HHS Study Finds SSI Payments Not Helping Drug Addicts and Alcoholics Receive Treatment
A Nov. 1994 report prepared by the Department of Health and Human Services (HHS) finds that a system to aid drug addicts and alcoholics to receive substance abuse treatment is seriously flawed (Department of Health and Human Services, Office of Inspector General, "SSI Payments to Drug Addicts and Alcoholics: Continued Dependence, Nov. 1994, OEI-09-94-00071).
The study looked at the 20,101 drug addicts and alcoholics (DA&As) receiving Supplemental Security Income (SSI) in June 1990 and matched social security numbers with database entries in Feb. 1994. For those 1990 entries without a corresponding record in 1994, SSI records were investigated to find the status of the 1990 recipients.
70 percent of those receiving payments in June 1990 were still receiving payments in Feb. 1994 due to alcoholism or drug addiction. Only one percent left the system because of medical or financial improvement. The most common reason for people to leave the SSI system was death. Over one half of those who left the system between June 1990 and Feb. 1994 did so because they died. Of the DA&As still receiving SSI funds in Feb. 1994, those people had been receiving funds an average of 7.4 years.
Overall, enrollment in the SSI program for DA&As quadrupled from 20,101 to 80,332 recipients between 1990 and 1994.
Public Law 92-603 allows SSI payments for drug addicts and alcoholics if those people have a representative payee (such as a mandated treatment program or a parent), participate in treatment, and (if possible) have their progress monitored, For all three conditions, HHS found the SSI payment system lacking.
The HHS report found that the database method for tracking the treatment program enrollment of SSI recipients was inadequate.
In this database field, more than half of the DA&A SSI recipients had missing information in 1990 that had not been corrected in 1994. Of the 9,033 records with missing treatment data in 1990, only 948 have since been updated.
Most importantly, only 8.9 percent of the DA&As receiving payments in Feb. 1994 met the treatment requirements of the program. For almost 84 percent, treatment status was coded as unknown or was not entered in the database.
The report finds that DA&As change their payees more often than other disabled recipients. 18 percent of DA&As versus 6 percent of other disabled recipients changed their payees or custody (living arrangements) between April 1993 and Feb. 1994.
Further, the coding system for representative payees does not provide adequate information for control. The SSI database allows for payee status to be entered as parent, other relative, organization, or "other." 36.6 percent of payees are coded as "other."
The Social Security Administration responded that they are reviewing the SSI DA&A system: "In addition to current treatment status, we may also need a historical, month-to-month record of both treatment availability and treatment compliance."
June 1990 Drug Addicts and Alcoholics:
Reasons for Non-payment, Suspension, or
Termination as of Feb. 1994 (page 6 of the report)
Recipient died 2417 (12.0%) Amount of other benefits* 852 (4.2%) Refused treatment 399 (2.0%) Recipient is in jail or another 370 (1.8%) public institution# Medical improvement or earnings 197 (1.0%) Other reasons 391 (1.9%) Terminated, reapplied in non-payment 204 (1.0%) statusTotal number of recipients: 20,101
* According to Linda Hall of the Inspector General's Office, a person is removed from the system if the "individual was receiving an amount of benefits, usually Social Security Title II benefits, that exceeded the amount permitted to remain eligible for the SSI benefits." Title II benefits are the "regular" social security payments made because of disability or age and based on the person's work and earnings history. Scott Patterson, one of the authors of the study, told NewsBriefs that individuals may be eligible for both SSI and Title II benefits because of a drug addiction or alcohol problem. The person may be no longer eligible for SSI payments because of increases in the amount of Title II benefits, usually due to the annual cost of living increase in Title II, aging, or other disability.
# [This number may be low. Some recipients may be incarcerated but their checks are being fraudulently cashed. Patterson said that there is some comparison of prison records to the SSI payment listing, but that some cases may exist. If this number is accurate, it is surprising. One would anticipate high percentages of alcoholics and drug addicts to be subject to prosecution. This population ought to be more extensively studied. Is it possible that providing SSI to addicts and alcoholics reduces their tendency to commit crime? -- EES]
[To receive a copy of this report, contact the Office of Inspector General, U.S. Department of Health and Human Services, 330 Independence Ave., S.W., Washington, D.C. 20201, 202-619-1142.]