# Presentation: 771544

## Social Security and the Health of Aging Adults with Disabilities

## Basic Premise:

*Cash benefits, Medical benefits, and opportunity to work lead to improved health of an aging population*

## Health and Work – Over Age 65

## SSA’s Role:

*Provide income support via SS and SSI benefits*
*Establish entitlement to Medicaid and Medicare*
*Establish entitlement to Medicare Part D subsidies *
*Provide opportunity for people with disabilities to return to work*

## Aged Programs

*32,500,000 retirees & spouses*
*1,233,000 aged SSI beneficiaries*
*Decisions made quickly, with minimum burden to beneficiary *
*2000--Eliminated retirement test at full retirement age*

## Disability Programs 

*6,200,000 disabled workers*
*1,750,000 dependents*
*5,775,000 disabled SSI beneficiaries*
*Disability Increases with Age*

## Percent on DI Rolls, by Age

## Cause of Disability, by Age

## Disabled Worker Applications

## Commissioner’s Commitment on Disability

*Not satisfied with status quo*
*Committed to improve process and modernize program*

## Disability Process Improvements

*Electronic disability process*
*Reduced backlog of court cases *
*New Case Processing System for Hearings*
*Video conferencing for hearings*

## Commissioner’s Approach to Additional Improvements

*Pay obvious claims more quickly*
*Build quality control and accountability into process*
*Streamline decision steps*
*Modernize Program*

## Modernize Program:

*First step—Ticket to Work *
- designed to increase beneficiary choice in obtaining rehabilitation and vocational services
- Legislation passed 1999
- Fully implemented in 2004
- Benefits Planning, Assistance and Outreach
- Protection and Advocacy for Beneficiaries

## Modernize Program (cont.)

*Additional program Changes—Require 2 basic paradigm shifts:*
*Old view—if working, not disabled; If disabled, can’t  work *
*New view—with right support systems, people with disabilities can work*

## Modernize Program (cont.)

- Paradigm Shifts
*Old view—medical benefits are secondary to cash benefits*
*New view—medical benefits are instrumental in managing disabilities and removing work disincentives *

## Modernize Program (cont.)

- Barriers to work:
*Psychological impact of the disability process.*
*The physical impact of delayed access to health care*
*Lack of access to training and employment services*
*Premature loss of benefits*
*Loss of ongoing employment supports. *
*DI cash cliff and SSI asset limits*
*Job loss and difficulty of reinstatement *
*Work related overpayments*

## Slide 17

## SSA’s Demonstration Projects

*Test effects of new ideas*
*Aimed at removing barriers to work*
*Provide justification for future legislative changes*

## Demonstration Projects (cont)

- Accelerated Benefits
*Immediate medical benefits for 2 – 3 years*
*Support improved health and return to work*

## Demonstration Projects (cont)

- Ongoing Medical Benefits
*Provide health insurance to beneficiaries who want to work*
*Pilot will target beneficiaries with HIV/immune disorders*
*Will be conducted in selected counties in California*

## Demonstration Projects (cont)

- Interim Medical Benefits
*Provide medical benefits to individuals:*
- With no medical insurance, and
- Whose condition may improve

## Demonstration Projects (cont)

- Mental Health Treatment Study
*Test impact of interventions on health care and job seeking behavior*
*Provide health insurance package and/or:*
*Vocational rehabilitation*

## Slide 23

## Summary

*SSA is:*
- Providing income to almost 50 million people
- Establishing eligibility to Medicare, Medicaid, and Subsidy for Part D
- Improving the disability process
- Addressing work disincentives
- Exploring modernization of disability program
- More Information: _[www.ssa.gov/disabilityresearch](file:///D:/Winthrop/mspowerpnt/www.ssa.gov/disabilityresearch)_