to be younger, stay on SSI longer, receive 
larger benefits, and depend more on SSI as a primary source of 
income. Factors contributing to caseload growth include the 
following: expansion in disability eligibility, notably for 
mentally impaired adults and for children; increased outreach 
by SSA; little effort to help recipients return to work; 
infrequent reviews of cases to confirm that the disability is 
continuing; immigration growth; and transfers from State 
programs, among others (U.S. General Accounting Office, 1995).
    Table 4-20 illustrates the changes in the number of 
individuals receiving assistance under the federally 
administered SSI Program and prior programs. The total number 
of individuals receiving assistance was 3.1 million in 1970; 
this increased to 4.3 million in 1975 and declined to 3.9 
million in 1982. Since then, the number of SSI recipients has 
grown each year. In 1995, there were over 6.5 million SSI 
recipients. Despite this overall growth, the number of aged 
receiving SSI has declined sharply since 1975 from 2.3 million 
(or 2.5 million if disabled over age 65 are counted as aged) to 
1.4 million individuals in 1995 (2.1 million if disabled over 
65 are counted). Meanwhile, the number of blind or disabled 
receiving assistance increased sharply from 1.0 million in 1970 
to roughly 5.1 million in 1995 (4.4 million if persons over age 
65 are excluded).
    The number of persons receiving SSI payment, by State, in 
December 1995 is provided in table 4-21.

  TABLE 4-20.--NUMBER OF PERSONS RECEIVING FEDERALLY ADMINISTERED SSI PAYMENTS, 1974-2001; AND ADULT ASSISTANCE 
                                          UNDER PRIOR PROGRAMS, 1970-73                                         
                                                 [In thousands]                                                 
----------------------------------------------------------------------------------------------------------------
                                                                     Blind or disabled                          
                                                                 ------------------------- Federal      State   
                  Year \1\                   Total \2\  Aged \3\             65 and older  SSI \6\  supplemental
                                                                  Total \4\       \5\                   only    
----------------------------------------------------------------------------------------------------------------
1970.......................................     3,098      2,082     1,016   ............  .......  ............
1971.......................................     3,172      2,024     1,148   ............  .......  ............
1972.......................................     3,182      1,934     1,248   ............  .......  ............
1973.......................................     3,173      1,820     1,353   ............  .......  ............
1974.......................................     3,996      2,286     1,710          (\7\)    (\8\)        (\8\) 
1975.......................................     4,314      2,307     2,007            201    3,893          421 
1976.......................................     4,236      2,148     2,088            249    3,799          437 
1977.......................................     4,238      2,051     2,187            302    3,778          460 
1978.......................................     4,217      1,968     2,249            344    3,755          462 
1979.......................................     4,150      1,872     2,278            386    3,687          462 
1980.......................................     4,142      1,808     2,334            419    3,682          460 
1981.......................................     4,019      1,678     2,341            443    3,590          429 
1982.......................................     3,858      1,549     2,309            462    3,473          384 
1983.......................................     3,901      1,515     2,386            485    3,590          311 
1984.......................................     4,029      1,530     2,499            507    3,699          331 
1985.......................................     4,138      1,504     2,634            525    3,799          339 
1986.......................................     4,269      1,473     2,796            540    3,922          348 
1987.......................................     4,385      1,455     2,930            560    4,019          366 
1988.......................................     4,464      1,433     3,030            573    4,089          375 
1989.......................................     4,593      1,439     3,154            587    4,206          387 
1990.......................................     4,817      1,454     3,363            605    4,412          405 
1991.......................................     5,118      1,465     3,654            615    4,730          389 
1992.......................................     5,566      1,471     4,095            628    5,202          364 
1993.......................................     6,011      1,475     4,536            638    5,664          347 
1994.......................................     6,296      1,466     4,830            653    5,965          331 
1995.......................................     6,514      1,446     5,068            669    6,194          320 
1996 \9\...................................     6,767      1,437     5,330            684    6,446          321 
1997 \9\...................................     6,946      1,423     5,523            698    6,625          321 
1998 \9\...................................     7,113      1,411     5,702            712    6,793          320 
1999 \9\...................................     7,282      1,403     5,879            726    6,962          320 
2000 \9\...................................     7,429      1,394     6,035            740    7,110          319 
2001 \9\...................................     7,566      1,387     6,179            754    7,246          320 
----------------------------------------------------------------------------------------------------------------
\1\ Data are for December of each year.                                                                         
\2\ All persons with Federal SSI payments and/or federally administered State supplementation; 1974-94. For 1970-
  73, the total is the number of recipients under the Old-Age Assistance and Aid to the Blind and Aid to the    
  Permanently and Totally Disabled Programs.                                                                    
\3\ For 1970-73, this column is the number of recipients under the Old-Age Assistance Program.                  
\4\ For 1970-73, this column is the number of recipients under the Aid to the Blind and Aid to the Permanently  
  and Totally Disabled Programs.                                                                                
\5\ For 1974-2001, this is the number of age 65 or older individuals who first received SSI benefits because of 
  being blind or disabled.                                                                                      
\6\ All persons with Federal SSI payments include those receiving Federal payments only or both Federal SSI and 
  federally administered State supplementation.                                                                 
\7\ Data not available for December 1974. In January 1974, there were 87,000 blind and disabled recipients aged 
  65 or older.                                                                                                  
\8\ Data not available.                                                                                         
\9\ For 1996-2001, data are projections based on the President's budget estimates of December 1996.             
                                                                                                                
Source: Office of the Actuary, Social Security Administration.                                                  


                 TABLE 4-21.--NUMBER OF PERSONS RECEIVING SSI PAYMENTS, BY STATE, DECEMBER 1995                 
----------------------------------------------------------------------------------------------------------------
                                                                Federally administered                  State   
                       State                       ------------------------------------------------ administered
                                                       Total       Aged        Blind     Disabled     total \1\ 
----------------------------------------------------------------------------------------------------------------
        Total \3\.................................   6,514,134   1,446,122      83,545   4,984,467      299,858 
                                                   -------------------------------------------------------------
Alabama \3\.......................................     165,093      38,052       1,465     125,576        1,985 
Alaska \3\........................................       6,879       1,217         116       5,546        4,726 
Arizona \3\.......................................      72,961      13,505         891      58,565          674 
Arkansas..........................................      94,486      20,826       1,157      72,503  ............
California........................................   1,031,872     332,090      21,979     677,803  ............
                                                                                                                
Colorado \3\......................................      56,672       9,608         552      46,512       30,812 
Connecticut \3\...................................      44,661       7,668         501      36,492       29,807 
Delaware..........................................      10,996       1,573         120       9,303  ............
District of Columbia..............................      20,238       3,246         187      16,805  ............
Florida \3\.......................................     338,246      99,038       3,255     235,953       14,223 
                                                                                                                
Georgia...........................................     198,933      43,666       2,549     152,718  ............
Hawaii............................................      18,731       7,552         159      11,020  ............
Idaho \3\.........................................      16,605       1,968         151      14,486    \4\ 2,985 
Illinois \3\......................................     266,563      35,769       2,461     228,333       44,367 
Indiana \3\.......................................      88,757       9,440       1,084      78,233        1,139 
                                                                                                                
Iowa..............................................      41,571       5,999       1,002      34,570  ............
Kansas............................................      37,552       4,678         400      32,474  ............
Kentucky \3\......................................     165,286      24,675       1,739     138,872        5,881 
Louisiana.........................................     182,104      33,339       2,182     146,583  ............
Maine.............................................      30,841       5,956         281      24,604  ............
                                                                                                                
Maryland \4\......................................      82,494      16,834         833      64,827        1,648 
Massachusetts.....................................     163,528      46,829       4,563     112,136  ............
Michigan..........................................     210,265      23,143       2,092     185,030  ............
Minnesota \3\.....................................      62,126      10,421         777      50,928   \5\ 17,571 
Mississippi.......................................     141,061      32,026       1,461     107,574  ............
                                                                                                                
Missouri \3\......................................     113,734      17,465       1,032      95,237       10,365 
Montana...........................................      14,057       1,674         133      12,250  ............
Nebraska \3\......................................      21,326       3,084         258      17,984        6,364 
Nevada............................................      20,783       6,072         610      14,101  ............
New Hampshire \3\.................................      10,533       1,314         106       9,113        6,881 
                                                                                                                
New Jersey........................................     144,004      35,450       1,123     107,431  ............
New Mexico \3\....................................      44,755       9,844         644      34,267          231 
New York..........................................     588,538     145,502       3,784     439,252  ............
North Carolina \3\................................     190,790      44,058       2,443     144,289       19,862 
North Dakota \3\..................................       8,970       1,820          92       7,058      \4\ 355 
                                                                                                                
Ohio..............................................     248,195      21,770       2,464     223,961  ............
Oklahoma \3\......................................      74,281      15,208         971      58,102   \5\ 68,765 
Oregon \3\........................................      47,124       7,183         617      39,324   \5\ 16,971 
Pennsylvania......................................     264,564      42,952       2,719     218,893  ............
Rhode Island......................................      24,245       4,948         244      19,053  ............
                                                                                                                
South Carolina \4\................................     111,095      23,851       1,782      85,462        4,124 
South Dakota \4\..................................      13,631       2,506         130      10,995          232 
Tennessee.........................................     179,676      32,697       1,860     145,119  ............
Texas \5\.........................................     404,097     126,932       5,652     271,513  ............
Utah..............................................      20,462       2,210         292      17,960  ............
                                                                                                                
Vermont...........................................      13,015       2,101         131      10,783  ............
Virginia \3\......................................     130,310      28,120       1,604     100,586        7,025 
Washington........................................      91,654      13,068         931      77,655  ............
West Virginia \6\.................................      67,791       7,737         708      59,346  ............
Wisconsin.........................................     111,585      18,548       1,188      91,849  ............
Wyoming \3\.......................................       5,759         682          58       5,019        2,865 
                                                                                                                
Other:                                                                                                          
  N. Mariana Islands..............................         544         190          12         342  ............
----------------------------------------------------------------------------------------------------------------
\1\ Includes fewer than 200 cases not distributed by State.                                                     
\2\ September 1995 data.                                                                                        
\3\ Data for Federal SSI payments only. State has state-administered supplementation.                           
\4\ Data for Federal SSI payments and federally administered state supplementation only, State also has state-  
  administered supplementation.                                                                                 
\5\ Estimated data.                                                                                             
\6\ Data for Federal SSI payments only, State supplementary payments not made.                                  
                                                                                                                
Source: Office of Research and Statistics and Office of Retirement and Survivors insurance and Supplemental     
  Security Income Policy, Social Security Administration.                                                       

                           SSI Program Costs

    Table 4-22 shows total expenditures for the SSI Program in 
each State, including not only the federally administered 
Federal and State supplementation payments but also the State 
administered State supplementation payments. Table 4-23 shows 
the total (Federal- and State-administered) State 
supplementation payments for SSI for fiscal years 1985 through 
1995.
    Table 4-24 illustrates the total amount of Federal and 
State benefit payments from calendar years 1970 to 1987 and 
fiscal years 1988 to 2002. From 1970 to 1973, these were the 
benefits under the old-age assistance, aid to the blind, and 
aid to the permanently and totally disabled programs. In fiscal 
year 1995, Federal benefit payments totaled $24.443 billion and 
State payments totaled $3.681 billion, amounting to an overall 
total of $28.124 billion. In fiscal year 1996, total (Federal 
and State) SSI benefits are estimated to total $27.9 billion 
and projected to increase to $41.5 billion in fiscal year 2002.

 TABLE 4-22.--SUPPLEMENTAL SECURITY INCOME: TOTAL PAYMENTS, FEDERAL SSI PAYMENTS, AND FEDERALLY ADMINISTERED AND
                        STATE ADMINISTERED STATE SUPPLEMENTARY PAYMENTS, FISCAL YEAR 1995                       
                                            [In thousands of dollars]                                           
----------------------------------------------------------------------------------------------------------------
                                                                                      State supplementation     
                                                                  Federal SSI  ---------------------------------
                     State                           Total            \1\           Federally          State    
                                                                                administered \2\   administered 
----------------------------------------------------------------------------------------------------------------
      Total...................................     $27,247,713     $23,512,463       $3,114,385         $620,865
                                               -----------------------------------------------------------------
Alabama.......................................         594,372         593,002  ................           1,370
Alaska \3\....................................          39,456          26,484  ................          12,972
Arizona.......................................         281,967         281,558  ................             409
Arkansas......................................         322,314         322,310                4   ..............
California....................................       5,335,712       3,354,710        1,981,002   ..............
                                                                                                                
Colorado......................................         269,875         213,172  ................          56,703
Connecticut...................................         277,012         176,682  ................         100,330
Delaware......................................          39,356          38,539              817   ..............
District of Columbia..........................          83,153          78,811            4,342   ..............
Florida.......................................       1,283,365       1,264,985            (\4\)           18,380
                                                                                                                
Georgia.......................................         681,292         681,277               15   ..............
Hawaii........................................          80,717          69,412           11,305   ..............
Idaho \3\.....................................          70,928          61,469  ................           9,459
Illinois......................................       1,220,637       1,151,187  ................          69,450
Indiana.......................................         345,508         341,722  ................           3,786
                                                                                                                
Iowa..........................................         145,538         142,587            2,951   ..............
Kansas........................................         137,252         137,251                1   ..............
Kentucky......................................         637,194         620,351  ................          16,843
Louisiana.....................................         708,185         708,185            (\5\)   ..............
Maine.........................................          94,373          86,831            7,542   ..............
                                                                                                                
Maryland......................................         334,378         328,143            (\4\)            6,235
Massachusetts.................................         687,156         527,076          160,080   ..............
Michigan......................................         892,043         854,774           37,269   ..............
Minnesota \3\.................................         294,510         230,790  ................          63,720
Mississippi...................................         500,936         500,930                6   ..............
                                                                                                                
Missouri......................................         452,238         422,689  ................          29,549
Montana.......................................          51,492          50,552              940   ..............
Nebraska......................................          80,478          74,508  ................           5,970
Nevada........................................          76,542          72,657            3,885   ..............
New Hampshire.................................          48,422          37,383  ................          11,039
                                                                                                                
New Jersey....................................         588,426         551,771           76,655   ..............
New Mexico....................................         162,046         161,753  ................             293
New York......................................       2,672,815       2,162,719          510,096   ..............
North Carolina................................         741,847         626,602  ................         115,245
North Dakota \3\..............................          30,392          28,464  ................           1,928
                                                                                                                
Ohio..........................................       1,027,215       1,027,215               13   ..............
Oklahoma......................................         297,636         261,825  ................          35,811
Oregon \3\....................................         206,606         178,561  ................          28,045
Pennsylvania..................................       1,139,278       1,003,125          136,153   ..............
Rhode Island..................................          97,234          78,423           18,811   ..............
                                                                                                                
South Carolina................................         391,142         378,392  ................          12,750
South Dakota..................................          47,306          46,533                9              764
Tennessee.....................................         636,486         636,486            (\4\)   ..............
Texas.........................................       1,365,758       1,365,758  ................  ..............
Utah..........................................          79,406          79,346               60   ..............
                                                                                                                
Vermont.......................................          49,195          38,799           10,396   ..............
Virginia......................................         481,064         461,908  ................          19,156
Washington....................................         391,780         363,264           28,516   ..............
West Virginia.................................         269,671         269,671  ................  ..............
Wisconsin.....................................         481,012         357,319          123,693   ..............
Wyoming.......................................          21,165          20,505  ................             660
                                                                                                                
N. Mariana Islands                                       2,351           2,351  ................  ..............
----------------------------------------------------------------------------------------------------------------
\1\ Includes $1.6 million not distributed by State.                                                             
\2\ Total reduced by $176,000 due to adjustments not yet identified and credited by State.                      
\3\ Data estimated for State-administered payments.                                                             
\4\ Amount not shown; negative adjustment exceeds amount paid.                                                  
\5\ Less than $500.                                                                                             
                                                                                                                
Source: Office of Research and Statistics, Social Security Administration.                                      


                                                              TABLE 4-23.--STATE SSI SUPPLEMENTATION PAYMENTS, FISCAL YEARS 1985-95                                                             
                                                                                    [In thousands of dollars]                                                                                   
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                        Year                                                                    
                      State                       ----------------------------------------------------------------------------------------------------------------------------------------------
                                                       1985         1986         1987         1988         1989         1990         1991         1992         1993         1994         1995   
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Alabama..........................................      $15,003      $13,659      $11,606      $10,436       $7,964       $6,594       $6,394       $3,845       $2,083       $1,673       $1,370
Alaska...........................................       12,970       12,970       12,970       12,970       12,970       12,972       12,972       12,972       12,972       12,972       12,972
Arizona..........................................        2,194        2,668        3,045        3,309        2,691        2,560        3,129        3,129        3,129          411          409
Arkansas.........................................           30           28           32           20           14           15           12            8            0            6            4
California.......................................    1,288,260    1,466,079    1,729,305    1,862,170    2,038,339    2,274,296    2,303,637    2,433,459    2,212,330    2,014,831    1,981,002
                                                                                                                                                                                                
Colorado.........................................       47,474       38,320       35,416       24,132       41,035       42,649       50,002       53,309       55,057       53,376       56,703
Connecticut......................................       31,200       36,578       46,577       54,584       74,257       67,670       98,838       94,725       96,836       99,424      100,330
Delaware.........................................          457          671          703          730          725          708          721          750          747          819          817
Dist. of Columbia................................        4,106        4,202        4,265        4,538        4,498        4,365        4,278        4,694        4,899        5,095        4,342
Florida..........................................        8,174        9,718       11,314       11,309       12,609       14,656       18,055       18,899       18,608       18,608       18,380
                                                                                                                                                                                                
Georgia..........................................           13            8           19           18           10           16            9           12           19           18           15
Hawaii...........................................        3,598        3,740        3,893        4,263        6,799       10,885       10,314       10,698       11,066       11,299       11,305
Idaho............................................        4,023        4,136        4,205        4,205        4,205        4,212        4,212        4,212        4,212        4,212        9,459
Illinois.........................................       44,491       51,197       56,856       59,573       55,716       57,137       65,756       64,241       65,836       73,398       69,450
Indiana..........................................        1,191        1,744        2,666        3,619        3,099        3,285        3,405        3,563        3,817        3,884        3,786
                                                                                                                                                                                                
Iowa.............................................        1,620        1,908        2,098        2,204        2,275        2,408        2,508        2,672        2,859        2,940        2,951
Kansas...........................................           32           27           34           25           21           21           17           12            0            2            1
Kentucky.........................................        9,947        9,795       10,109       10,467       10,473       11,611       14,801       15,492       15,313       16,612       16,843
Louisiana........................................           51           42           47           33           23           25           19           12            4        (\1\)        (\1\)
Maine............................................        5,372        5,413        7,454        7,540        7,452        7,494        7,371        7,325        7,233        7,415        7,542
                                                                                                                                                                                                
Maryland.........................................        4,238        5,252        5,505        6,159        6,159        6,155        6,520        6,542        6,269        6,102        6,235
Massachusetts....................................      109,954      109,452      112,561      120,010      114,691      117,113      124,761      137,516      147,866      153,034      160,080
Michigan.........................................       62,824       66,338       68,779       69,833       72,369       74,682       72,561       61,636       62,683       61,955       37,296
Minnesota........................................       17,024       19,818       22,850       24,667       40,641       43,924       48,933       55,224       53,860       53,860       63,720
Mississippi......................................           33           29           35           27           26           22           19           12           11            7            6
                                                                                                                                                                                                
Missouri.........................................        6,027        5,132        4,410        4,009        3,102        2,808        8,476       26,158       25,866       24,286       29,549
Montana..........................................          805          834          844          839          842          864          910          909          902          960          940
Nebraska.........................................        5,325        5,348        5,457        5,454        6,550        5,793        5,334        6,175        6,705        5,990        5,970
Nevada...........................................        2,421        2,531        2,594        2,704        2,771        2,928        3,029        3,184        3,586        3,717        3,885
New Hampshire....................................        7,740        7,326        6,501        5,865        9,662        6,843        7,675        7,948        8,512        9,573       11,039
                                                                                                                                                                                                
New Jersey.......................................       46,675       48,124       49,996       50,446       59,291       53,697       57,328       64,765       71,965       74,242       76,655
New Mexico.......................................          226          216          280          248          270          263          307          333          329          321          293
New York.........................................      225,075      277,035      305,678      317,504      366,972      388,150      410,081      440,374      476,029      494,345      510,096
North Carolina...................................       36,449       41,091       47,963       52,745       58,989       63,135       75,066       91,925       95,445      106,493      115,245
North Dakota.....................................        1,183        1,518        1,406        1,480        1,549        1,390        1,291        1,408        1,220        1,676        1,928
                                                                                                                                                                                                
Ohio.............................................            1           35           37           31           30           34           31           31           28           18           13
Oklahoma.........................................       30,187       31,380       32,894       34,045       33,414       34,168       35,055       36,012       36,557       34,987       35,811
Oregon...........................................        9,781        9,767       10,342       11,843       15,419       17,946       20,169       20,169       20,169       20,169       28,045
Pennsylvania.....................................       65,203       69,186       75,502       74,670       76,565       79,571       84,668       94,971      109,947      128,339      136,153
Rhode Island.....................................        8,842        9,402        9,848       10,263       10,816       11,729       12,973       14,967       16,097       17,384       18,811
                                                                                                                                                                                                
South Carolina...................................        3,932        4,812        4,927        5,004        9,785        8,897       11,994       11,685       12,377       11,880       12,750
South Dakota.....................................          499          591          636          587          590          567          620          652          681          709          773
Tennessee........................................            6            0            6            1            4            4            1            1            0        (\2\)        (\2\)
Texas \1\........................................            0            0            0            0            0            0            0            0            0        (\3\)        (\3\)
Utah.............................................          820          872          855        1,086          981          808          898          959          878          201           60
                                                                                                                                                                                                
Vermont..........................................        6,709        7,236        7,684        7,841        8,346        8,685        9,374       10,299        9,927        9,715       10,396
Virginia.........................................       11,267       12,164       12,846       14,432       15,949       15,296       16,863       16,782       17,317       17,752       19,156
Washington.......................................       20,022       17,443       19,424       18,058       18,994       19,915       21,558       24,043       26,808       28,374       28,516
West Virginia \1\................................            0            0            0            0            0            0            0            0            0        (\3\)        (\3\)
Wisconsin........................................       71,733       80,288       86,363       90,642       95,205      100,276      107,543      118,063      132,761      125,789      123,693
Wyoming..........................................          199          216          218          226          296          279          326          440          527          597          660
                                                  ----------------------------------------------------------------------------------------------------------------------------------------------
      Total......................................    2,234,846    2,496,275    2,835,516    3,006,796    3,308,277    3,589,348    3,750,812    3,987,110    3,862,151    3,719,314    3,735,250
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ Less than $500.                                                                                                                                                                             
\2\ Amount not shown; negative adjustment exceeds amount paid.                                                                                                                                  
\3\ Texas and West Virginia do not pay State supplementation.                                                                                                                                   
                                                                                                                                                                                                
Source: Office of Research and Statistics, Social Security Administration.                                                                                                                      


  TABLE 4-24.--FEDERAL AND STATE BENEFIT PAYMENTS UNDER SSI AND PRIOR ADULT ASSISTANCE PROGRAMS, CALENDAR YEARS 
                                     1970-87 AND FISCAL YEARS 1988-2002 \1\                                     
                                            [In millions of dollars]                                            
----------------------------------------------------------------------------------------------------------------
                                          Total                             State payments              SSI     
                                        constant   Federal    Total  ---------------------------- administrative
          Year \2\              Total     1995    payments    State     Federally       State      costs (fiscal
                                         dollars            payments  administered  administered       year)    
----------------------------------------------------------------------------------------------------------------
1970........................     2,939    11,779     1,801     1,138  ............  ............  ..............
1971........................     3,206    12,218     (\3\)     (\3\)  ............  ............  ..............
1972........................     3,392    12,479     1,993     1,398  ............  ............  ..............
1973........................     3,418    12,088     1,987     1,432  ............  ............  ..............
1974........................     5,246    17,034     3,833     1,413       1,264           149        \4\ 285   
                                                                                                                
1975........................     5,878    17,182     4,314     1,565       1,403           162            399   
1976........................     6,066    16,559     4,512     1,554       1,388           166            500   
1977........................     6,306    16,605     4,703     1,603       1,431           172             NA   
1978........................     6,552    15,535     4,881     1,671       1,491           180            539   
1979........................     7,075    15,205     5,279     1,796       1,590           207            610   
                                                                                                                
1980........................     7,941    15,026     5,866     2,074       1,848           226            668   
1981........................     8,593    14,636     6,518     2,076       1,839           237            718   
1982........................     8,981    14,246     6,907     2,074       1,798           276            779   
1983........................     9,404    14,411     7,423     1,981       1,711           270            830   
1984........................    10,372    15,267     8,281     2,091       1,792           299            864   
                                                                                                                
1985........................    11,060    15,701     8,777     2,283       1,973           311            953   
1986........................    12,081    16,740     9,498     2,583       2,243           340          1,022   
1987........................    12,951    17,446    10,029     2,922       2,563           359            976   
1988........................    14,375    18,598    11,368     3,007       2,645           362            975   
1989........................    14,707    18,163    11,399     3,308       2,881           427          1,051   
                                                                                                                
1990........................    16,095    18,933    12,507     3,589       3,159           431          1,075   
1991........................    17,979    20,133    14,228     3,751       3,235           516          1,257   
1992........................    21,258    23,109    17,270     3,987       3,431           556          1,538   
1993........................    24,173    25,504    20,312     3,862       3,298           564          1,467   
1994........................    28,288    29,082    24,461     3,827       3,219           608          1,781   
                                                                                                                
1995........................    28,124    28,124    24,443     3,681       3,060           621          1,978   
1996 \4\ \6\................    27,946    27,209    24,336     3,610       2,940           670          2,102   
1997 \4\ \5\................    31,991    30,215    28,151     3,840       3,125           715          2,123   
1998 \4\ \5\................    33,984    31,145    30,094     3,890       3,125           765          2,124   
1999 \4\ \5\................    35,847    31,906    31,912     3,935       3,125           810          2,124   
2000 \4\ \5\................    40,536    35,069    36,311     4,225       3,365           860          2,124   
2001 \4\ \5\................    36,784    30,922    32,999     3,785       2,880           905          2,124   
2002 \4\ \5\................    41,517    33,885    37,437     4,080       3,125           955          2,124   
----------------------------------------------------------------------------------------------------------------
\1\ Payments and adjustments during the respective year but not necessarily accrued for that year.              
\2\ 1970-73 refers to Old-Age Assistance, Aid to the Blind and Aid to the Permanently and Totally Disabled; 1974-
  2002 refers to Supplemental Security Income.                                                                  
\3\ Data not available.                                                                                         
\4\ Additional administrative costs are reflected for the SSI program share of the President's Disability       
  Investment in fiscal years 1994-2002 and for the Automation Investment in fiscal years 1994-98.               
\5\ Estimated. Federal outlays are projections based on the President's budget estimates of January 1996. State 
  outlays are rough estimates on an aggregate national basis.                                                   
\6\ Fiscal year 1995 adminstrative expenses included funds to pay back the OASI Trust Fund with interest for SSI
  administrative funding shortfalls in prior years.                                                             
                                                                                                                
Source: Office of Budget, Social Security Administration.                                                       

                          LEGISLATIVE HISTORY

              Legislative Changes Made in the 92d Congress

1972

    Public Law 92-603, the Social Security amendments of 1972, 
replaced existing Federal-State programs of assistance to the 
aged, blind, and disabled with a program fully financed and 
administered by the Federal Government, effective January 1, 
1974. The old Federal-State programs remained in effect for 
Guam, Puerto Rico, and the Virgin Islands, since these 
jurisdictions are not covered by the new SSI Program. The SSI 
Program used the same definitions of ``blindness'' and 
``disability'' as those used under the Old-Age Survivors and 
Disability Insurance (OASDI) Program and an individual had to 
be at least age 65 to be considered ``aged.''
    To be eligible for SSI benefits, aged, blind, and disabled 
persons could not have resources of more than $1,500 and a 
couple could not have resources of more than $2,250. In 
determining resources, a number of items generally are not 
counted, such as the individual's home, household goods, 
automobile and personal effects. In January 1974, an aged, 
blind, or disabled individual with no other income received an 
SSI benefit payment of $140 per month. An eligible couple with 
no other income received $210 per month. The SSI law required 
that the amount of SSI payable was to be reduced by other 
income available to recipients, but the reductions were not on 
a dollar-for-dollar basis. The first $20 of almost any kind of 
income was to be disregarded as well as the first $65 of earned 
income plus one half of any earnings above that $65. It also 
required that individuals who were living in another person's 
household and receiving in-kind support and maintenance from 
that person were to have their SSI benefit based on a one-third 
reduction of the Federal SSI benefit standard. Persons in a 
medical facility where the Medicaid Program was paying at least 
50 percent of the cost of the person's care received an SSI 
benefit based on a reduced Federal SSI benefit standard of $25 
in the case of an individual and $30 in the case of a couple 
(i.e., a personal needs allowance). The 1972 law included a 
provision that prohibited persons receiving SSI benefits from 
participating in the food stamp or surplus commodity 
distribution programs.
    To protect individuals who were eligible for payments under 
the Federal-State programs of old-age assistance (enacted in 
1935), aid to the blind (enacted in 1935), and aid to the 
permanently and totally disabled (enacted in 1950), but who 
would have been ineligible or eligible for a lesser payment 
under the SSI Program, the 1972 law contained several 
``grandfather clauses.'' Under the grandfather clause 
provisions (1) persons who received aid to the blind or aid to 
the disabled in December 1973 were considered blind or disabled 
under the SSI Program if they met the definitions of blindness 
or disability in effect in their States as of October 1972 and 
(2) persons who received assistance in December 1973 and 
December 1972 were considered able to meet the resource 
requirement as long as their resources did not exceed the 
resource limits of the State assistance plan in effect in 
October 1972.
    The 1972 law permitted States to supplement the Federal SSI 
benefit payment (without such payments being counted as income 
for the SSI Program). It also allowed States to have the 
Federal Government make the supplementary payment and absorb 
the administrative costs of doing so. Under the 1972 law, 
States were guaranteed that if they were required to pay more 
than they paid in calendar year 1972 in order to maintain pre-
SSI assistance levels, they would receive some financial relief 
under a fiscal savings provision, sometimes called the ``hold 
harmless'' clause. Under the fiscal saving provision, a State 
which elects to have the Federal Government administer its 
State supplementary payments (including required supplementary 
payments) is not required to contribute more toward the cost of 
these payments than the State's calendar year 1972 share of the 
cost of aid to the aged, blind, and disabled.
    The 1972 law required disabled and blind recipients to be 
referred to State agencies for vocational rehabilitation 
services. A recipient who refused without good cause any 
vocational rehabilitation services offered would no longer be 
eligible for SSI benefits. It also required that payments to 
persons classified as SSI drug addicts or alcoholics be made to 
a representative payee (i.e., person or agency responsible for 
managing the recipient's finances), that these recipients 
participate in drug treatment programs if available and 
appropriate, and that the treatment be monitored. In addition, 
the 1972 law provided States with several options, largely 
dependent on their previous coverage levels, for purposes of 
determining Medicaid eligibility for the aged, blind, and 
disabled.

              Legislative Changes Made in the 93d Congress

1973

    Public Law 93-66 increased the SSI payment levels from $130 
to $140 per month for an individual and from $195 to $210 per 
month for a couple, effective for July 1974.
    Public Law 93-66 required that States, in order to be 
eligible for Federal matching funds for Medicaid, provide 
additional payments to supplement the SSI payment of those who 
were receiving aid to the aged, blind, or disabled in December 
1973. These payments must be sufficient to assure that the 
individual continues to have as much total income (SSI payment 
plus other income) as he had in December 1973 (aid to the aged, 
blind, or disabled plus other income). This requirement applied 
only to those individuals who were actually on the assistance 
rolls in December 1973. Public Law 93-66 also provided that in 
cases where an essential person (a person whose needs were 
taken into account under a State plan as a person whose 
presence in the household was considered necessary to provide 
care and essential services for the public assistance 
recipient) was included in the State's assistance payment in 
December 1973, the SSI benefit would also include the essential 
person (i.e., the amount would be increased by $65 per month 
($70 per month effective July 1974)).
    Public Law 93-86 permitted SSI recipients to receive food 
stamp benefits only if the individual's SSI benefits were not 
equal to the total of the SSI payment (including any State 
supplement) plus the food stamp bonus that was available in 
December 1973.

1974

    Public Law 93-233, the Social Security Act amendments of 
1973, increased SSI payments to $140 per month for an 
individual and $210 per month for a couple effective January 1, 
1974. Effective July 1, 1974 these amounts were increased to 
$146 for an individual and to $219 for a couple. The l973 
Social Security Act amendments temporarily suspended the SSI-
food stamp provision of Public Law 93-86 (effective January-
June 1974). Thus, SSI recipients in all States except the 
States where food stamps were cashed out were eligible for food 
stamps if they met the income and resource requirements (Public 
Law 93-335 extended this provision for another 12 months--until 
July 1, 1975). Under the 1973 amendments, only persons who had 
received aid to the disabled before July 1973 and who were on 
the rolls in December 1973 would be grandfathered into the SSI 
Program. Moreover, the grandfather clause with respect to the 
resource limit was liberalized in that persons who met the 
State resource limits in October 1972 and who were on the rolls 
in December 1973 (in the same State) were eligible for SSI (as 
long as they were continuously eligible for SSI). Public Law 
93-233 permitted the adjustment of the grandfather clause in 
such a way that it assures the same level of total family 
income (rather than the individual's income) in cases where the 
SSI recipient lived with an AFDC family.
    Another provision of Public Law 93-233 stipulated that the 
Federal SSI payment would be reduced dollar-for-dollar for any 
State supplementary payment which was made for care provided to 
institutionalized individuals, if the care could be provided 
under the State's Medicaid Program.
    Public Law 93-368 provided for automatic increases in 
Federal SSI benefits at the same percentages as cost-of-living 
increases for Social Security recipients. It also contained a 
provision giving the Federal Government the authority to 
reimburse States for assistance provided to individuals who 
applied for, but had not yet received, SSI benefits.

             Legislative Changes Made in the 94th Congress

1976

    Public Law 94-585 established Federal SSI ``passthrough'' 
requirements, effective with the cost-of-living increase 
provided in July 1977. These provisions provide States with two 
options for meeting the passthrough requirements. One option is 
the aggregate spending level option, under which a State may 
make State supplementary payments in any current 12-month 
period that are no less, in the aggregate, than were made in 
the previous 12-month period. The other option is the 
individual payment level option, under which a State may 
maintain the supplementary payment levels that were in effect 
for categories of individual recipients in December 1976.

             Legislative Changes Made in the 96th Congress

1980

    Public Law 96-265, the Social Security Disability 
amendments of 1980, established a new section, 1619, which 
authorized a 3-year demonstration project (beginning January 1, 
1981) providing special cash benefits (equivalent to 
``regular'' SSI benefits) and continued Medicaid eligibility to 
persons who had been eligible for SSI disability payments, but 
had earned income in excess of the ``substantial gainful 
activity'' standard (this provision is later referred to as the 
section 1619 provision). Public Law 96-265 allowed wages 
received by an SSI recipient for working in a sheltered 
workshop to be eligible for the earned income disregard used in 
computing benefits. It permitted disabled SSI and SSDI 
recipients to deduct costs of items and services (e.g., 
prostheses, medical devices and equipment, attendant care 
services, etc.) needed to enable the recipient to work from 
income in determining whether the recipient is engaging in 
substantial gainful activity and in determining the recipient's 
SSI benefit amount. The 1980 amendments extended to 24 months, 
from 9 months, the ``trial work period'' during which a 
disabled person could return to work without losing the right 
to an immediate reinstatement of SSI and/or SSDI benefits if 
continued employment proved impossible.
    Public Law 96-265 eliminated the ``deeming'' of income and 
resources requirement for children aged 18-20, so that all 
deeming of income and resources from parents to children would 
end when the child reached age 18. It also stipulated that a 
portion of the income and resources of a sponsor of an alien/
immigrant be deemed to the alien for 3 years after entry 
(excludes refugees, political asylees, and those who become 
blind or disabled after entry into the United States).

             Legislative Changes Made in the 97th Congress

1981

    Public Law 97-35, the Omnibus Budget Reconciliation Act of 
1981, established a new period for determining SSI eligibility 
and benefit amount. Under the 1981 law, eligibility and benefit 
amount which were based on an individual's income, resources, 
and other relevant circumstances in a calendar quarter are now 
to be based on a month. The 1981 Act stipulated that States 
would be paid only for vocational rehabilitative services 
provided to persons who were to return to the performance of 
substance gainful activity for a continuous period of at least 
9 months. In addition, while the negotiability of SSI checks 
was not limited, the Secretary of the Treasury, on a monthly 
basis, was required to notify the Secretary of the Department 
of Health and Human Services of all benefit checks which were 
not cashed within 180 days of issuance. Moreover, the DHHS 
Secretary was required to return or credit amounts which 
represented State supplementary payments to the States. (Public 
Law 97-248 clarifies that State supplementary payments includes 
``State supplementation only checks.''

1982

    Public Law 97-248, the Tax Equity and Fiscal Responsibility 
Act of 1982, established a prorating procedure under which SSI 
benefit levels for recipients during their first month on the 
program would be determined according to the day of the month 
on which they applied or met the eligibility requirements, 
whichever date is later, provided that a recipient's SSI 
benefit be rounded down to the next lower dollar, required that 
SSI benefits be reduced in the first month in which a recipient 
received a cost-of-living increase in Social Security payments, 
excluded from countable resources, for eligibility purposes, 
burial spaces and burial funds of up to $1,500 each for the 
individual and spouse.
    It also authorized reductions in the hold harmless payment 
(payments to limit State's financial liability for 
supplementing Federal SSI benefits to maintain benefit levels 
of pre-SSI recipients at their January 1972 benefit levels), as 
follows: 40 percent of what it would have otherwise been in 
1983, to 20 percent in 1984, and no hold harmless payments in 
1985 and years thereafter.
    In addition, it allowed States to shift from the aggregate 
spending option (States which supplement Federal SSI benefits 
are required to pass through the Federal SSI cost-of-living 
increases by (1) maintaining the December 1976 State 
supplementation payment level for recipients or (2) providing 
no less than the total aggregate amount of State 
supplementation paid by the State in the previous 12-month 
period) to the State supplementation payment level option by 
maintaining the payment level in the previous December rather 
than December 1976.

             Legislative Changes Made in the 98th Congress

1983

    Public Law 98-21, the Social Security amendments of 1983, 
increased the Federal SSI benefit standard by $20 per month for 
an individual and by $30 per month for a couple, effective July 
1, 1983, and delayed the annual cost-of-living adjustments from 
January to July, beginning January 1984 (thus, SSI and OASDI 
cost-of-living adjustments would continue to occur at the same 
time). It provided that aged, blind, and disabled residents of 
public emergency shelters for the homeless could be eligible 
for SSI payments for as many as 3 months in a 12-month period. 
Under Public Law 98-21, in-kind support and maintenance 
provided by a private nonprofit organization was excluded from 
income by the SSI Program if it was determined that the 
assistance was based on need. The 1983 amendments also required 
the DHHS Secretary to provide, before July 1984, a one-time 
notice to all elderly OASDI recipients who were potentially 
eligible for SSI payments of the availability of SSI. Moreover, 
similar information on SSI availability was to be included with 
the standard notice to OASDI recipients of upcoming eligibility 
for Supplementary Medical Insurance at age 65.
    Public Law 98-21 modified Public Law 94-585 by substituting 
the State supplementary payment levels in effect in March 1983 
for those in effect in December 1976 as the levels that States 
must maintain in order to comply with the payment level 
passthrough requirement and with regard to the $20/$30 increase 
in the Federal SSI benefit standard in July 1983, by requiring 
States to pass through only as much as would have been required 
if the SSI cost-of-living adjustment had not changed from July 
1983 to January 1984.

1984

    Public Law 98-460, the Social Security Disability Benefits 
Reform Act of 1984, extended the section 1619 provision 
(continued SSI benefits and Medicaid coverage for persons 
working despite severe impairments) through June 30, 1987 (the 
demonstration was scheduled to end December 31, 1983). In 
addition, it required the Secretaries of the Department of 
Health and Human Services and the Department of Education to 
inform SSI applicants, recipients, and potentially interested 
public and private organizations of the Section 1619 program. 
It also permitted the DHHS Secretary to terminate OASDI or SSI 
benefits only if there was substantial evidence that an 
individual's medical condition had improved since the 
individual began receiving benefits and that the individual was 
able to work. Public Law 98-460 required that the combined 
effects of an individual's multiple impairments be weighed in 
making the disability determination. It continued the existing 
practice of rejecting as conclusive evidence of a disability an 
individual's claim that he or she was in pain, but required the 
Department of Health and Human Services to conduct a study on 
the role of pain in determining disability. It also continued 
the moratorium on reviews of mentally impaired recipients, 
which had been in place since June 7, 1983, until new standards 
were published in the Federal regulations.
    Public Law 98-460 required stricter rules for the 
appointing and monitoring of persons who receive OASDI or SSI 
payments on behalf of the eligible persons (representative 
payees--responsible for managing the recipient's finances). The 
penalties against misuse of OASDI or SSI funds by 
representative payees were raised.

             Legislative Changes Made in the 99th Congress

1986

    Public Law 99-643, the Employment Opportunities for 
Disabled Americans Act, made permanent and simplified the 
provisions of section 1619. (As mentioned earlier, the section 
1619 provisions seek to encourage disabled and blind recipients 
of SSI to work by providing special SSI payments and Medicaid 
coverage while they work.) It also authorized full SSI benefits 
for 2 months for persons in a public medical or psychiatric 
institution if they were eligible for section 1619 benefits or 
services in the month prior to their admission. Public Law 99-
643 provided that States shall not be required to follow the 
SSI rule that members of a couple sharing a room in a Medicaid 
institution be considered as two individuals if following the 
SSI rule would disadvantage either spouse in determining 
eligibility for any other program under the Social Security 
Act.

             Legislative Changes Made in the 100th Congress

1987

    Public Law 100-203, the Budget Reconciliation Act of 1987, 
permanently extended the provision that authorized in-kind 
support and maintenance (that was based on need) provided by a 
private nonprofit organization to be excluded from income by 
the SSI Program (the provision was to expire September 30, 
1987). Public Law 100-203 excluded real property from SSI 
eligibility calculations if the property could not be sold 
because it was jointly owned and the sale would cause a 
hardship to other owners, its sale was legally prevented, or 
reasonable efforts to sell it had been unsuccessful. It 
permitted the DHHS Secretary to waive the transfer of assets 
rule, which counted the value of assets sold at less than 
market value for 24 months after the transaction in computing 
benefit eligibility, if the absence of such a waiver would 
cause undue hardship.
    Public Law 100-203 extended to July 1, 1988, the period 
during which widows and widowers who would have lost 
eligibility for SSI because of the 1983 Social Security benefit 
increase for widows and widowers could apply for Medicaid as 
SSI recipients. It continued SSI eligibility for blind or 
disabled widows or widowers who were required to apply for 
Social Security benefits at age 60. It increased the amount of 
immediate emergency SSI payments from $100 to the Federal SSI 
benefit standard ($470 for an individual in 1996) plus, if any, 
the federally administered State supplementary payment. It 
permitted the Federal Government to reimburse States that paid 
SSI benefits to persons whose eligibility was terminated or 
suspended but who later were found to be eligible for SSI 
benefits. It continued full SSI benefits to persons in a 
Medicaid hospitals or in public institutions whose primary 
purpose is to provide medical or psychiatric care if a doctor 
certified that they were not likely to stay more than 3 months.
    Public Law 100-203 required that any interest on burial 
accounts must be disregarded in determining whether an 
individual met the SSI resource requirement. It required that 
AFDC payments be disregarded in determining SSI benefits 
(previously, under the SSI retrospective accounting period, 
AFDC benefits received in the month of SSI application were 
counted as income in determining SSI benefit for the first 2 
months of SSI receipt). It gives the States the option of 
treating a husband and wife who have been living in a Medicaid 
institution for 6 months as a couple, if doing so would prevent 
a reduction or termination of Medicaid benefits. It increased 
the ``personal needs'' allowance for SSI recipients in Medicaid 
facilities from $25 to $30 in the case of an individual and 
from $50 to $60 in the case of a couple. It continues SSI 
benefits to individuals whose blindness has ceased if they are 
participating in an approved vocational rehabilitation program 
(under the same conditions that apply to the disabled). It 
required SSA to inform blind SSI recipients about their 
benefits by telephone, certified letter, or some other process 
agreed to by the recipient.
    Public Law 100-203 provided that a person in an emergency 
shelter could receive SSI benefits for 6 months in a 9-month 
period. It authorized several types of demonstration projects 
designed to help homeless persons who could qualify for SSI 
benefits. It provided that, for the 2-year period beginning 
October 1, 1987, retroactive SSI and Social Security payments 
received during the period must be disregarded as resource for 
9 months. It required that death benefits and gifts and 
inheritances from a family member be disregarded from the 
determination of a person's SSI eligibility if the benefits 
were used to pay for the deceased person's last illness and 
burial.

             Legislative Changes Made in the 101st Congress

1989

    Public Law 101-239, the Omnibus Budget Reconciliation Act 
of 1989, (1) established a permanent outreach program for 
disabled and blind children, (2) continued eligibility for 
disabled children in a military family that moves overseas, (3) 
waived the SSI income and resource deeming rules in the case of 
severely disabled children who were eligible for SSI while in a 
medical institution and who qualify for Medicaid under a State 
home care plan, (4) disregarded domestic commercial 
transportation tickets given as gifts to SSI recipients (unless 
they are converted to cash), (5) required that a married couple 
be treated as separate individuals beginning with the first 
month following the month of separation, (6) excluded interest 
and other accruals on burial spaces in determining income and 
resources for the purpose of the SSI Program, (7) required that 
the value of property which is used in a person's trade or 
business, or in the employment of a family member, be excluded 
from the equity value of the person's property, and (8) 
authorized demonstration projects to test the use of volunteer 
senior aides to provide basic medical assistance and support to 
families with disabled or chronically ill children.

1990

    Public Law 101-508, the Omnibus Budget Reconciliation Act 
of 1990, included a provision that requires the Secretary of 
the Department of Health and Human Services to inform the 
family of a child who is awarded a retroactive payment as a 
result of the Sullivan v. Zebley Supreme Court decision that 
the family may be able to place the payment in a trust for the 
benefit of the child and that legal aid may be available for 
this. Public Law 101-508 also included a provision that 
requires the DHHS Secretary to make reasonable efforts to 
ensure that a qualified pediatrician or other specialist in a 
field of medicine appropriate to the disability of the child 
evaluate the child's disability for purposes of determining 
eligibility for SSI.
    The 1990 Omnibus Budget Reconciliation Act also liberalized 
the treatment of certain income by disregarding certain 
expenses and payments in determining SSI eligibility and/or 
benefits. Pursuant to the 1990 law, the SSA is to (1) exclude 
victim's compensation payments from income for purposes of SSI 
eligibility and benefits and exclude such payments from 
resources for the 9-month period beginning after the month of 
receipt, (2) treat royalties and honoraria as earned income 
rather than unearned income, and (3) exclude State or local 
relocation assistance from income and from resources for no 
more than 9 months (provision effective for 3 years).
    Public Law 101-508 included four provisions related to 
section 1619 of the Social Security Act. The first provision 
eliminates the age limit requirement for persons in the section 
1619(b) program. The second provision requires that impairment-
related work expenses be excluded from the earnings of a 
disabled individual in determining State supplementary payments 
and Federal SSI benefits. Previous law permitted only disabled 
persons who received Federal SSI benefits to deduct impairment-
related work expenses from income in determining SSI 
eligibility and reeligibility. The third provision authorizes 
reimbursement for vocational rehabilitation services provided 
in months for which individuals were eligible for Medicaid 
coverage under section 1619(b), were in suspended benefit 
status, \1\ or were receiving federally administered State 
supplementary payments. Under previous law, State vocational 
rehabilitation agencies already were reimbursed for the costs 
incurred by regular SSI recipients and section 1619(a) 
recipients. The fourth provision provides that continuing 
disability and blindness reviews are required only once every 
12 months for section 1619 recipients. Under previous law, a 
disabled or blind individual with income fluctuations was 
subject to several disability reviews in the course of a year.
---------------------------------------------------------------------------
    \1\ Disabled or blind persons are considered to be in ``suspended 
eligibility or benefit status'' if, within the last 12 months, they 
were recipients of regular SSI, section 1619(a) benefits or 1619(b) 
coverage.
---------------------------------------------------------------------------
    Public Law 101-508 also (1) required the Secretary of the 
Department of Health and Human Services and the Secretary of 
Agriculture to develop a procedure under which concurrent 
applications for the SSI and Food Stamp Programs are given to 
persons who are about to be released from an institution, and 
(2) extended the presumptive eligibility time period from 3 
months to 6 months.

             Legislative Changes Made in the 103d Congress

1993

    Public Law 103-66, the Omnibus Budget Reconciliation Act of 
1993, required the DHHS Secretary to charge States fees for the 
Federal cost of administering SSI supplementary payments. The 
fees started at $1.67 for each monthly supplementary payment in 
fiscal year 1994, increasing to $3.33 in fiscal year 1995, and 
to $5 in fiscal year 1996. The fee in subsequent years would be 
$5 or an amount determined by the DHHS Secretary. It 
permanently excluded from consideration as income or resources 
any State or local relocation assistance received by SSI 
recipients, prevented SSI benefits from declining when the 
spouse or parent of a recipient was absent from home solely 
because of active military service (certain hazardous duty pay 
was also excluded from income), and required that children who 
were U.S. citizens would remain eligible for SSI when they 
accompanied their parents on U.S. military assignments to 
Puerto Rico or to U.S. territories and possessions (previous 
law continued payments only if the parents were on military 
assignments in foreign countries).
    In addition, to eliminate the unintended SSI benefit 
increase for January and February following a cost-of-living 
adjustment and the offsetting reduction for March (i.e., the 2-
month retrospective benefit calculation rule), Public Law 103-
66 required that the benefit reduction for in-kind support and 
maintenance (generally one-third of the Federal SSI benefit 
standard plus $20 monthly) be based on the existing month's 
benefits. Public Law 103-66 also disregarded from income up to 
$2,000 received by American Indians that came from leases on 
individually owned trust or restricted American Indian lands 
(previously only income received by American Indians from 
tribally owned trust lands had been excluded as income).

1994

    Public Law 103-296, the Social Security Independence and 
Program Improvements Act of 1994, made numerous changes to the 
SSI Program. In addition to establishing SSA as an independent 
agency (with responsibility for both OASDI and SSI, it included 
the provisions discussed below.
    Restrictions on benefits based on disability of substance 
abusers.--Places restrictions on SSI disability insurance 
payments to individuals disabled by drug addiction and 
alcoholism (DAA) and establishes barriers against a 
beneficiary's using SSI benefits to support an addiction.
    Payment limitation.--Limits the payment of SSI benefits to 
36 months for individuals whose substance abuse is material to 
their disability, beginning with the first month for which 
treatment is available. This restriction sunsets October 1, 
2004. Medicare, Medicaid, and dependent's benefits will 
continue as long as the terminated beneficiary continues to be 
disabled and otherwise eligible (i.e., except for the 36-month 
limit). The payment limit will not apply to individuals who are 
disabled independent of the alcoholism or drug addiction at the 
close of the 36-month period.
    Suspension for noncompliance.--Provides for suspending 
benefits for noncompliance with treatment for substance 
abusers, beginning the month after SSA sends notification of 
noncompliance. Once benefits are suspended for noncompliance, 
they may be reinstated only after demonstrated compliance with 
treatment requirements for specified periods--a minimum of 2 
months, 3 months, and 6 months, respectively, for the first, 
second, third and additional instances of noncompliance. 
Suspension of benefits for 12 consecutive months will result in 
termination of benefits.
    Referral and monitoring.--Requires the establishment of 
referral and monitoring agency contracts in each State and 
issuance of regulations defining appropriate treatment for 
substance abusers.
    Retroactive benefits.--Requires gradual payment of 
retroactive disability benefits to substance abusers, except 
for beneficiaries who have outstanding debts related to housing 
and are at high risk of homelessness. Retroactive benefits due 
to an individual whose entitlement terminates will continue in 
prorated amounts until they are fully paid. In addition, if a 
beneficiary dies without having received all retroactive 
benefits, the unpaid amount becomes and underpayment.
    Representative payment.--Requires SSA to give preference to 
the appointment of social service agencies or to Federal, 
State, or local government agencies as representative payees 
for disability substance abusers, unless SSA determines that a 
family member would be a more appropriate payee.
    Permits organizations that serve as representative payees 
for substances abusers to retain, as compensation for their 
services, the lesser of 10 percent of the monthly benefit or 
$50, indexed to the CPI. Also indexes to the CPI the maximum 
payee service fee ($25) for other beneficiaries with a 
qualified organizational payee.
    Studies and reports.--Requires the following studies and 
reports:
    A study of (1) the feasibility, cost and equity of 
requiring representative payees for all disability 
beneficiaries who suffer from drug addiction or alcoholism, 
regardless of whether their addiction is material to their 
addiction; (2) the feasibility, cost and equity of providing 
noncash benefits; and (3) the extent of substance abuse among 
child recipients and their representative payees. A report on 
the studies is due by December 31, 1995.
    A report on the Secretary's activities relating to the 
monitoring and testing of disability beneficiaries. The report 
is due by December 1, 1996.
    Demonstration projects designed to explore innovative 
referral, monitoring, and treatment approaches with respect to 
disability beneficiaries who are subject to a treatment 
requirement. A report on these projects is due by December 31, 
1997.
    Continuing disability review (CDRs) for SSI recipients.--
Requires SSA, in each of the fiscal years 1996, 1997, and 1998, 
to perform CDRs for a minimum of 100,000 SSI recipients and 
one-third of all childhood SSI recipients who are between age 
18 and age 19. The latter provision applies to individuals who 
attain age 18 in or after the ninth month after enactment. 
Requires SSA to report its findings no later than October 1, 
1998.
    SSI eligibility for students temporarily abroad.--Allows 
individuals who leave the United States temporarily as part of 
an educational program that is not available in the United 
States, that is designed for gainful employment, and that is 
sponsored by a school in the United States to continue 
receiving SSI benefits for up to 1 year if they were eligible 
for SSI the month they left the country.
    Disregard of cost-of-living increases for continued 
eligibility for work incentives.--Continues Medicaid under 
section 1619(b) for an individual whose Social Security cost-
of-living increase otherwise would make them ineligible because 
of excess unearned income.
    Provisions to combat SSI Program fraud.--Strengthens 
present law in deterring fraud and abuse in the SSI Programs 
by:
 1. Requiring that third-party translators certify under oath 
        the accuracy of their translations, whether they are 
        acting as the applicant's legal representative, and 
        their relationship to the applicant.
 2. Authorizing civil penalties to be imposed against third 
        parties, medical professionals, and SSI recipients who 
        engage in fraudulent schemes to enroll ineligible 
        individuals in the SSI Program. In addition, medical 
        professionals may be barred from participation in 
        Medicare and Medicaid.
 3. Treating SSI fraud as a felony.
 4. Clarifying SSA's authority to reopen SSI cases where there 
        is reason to believe that an application or supporting 
        documents are fraudulent, and to terminate benefits 
        expeditiously in cases where SSA determines that there 
        is insufficient reliable evidence of disability.
 5. Requiring the Inspector General to immediately notify SSA 
        about SSI cases under investigation for fraud, and 
        requiring SSA to immediately reopen such cases where 
        there is reason to believe that an application or 
        supporting documents are fraudulent, unless the U.S. 
        Attorney or equivalent State prosecutor determines that 
        doing so would jeopardize criminal prosecution of the 
        parties involved.
 6. Requiring SSA to obtain and utilize, to the extent it is 
        useful, preadmission immigrant and refugee medical 
        information, identification information, and employment 
        history compiled by the Immigration and Naturalization 
        Service or the Centers for Disease Control when 
        developing SSI claims for aliens.
 7. Requiring SSA to submit an annual report to the House 
        Committee on Ways and Means and the Senate Committee on 
        Finance on the extent to which it has reviewed SSI 
        cases, including the extent to which the cases reviewed 
        involved a high likelihood of probability of fraud.
    Exemption from adjustment in pass along requirements.--
Allows states the option of exempting Zebley-related 
retroactive State supplementary payments from the annual 
supplementary payments expenditure amount that a State must 
maintain in the following year in order to meet the pass along 
requirement.
    Nursing home notification.--Requires nursing homes to 
notify SSA within 2 weeks after they admit SSI recipients.
    Public Law 103-432, the Social Security Act amendments of 
1994, replaced the words children under age 18 with individuals 
under age 18 with respect to the disability definition. The 
purpose of this provision was to enable all persons under age 
18 to be evaluated under the childhood disabilities criteria. 
Under previous law a person who was married or the head of a 
household was not considered a child for SSI purposes even 
though he or she was under age 18.

             Legislative Changes Made in the 104th Congress

1996

    Public Law 104-121, the Contract with America Advancement 
Act of 1996, among other things, prohibits disability insurance 
(DI) and Supplemental Security Income (SSI) eligibility to 
individuals whose drug addiction and/or alcoholism (DAA) is a 
contributing factor material to the finding of disability. This 
provision would apply to individuals who file for benefits on 
or after the date of enactment and to individuals whose claims 
are finally adjudicated on or after the date of enactment. This 
provision applies to current beneficiaries on January 1, 1997. 
It stipulates that SSI must: (1) notify current DAA 
beneficiaries of new provisions within 90 days of enactment; 
and (2) complete new medical determinations by January 1, 1997 
for affected current beneficiaries who request such a 
determination within 120 days after the date of enactment. 
Public Law 104-121 applies representative payee requirements to 
DI or SSI beneficiaries who have a DAA condition, as determined 
by the Commissioner, and who are incapable of managing 
benefits. SSA would refer these individuals to the appropriate 
State agency for treatment. The representative payee and 
referral for treatment provisions would apply to applications 
filed after the third month following the month of enactment. 
In addition, it retains the $50 fee that representatives can 
collect for beneficiaries who have a DAA condition. Public Law 
104-121 authorizes an appropriation of $50 million for each of 
fiscal years 1997 and 1998 to carry out on a priority basis 
activities relating to the treatment of drug and alcohol abuse 
under the Public Health Service Act.
    In addition, Public Law 104-121 authorizes additional funds 
to SSA for fiscal years 1996 through 2002 for the purpose of 
conducting Social Security disability insurance (DI) continuing 
disability reviews (CDRs) and Supplemental Security Income 
(SSI) CDRs and disability eligibility redeterminations. This 
would be accomplished by increasing the amount of funds 
available for appropriations under the discretionary spending 
cap. It directs the Commissioner of Social Security to ensure 
that the funds made available pursuant to this provision are 
used, to the greatest extent practicable, to maximize the 
combined savings to the old-age, survivors, and disability 
insurance (OASDI), SSI, Medicare, and Medicaid Programs. 
Moreover, it requires the Commissioner to report annually, for 
fiscal years 1996 through 2002, to Congress on the amount of 
money spent on CDRs, the number of reviews conducted (by 
category), the disposition of such reviews (by program), and 
the estimated savings over the short-, medium-, and long-term 
for OASDI, SSI, Medicare, and Medicaid Programs from CDRs which 
result in cessations, and the estimated present value of such 
savings.

                               REFERENCES

Louis W. Sullivan, Secretary of Health and Human Services, 
        petitioner, v. Brian Zebley, et al., No. 88-1377 (U.S. 
        filed February 20, 1990).
National Academy of Social Insurance. (1995). Restructuring the 
        SSI disability program for children and adolescents. 
        Washington, DC: Author.
Social Security Administration. (1995 and various years). 
        Annual statistical supplement to the Social Security 
        Bulletin, 1995 (SSA Pub. No. 13-11700). Washington, DC: 
        Author. [earlier years of this annual publication were 
        used in preparing various tables for this chapter.]
Social Security Administration. (1995, October). Supplemental 
        Security Income for Children with Disabilities (Report 
        to Congress of the National Commission on Childhood 
        Disability). Washington, DC: Author.
U.S. General Accounting Office. (1995, July). Supplemental 
        security income: Growth and changes in recipient 
        population call for reexamining program (GAO/HEHS 95-
        137). Washington, DC: Author.
U.S. House of Representatives, Committee on Ways and Means. 
        Social Security Amendments of 1971 (House Report No. 
        92-231). Washington, DC: U.S. Government Printing 
        Office.
U.S. Senate, Committee on Finance. Social Security Amendments 
        of 1972 (Senate Report No. 92-1230). Washington, DC: 
        U.S. Government Printing Office.