SECTION 3. SUPPLEMENTAL SECURITY INCOME (SSI)

                                CONTENTS

Background
Trends
Basic Eligibility
  Categorical Requirements
  Citizenship and Residency Requirements
  Prohibition of Payment to Felons and Fugitives
  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 Medicaid
  Eligibility for Food Stamps
Self-Sufficiency and SSI
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 (and Social Security) 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 Noncitizens for SSI
Eligibility of the Homeless
Special SSI Provisions for the Working Disabled
  Earned Income Disregards
  Eliminating Work Disincentives
  Special Benefits for Certain World War II Veterans
Measures of SSI Participation and Growth
  SSI Participation Rates
  Changes in Number of Recipients, 1970-99
  SSI Program Costs
Legislative History
  104th Congress
  105th Congress
  106th 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
eligible persons 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'' (U.S. Senate, 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 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 dependency (U.S. House, 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 ways 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 SSA.

                                 TRENDS

    Table 3-1 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 nearly 6.6 million in December 1999.
        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 mideighties as
        rapid growth in disabled recipients outstripped the
        minimal change in the elderly and blind SSI
        populations. However, since 1996, there has been a
        slight decrease in the total number of SSI recipients.
 2. Total annual benefits paid under the SSI Program rose from
        about $5.2 billion in 1974 to $31.3 billion in 1999.
 3. The monthly Federal benefit rates for individuals and
        couples rose from $140 and $210 in 1974 to $512 and
        $769 in 2000 (2000 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).

                                                            TABLE 3-1.--SUPPLEMENTAL SECURITY INCOME SUMMARY, SELECTED YEARS 1974-99
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                            Year
                           Item                            -------------------------------------------------------------------------------------------------------------------------------------
                                                               1974       1978       1980       1984        1986        1988       1990       1992       1994       1996       1998       1999
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Recipients: \1\
    Aged..................................................  2,285,909  1,967,900  1,807,776   1,530,289   1,473,428  1,433,420  1,454,041  1,471,022  1,465,905  1,412,632  1,331,782  1,308,062
    Blind.................................................     74,616     77,135     78,401      80,524      83,115     82,864     83,686     85,400     84,911     82,137     80,243     79,291
    Disabled..............................................  1,635,539  2,171,890  2,255,840   2,418,522   2,712,641  2,947,585  3,279,400  4,009,767  4,744,470  5,118,949  5,154,044  5,169,281
                                                           -------------------------------------------------------------------------------------------------------------------------------------
      Total...............................................  3,996,064  4,216,925  4,142,017   4,029,333   4,269,184  4,463,869  4,817,127  5,566,189  6,295,786  6,613,718  6,566,069  6,566,634
                                                           =====================================================================================================================================
Number with section 1619(a)...............................         NA         NA         NA  406 (8/84)  992 (1/86)     19,920  \2\ 13,99     17,603     24,315     31,085     37,271     25,528
                                                                                                                                        4
Number with section 1619(b)...............................         NA         NA         NA       6,804       8,106     15,625     23,517     31,649     40,683     51,905     59,542     69,265
Annual payments (in millions):
    Federal benefits......................................     $3,833     $4,881     $5,866      $8,281      $9,498    $10,734    $12,894    $18,247    $22,175    $25,265     26,405     26,805
    Federally administered State supplementation..........      1,264      1,491      1,848       1,792       2,243      2,671      3,239      3,435      3,116      2,988      3,003      3,301
    State administered State supplementation..............        149        180        226         299         340        381        466    \3\ 556        579        539        808    \4\ 808
                                                           -------------------------------------------------------------------------------------------------------------------------------------
      Total...............................................     $5,246     $6,552     $7,940     $10,372     $12,081    $13,786    $16,599    $22,238    $25,870    $28,252     30,216     30,914
                                                           =====================================================================================================================================
Annual payments (in millions of 1999 dollars).............    $18,630    $16,969    $16,427     $16,682     $18,293    $19,501    $23,821    $26,414    $29,074    $30,824    $30,793    $32,153
Monthly Federal benefits:
    Individuals...........................................    $140.00    $177.80    $208.20     $314.00     $336.00    $354.00    $386.00    $422.00    $446.00    $470.00    $494.00    $500.00
    Couples...............................................     210.00     266.70     357.00      472.00      504.00     532.00     579.00     633.00     687.00     705.00     741.00     751.00
Average Federal SSI payments: \1\
    All recipients........................................     $95.11    $111.98    $143.35     $196.16     $215.40    $227.49    $261.47    $329.74    $325.26    $339.24     359.45     368.53
    Aged individuals......................................      78.48      91.22     112.45      143.24      151.38     159.36     175.29     195.86     211.55     227.42     271.66     282.37
    Aged couples..........................................      93.02     120.48     157.56      221.98      246.07     273.18     322.82     448.61     505.64     563.39     611.00     642.29
Average federally administered: \1\
    State supplementation.................................     $70.92     $75.00     $99.15      $97.61     $115.41    $122.68    $139.79    $118.08    $101.46    $104.58     102.33     110.92
Percent of recipients with other income: \1\
    Social Security benefits..............................       52.7       51.7       51.0        49.6        48.9       47.8       45.9       41.3       39.1       37.0       36.5       36.3
    Other unearned income.................................       10.5       11.5       11.0        11.2        12.1       12.4       13.0       14.5       13.1       12.4       11.7       11.7
    Earnings..............................................        2.8        3.1        3.2         3.5         3.9        4.4        4.7        4.4        4.2        4.4        4.5        4.5
Average amount of: \1\
    Social Security benefits..............................    $130.01    $156.50    $196.94     $250.61     $263.29    $286.49    $318.57    $335.72    $345.20    $382.56     374.60     383.82
    Other unearned income.................................      61.10      66.93      74.35       84.56       86.40      85.92      98.13      91.96     101.13     112.46     129.90     128.99
    Earnings..............................................      80.00      99.32     106.95      126.47      142.17     173.09     195.64     207.55     225.01     258.42     282.52     286.62
Poverty thresholds (age 65 and over):
    Individual............................................     $2,364     $3,127     $3,949      $4,979      $5,255     $5,674     $6,268     $6,729     $7,108     $7,525     $7,818     $7,990
    Couple................................................      2,982      3,944      4,983       6,282       6,630      7,158      7,905      8,489      8,967      9,491      9,862     10,070
Federal benefit as a percent of poverty:
    Individual............................................       74.1       72.7       72.3        75.6        76.7       74.9       73.9       75.3       75.3       75.0       75.8       75.0
    Couple................................................       88.1       86.4       86.0        90.2        91.2       89.2       87.9       89.5       89.5       89.1       90.2       89.3
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ December data. Includes Federal SSI and federally administered State supplements.
\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\ Estimated.

 NA--Not available.

 Source: Social Security Administration (1999 and various years) and unpublished data.

 4. The proportion of SSI recipients receiving Social Security
        benefits declined from nearly 53 percent in 1974 to 36
        percent in 1999. The fraction of SSI recipients
        receiving some other type of unearned income rose
        slightly from about 11 percent in 1974 to nearly 12
        percent in 1999, and the fraction with earnings
        increased slightly from less than 3 percent in 1974 to
        more than 4 percent in December 1999.
 5. The Federal benefit rate as a percent of the appropriate
        poverty level for individuals has ranged from 72 to 77
        percent and was 75 percent in 1999; for couples it has
        ranged from 86 to 91 percent and was 89 percent in
        1999. 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. Public
        Law 104-193 (enacted August 22, 1996) established a
        more restrictive disability definition for children
        which is expected to result in a slower rate of growth
        in the number of children receiving SSI benefits.

                           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
$700 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. Public Law 104-193, the Personal Responsibility
and Work Opportunity Reconciliation Act (PRWORA) of 1996,
established a new disability definition for children under age
18 which requires a child to have ``a medically determinable
physical or mental impairment which results in marked and
severe functional limitations, and which can be expected to
result in death or which has lasted or can be expected to last
for a continuous period of not less than 12 months.''
     Under pre-1996 law, low-income children could qualify for
SSI benefits in two ways: their disability could match one of
the impairments in the medical ``listing of impairments'' or
they could be evaluated under an individualized functional
assessment disability determination procedure (generally
considered a less stringent process) that determined whether an
unlisted impairment seriously limited a child's ability to
perform activities normal for his age. Both methods were
stipulated in Federal regulations. Until the Supreme Court's
1990 ruling in Sullivan v. Zebley, the medical listings were
the only way to determine a child's eligibility for SSI
benefits. Adults, in contrast, could receive an assessment of
their functional and vocational capacities even if they did not
meet one of the listings. The Court ruled that sole reliance on
the listings did not satisfy the law's requirement to gauge
whether children's disorders were of comparable severity to
impairments that would disable adults.
    The 1996 welfare reform law discontinued the individualized
functional assessment and the ``comparable severity'' standard
upon which it was based. Many children on the rolls as a result
of an individualized functional assessment will have their
benefits terminated, and future awards based on individualized
functional assessments will be barred. Thus, the SSI Program
for Children will be restricted to those who have impairments
that meet or equal at least one of the listings. Pursuant to
the 1996 law, the listing of impairments has been changed to
reflect the new disability definition for children.

                 Citizenship and Residency Requirements

     To qualify for SSI a person must be a citizen of the
United States or, if not a citizen, be a refugee or asylee who
has been in the country for less than 7 years, or be a
``qualified alien'' who was receiving SSI as of August 22, 1996
or who was living in the United States on August 22, 1996 and
subsequently became disabled. (For more detailed information on
eligibility requirements for noncitizens, see appendix J.)
    In addition to the citizenship requirement, a person must
be a resident of the United States or the Northern Mariana
Islands, or a child of a person in the military stationed
outside the United States, or a student temporarily abroad;
must apply for all other benefits to which she is entitled; and
must, if she is disabled, accept vocational rehabilitation
services if they are offered.

             Prohibition of Payment to Felons and Fugitives

    The 1996 welfare reform law provides that, as of August 22,
1996, SSI benefits may not be paid to individuals who are
fleeing to avoid prosecution for a felony crime, or fleeing to
avoid custody or confinement after conviction for a felony
crime, or violating a condition of probation or parole imposed
under Federal or State law.

                    Income and Resource Requirements

Income
    Individuals and couples are eligible for SSI if their
incomes fall below the Federal maximum monthly SSI benefit,
currently $512 for an individual and $769 for a couple
(calendar year 2000 standards). 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 procedure is
called ``deeming''). If a couple separates, each person is
treated as an individual in the month following the month of
separation. If an unmarried child living at home is under age
18, some of the parent's income is deemed to that child. If an
immigrant is sponsored into the United States, some of the
sponsor's and the sponsor's spouse's income may be 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.
Since 1972, the major exclusions have included the first $20 of
monthly income from virtually any source (such as Social
Security benefits), 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 the
earned income exclusion. Table 3-2 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 3-2.--MAXIMUM INCOME FOR ELIGIBILITY FOR FEDERAL SSI BENEFITS, 2000
----------------------------------------------------------------------------------------------------------------
                                                                   Receiving only Social    Receiving only wage
                                                                         Security                 income
                                                                 -----------------------------------------------
                                                                    Monthly    Annually     Monthly    Annually
----------------------------------------------------------------------------------------------------------------
Individual......................................................        $532      $6,384      $1,109     $13,308
Couple..........................................................         789       9,468       1,623     19,476
----------------------------------------------------------------------------------------------------------------
Source: Office of Research, Evaluation and Statistics, 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 him, 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-kind assistance received 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
also 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 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 are also excluded.
    The cash surrender value of life insurance policies if the
total face value of all policies 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.
    Individuals who give away or sell any nonexcludable
resource for less than fair market value are subject to
penalty. 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, and other
sources. In fiscal year 1987, computer matches between IRS tax
files and SSI records resulted in 239,000 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,
there were 508,000 matches. 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 year 1999 there
were 76,000 matches.
    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 there are 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 (PNAs) 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 PNA
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 2000 in a State with no supplementation,
here is how the deeming procedure would work in the case of an
ineligible spouse earning $600 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.....................       600.00
Less $65 earned income disregard...........................       -65.00
Less one-half of remaining earnings ($535).................      -267.50
                                                            ------------
      Countable earned income..............................       267.50
Plus countable unearned income.............................       180.00
                                                            ------------
      Couple's total countable income......................       447.50
                                                            ============
SSI payment standard for couples...........................       769.00
Less countable income......................................      -447.50
                                                            ------------
      Benefit payable to eligible individual...............       321.50
                                                            ============

    Thus, the benefit for the eligible individual will be $321
(SSI law requires that benefits be rounded down to the next
lower dollar). Without deeming and as an individual, the
recipient would have received $332 [$512 - ($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 1999, there were about 130,500 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. (For a discussion of
deeming rules for noncitizens, see appendix J.)

       Presumptive SSI Eligibility for Persons with AIDS and HIV

    Section 1631(a)(4)(B) of the Social Security Act provides
that the Commissioner of Social Security may pay up to 6 months
of Supplemental Security Income (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 a
finding of presumptive eligibility may be made for any
impairment category.
    On February 11, 1985, acquired immune deficiency 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, rather than only for those who
have been diagnosed with AIDS.
    The Social Security Administration (SSA) 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 Centers for Disease Control definition and the
somewhat broader SSA listing have failed to keep pace with
changing manifestations of HIV disease.

                     Public Institution Requirement

    Public institutions are prisons, hospitals, nursing homes,
or any institution that is operated or administered by a
governmental unit. The 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'') 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 she 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.
    Under Federal law, residents of public institutions for a
full calendar month generally are ineligible for SSI benefits.
Prisons are considered public institutions. The bar against SSI
benefits to prisoners has been enforced through an exchange of
computerized data between the Social Security Administration
and the Federal Bureau of Prisons, State prisons, and some
county prisons. According to the SSA's Office of the Inspector
General, these computerized arrangements generally covered
about three-quarters of inmates--all Federal and State
prisoners but only about 15 percent of county prisoners. The
agreements were voluntary and until recently involved no
payments to the institutions. However, the 1996 welfare reform
law (Public Law 104-193), required the Commissioner of Social
Security to enter into a contract with any interested State or
local institution (such as a prison, jail, or mental hospital)
under which the institution must provide to the Commissioner on
a monthly basis the names, Social Security numbers, dates of
birth, and such other identifying information concerning the
inmates or residents of the institution to help the
Commissioner enforce the ``prohibition of payments to residents
of public institutions'' rule. The Commissioner must pay the
institution up to $400 for each resident if the information is
provided to the Commissioner within 30 days after such
individual becomes a resident or up to $200 for each inmate if
the information is provided after 30 days but within 90 days of
the person becoming a resident.
     Between March 1, 1997 and August 2, 1999, SSA paid $19.2
million for 53,900 incentive payments.
     In 1999, Congress acted to further tighten restrictions on
the payment of Federal benefits to prisoners. Public Law 106-
169, signed into law on December 14, 1999, expands the SSI
Program's benefit suspension rules and incentive payments
regarding State and local prisoners to include individuals
receiving Old-Age, Survivors, and Disability Insurance (OASDI)
benefits. (Payments to prisons will be reduced by 50 percent
for multiple reports on individuals who receive both SSI and
OASDI benefits.)
     Public Law 106-169 also requires State prisons to provide
inmate information to Federal and federally assisted benefit
programs, including SSA. To help reduce fraudulent benefit
payments of food stamps, veterans benefits, unemployment
benefits, and educational aid, Public Law 106-169 directs SSA
to share its prisoner database with other Federal agencies and
departments.

               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

    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 1999,
36.3 percent of all SSI recipients also received Social
Security benefits (60 percent of the aged, 30 percent of the
disabled, and 35 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 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, 2000, 32
States and the District of Columbia chose this option, and SSI
recipients in these States account for approximately 79 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. Alaska, Idaho, Kansas,
Nebraska, Nevada, Oregon, and Utah and the Commonwealth of the
Northern Mariana Islands, affecting about 5 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
the State has a medically needy program. Currently 11 States
use the 209(b) option for Medicaid coverage of aged, blind, and
disabled SSI recipients. About 16 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, and 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 section below on ``Special SSI Provisions for the Working
Disabled'').
    The same legislation required States to provide continued
Medicaid coverage for those individuals who lose 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 was disabled as a child (disabled adult child)
or because of an increase in their benefits as an adult who was
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.

                      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.

                        SELF-SUFFICIENCY AND SSI

    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.
     In 1999, Congress expanded the Vocational Rehabilitation
Program. Public Law 106-170, signed into law on December 17,
1999, creates a Ticket to Work and Self-Sufficiency Program.
The purpose of the program is to help recipients leave the SSI
rolls through greater accessibility to a broader pool of
vocational rehabilitation providers than is currently available
to them.
     Under the new law, the Commissioner of Social Security
will provide tickets to work to disabled SSI beneficiaries that
they can use as vouchers to obtain employment services, case
management, vocational rehabilitation, and support services
from providers of their choice, including State vocational
rehabilitation agencies. The program will be implemented on a
graduated basis beginning within 1 year of enactment at sites
selected by the Commissioner and within 4 years of enactment in
every State. The program is permanently authorized.
     The elements of the ticket system include program
managers, employment networks, individual work plans, program
evaluations, and a Ticket to Work and Work Incentives Advisory
Panel composed of 12 members. The Commissioner is required to
contract with program managers (one or more public or private
organizations with expertise and experience in the field of
vocational rehabilitation or employment services) through a
competitive bidding process to help SSA administer the program.
Program managers will have to recruit and recommend employment
networks to the Commissioner, ensure that adequate choices of
services are available to beneficiaries, ensure beneficiary
access to services, and provide assurances to SSA that
employment networks are complying with agreement terms.
     The ticket to work law requires employment networks to
consist of a single public or private provider or an
association of providers combined into a single entity which
assumes responsibility for the coordination and delivery of
services. Employment networks are required to have experience
providing relevant employment services and support for
individuals with disabilities and will have to provide an array
of such services under the program. Employment networks and
beneficiaries will have to develop an individual employment
plan so that the beneficiary can exercise informed choice in
selecting an employment goal and specific services needed to
achieve that goal. Employment networks will prepare and provide
periodic performance reports to beneficiaries holding a ticket
and will have to provide periodic quality assurance reviews of
employment networks. The Commissioner is required to establish
a method for resolving disputes between beneficiaries and
employment networks. The ticket to work law also requires that
State vocational rehabilitation agencies and employment
networks enter into agreements regarding the conditions under
which services will be provided when an individual is referred
by an employment network to State vocational rehabilitation
agencies. The Commissioner is required to establish a timeframe
for these agreements and a dispute resolution method.
     Payment to employment networks are based on outcomes and
long-term results by providing one of two payment systems: an
outcome payment system or an outcome-milestone payment system.
Under the outcome payment system, employment networks are
provided with up to 40 percent of the average monthly
disability benefit for each month benefits are not payable to
the beneficiary due to work (but not for more than 60 months).
Under the outcome-milestone payment system, the employment
networks receive early payments based on the achievement of one
or more milestones toward permanent employment. The total
amount payable under the outcome-milestone payment system must
be less than the total amount that otherwise would have been
payable for an individual under the outcome payment system.
Regardless of which payment system is used, SSI beneficiaries
forgo SSI payments to participate in the ticket to work system,
and instead receive earnings from work. Providers use the
ticket, or voucher, to claim payment from SSA for services they
provide to beneficiaries. Providers are paid for each month in
which an SSI beneficiary is not receiving benefits because the
individual is working or has earnings. The Commissioner is
required to design and conduct a series of evaluations of the
payment system to assess the cost effectiveness and effects of
the program, in consultation with the Advisory Panel, and
report the findings to Congress.

                              SSI BENEFITS

                      Federal SSI Benefit Standard

    The Federal SSI benefit standard for 2000 is $512 a month
for an individual and $769 for a couple. As is discussed later,
most States supplement the Federal SSI benefit. The result is a
combined Federal SSI/State supplemental benefit standard
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.
    Like Social Security benefits, Federal SSI benefits are
indexed to the Consumer Price Index (CPI). Indexing 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 COLAs from July 1983 to January 1984. However, in lieu of a
COLA increase in the SSI benefit standard, the Federal SSI
benefit was increased in July 1983 by $20 a month for an
individual and $30 a month for a couple. Table 3-3 shows the
Federal SSI benefit from the beginning of the SSI Program until
the present time.

                                TABLE 3-3.--FEDERAL SSI BENEFIT LEVELS, 1974-2000
----------------------------------------------------------------------------------------------------------------
                                                                   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
Jan. 1997.............................       30.00     484.00    726.00    242.00    322.67    484.00    161.33
Jan. 1998.............................       30.00     494.00    741.00    247.00    329.34    494.00    164.67
Jan. 1999.............................       30.00     500.00    751.00    250.00    333.34    500.67    166.67
Jan. 2000.............................       30.00     512.00    769.00    256.00    341.34    512.67    170.67
----------------------------------------------------------------------------------------------------------------
\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, Evaluation and Statistics, Social Security Administration.

     In calendar year 1999, about 757,580 applicants were
awarded SSI benefits. Under previous law, new recipients
received a prorated SSI benefit for the month in which they
applied. For example, a person who applied on the 15th of the
month could receive 2 weeks of benefits for that month. (The
typical applicant did not get that money immediately because
SSA might take several months to process the application.) The
1996 welfare reform law changes the effective date of an SSI
application to the later of the first day of the month
following the date the application is filed or the date the
individual first becomes eligible for SSI benefits.

        Benefits for Persons Living in the Household of Another

    SSI law provides that if an 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 3-3, the
Federal SSI benefit in 2000 for those determined to be living
in the household of another is $341 for an individual and $513
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 December 1999 4.1 percent, or about 268,800 SSI
recipients, had their benefits determined on the basis of this
``one-third reduction'' benefit standard. Sixty-five percent of
those recipients were receiving benefits on the basis of
disability (see table 3-4).

  TABLE 3-4.--PERCENTAGE AND NUMBER OF PERSONS RECEIVING FEDERALLY ADMINISTERED PAYMENTS, BY LIVING ARRANGEMENT
                                           AND CATEGORY, DECEMBER 1999
----------------------------------------------------------------------------------------------------------------
                                                                                     Reason for eligibility
                      Living arrangement \1\                          Total   ----------------------------------
                                                                                  Aged      Blind      Disabled
----------------------------------------------------------------------------------------------------------------
Own household.....................................................       93.7       91.0       92.3         94.4
Another's household...............................................        4.1        7.0        5.1          3.4
Institutional care covered by Medicaid............................        2.2        2.0        2.6          2.2
                                                                   ---------------------------------------------
    Total percent.................................................      100.0      100.0      100.0        100.0
                                                                   =============================================
    Total number..................................................  6,556,634  1,308,062  \2\ 79,29  \3\ 5,169,2
                                                                                                  1          81
----------------------------------------------------------------------------------------------------------------
\1\ As defined for determination of Federal SSI payment standards.
\2\ Includes approximately 19,200 persons aged 65 or older.
\3\ Includes approximately 690,400 persons aged 65 or older.

 Source: Social Security Administration, Office of Research, Evaluation and Statistics, Division of SSI
  Statistics and Analysis.

         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 benefit, called a 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 1996 welfare reform law requires that
children (under age 18) residing in medical institutions who
have private medical insurance be eligible only for the $30 SSI
PNA, just like those with Medicaid coverage. 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
PNA. However, the 1987 Budget Reconciliation Act provides 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.
    Approximately 142,813 or 2.2 percent of SSI recipients
received benefits as of December 1999 on the basis of this
personal needs allowance. The average benefit was $21.80. 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 SSI recipients
(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.
These regulations are applicable to 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).
    Eighteen 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
1999, California, the District of Columbia, Massachusetts,
Michigan, New Jersey, New York, Rhode Island, and Vermont had
opted for Federal administration. Approximately 30 States allow
some or all of those individuals affected by the Medicaid PNA
regulations to retain more than $30 a month.

           Benefits of Former Recipients of State Assistance

    The essential person payment is a Federal benefit for an
individual who was transferred to SSI from a former State
Program of Aid to the Aged, Blind, or Disabled. As shown in
table 3-3, the Federal benefits of these persons are increased
by up to $250 monthly in 1999 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
for 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
limits on recovery by the Social Security Administration (SSA)
of overpayments made to SSI recipients. 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 (and Social Security) Payments

    Making initial payments faster for those who are
presumptively or proven eligible is a goal of the Supplemental
Security Income (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. Pursuant to the 1996 welfare reform
legislation, these emergency advance payments must be repaid
through proportionate reductions in SSI benefits over a period
of not more than 6 months. In fiscal year 1999, Social Security
offices made 6,510 emergency advance payments using their
third-party drafts in these new claims situations totaling
$3,137,417 with an average payment amount of $474.
    Beginning in October 1985, local Social Security offices
were given the authority to make ``immediate payments'' for
Social Security and SSI cases at management's discretion when
the local offices found that benefits were 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 third-party drafts issued
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 payment must be approved by office
management. During fiscal year 1999, 61,563 Social Security and
71,778 SSI immediate payments were issued under this procedure.
The total amount of these payments equalled $49,269,896 for an
average of $369 per payment.

                         State Supplementation

Mandatory State supplementation

    State supplementary payments are required by law to
maintain income levels of former State adult 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
transfer 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 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 1999, approximately 1,800 recipients or
less than 0.02 percent of all recipients were receiving
payments based in part or solely on 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 seven 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, and West Virginia. States (or local jurisdictions)
may elect to administer their supplementary payments themselves
or may contract with SSA for Federal administration. Fifteen
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.
    Section 1618 of the Social Security Act requires States
that have chosen to supplement the Federal SSI benefit to
continue to provide supplementation and to maintain the
supplementary payments (or spending for supplements) at
specified levels. The purpose of section 1618 is to require
States to pass along to SSI recipients the amount of any
Federal benefit increase. Some States had not done this before
the enactment of section 1618 on October 21, 1976 (Public Law
94-585). Instead, when Congress enacted cost-of-living
increases in the Federal SSI benefit amount, some States would
reduce the levels of the State supplementary payments by the
amount of the Federal benefit increase. Congress responded by
enacting the section 1618 pass-along/maintenance-of-effort
provision for State supplementary payments.
    Section 1618 allows States to comply with the pass along
requirement by either (1) maintaining their State supplementary
payment levels for specified types of living arrangements at or
above March 1983 levels (sometimes referred to as the payment
level method) or (2) maintaining their supplementary payment
spending so that total annual Federal and State expenditures
will be at least equal to what they were in the prior 12-month
period plus any Federal cost-of-living increase, provided the
State was in compliance for that period (sometimes referred to
as the total expenditures method). In effect, section 1618
requires that once a State elects to provide supplementary
payments, it must continue to do so.
    Under section 1618, a State that is found to be out of
compliance under the maintenance-of-effort rules is subject to
loss of its Federal Medicaid reimbursement. In California's
case, a further ``penalty'' would be levied for failure to meet
the pass along/maintenance-of-effort mandate. It would lose
permission to ``cash out'' food stamp benefits for SSI
recipients, and regular food stamp allotments would have to be
offered to them.

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
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 $512 a month in 2000, and often more than the
combined Federal and SSI State supplementation for those
classified as living independently. Thus, 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 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 of $512. Thus the maximum total Federal and
State SSI payment in a month in Maryland is $1,178. 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. Some States
make 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 PNA 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, the administration fee was $1.67 per payment.
The rate per payment rose 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.
    The Balanced Budget Act of 1997 (Public Law 105-33)
increased the fee charged by the SSA to administer a State's
supplementary SSI payments. The current fee is $7.80 per check.
It will be increased to $8.10 in fiscal year 2001, and $8.50 in
fiscal year 2002. Each succeeding year, fees would be indexed
to increases in the Consumer Price Index or set at a different
rate as determined by the Commissioner of Social Security.
Amounts of fees collected in excess of $5 per check would be
credited to a special Treasury fund available for Social
Security Administration administrative purposes. Such amounts
would be credited as a discretionary offset to discretionary
spending to the extent that they are made available for
expenditures in appropriation acts.
     Public Law 106-170 authorizes SSA to penalize States that
are late in paying their administrative fees. Specifically, SSA
may charge a State for whom it administers supplementary
payments a penalty equal to 5 percent of the supplementary
payment and administrative fees due if that State has not paid
SSA the administrative fees it owes. States must pay SSA on the
business day preceding the date that SSA pays monthly benefits,
or for the last month in a State's fiscal year, the fifth
business day following the date that SSA pays monthly benefits.

State SSI supplement levels over time

     Throughout the period from July 1975 to January 2000, 23
States have continuously provided supplemental SSI payments to
aged individuals living independently.
    During the period from July 1975 to January 2000, no State
increased supplements faster than inflation for aged
individuals living independently or aged couples living
independently (see tables 3-5 and 3-6).
    As of December 1999, there were 2,441,482 beneficiaries (37
percent) receiving 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 $1.70 a
month to $362 a month for an individual. At present, 25 States
supplement the Federal standard for individuals living
independently.

              TABLE 3-5.--STATE SSI SUPPLEMENTS FOR AGED INDIVIDUALS WITHOUT COUNTABLE INCOME LIVING INDEPENDENTLY, SELECTED YEARS 1975-99
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                                               Percent
                           State                              July   July   Jan.   Jan.   Jan.   Jan.   Jan.   Jan.   Jan.   Jan.    Jan.   change 1975-
                                                              1975   1980   1985   1988   1990   1992   1994   1996   1997   1998    1999      99 \1\
--------------------------------------------------------------------------------------------------------------------------------------------------------
Alaska \2\.................................................   $142   $235   $261   $305   $331   $362   $362   $362   $362    $362    $362           -20
California.................................................    101    182    179    221    244    223    157    156    156     156     176           -45
Colorado...................................................     27     55     58     58     54     56     56     56     62      39      36           -58
Connecticut \3\............................................     NA    102    141    403    366    325    301  \3\ N    243     253     247            NA
                                                                                                                  A
District of Columbia.......................................      0     15     15     15     15     15     15      5      0       0       0            NA

Hawaii.....................................................     17     15      5      5      5      5      5      5      5       5       5           -91
Idaho......................................................     63     74     78     73     73     70     45     37     48      48      48           -76
Illinois \3\...............................................     NA     NA     NA     NA     NA     NA     NA     NA     NA       0       0            NA
Maine......................................................     10     10     10     10     10     10     10     10     10      10      10           -69
Massachusetts..............................................    111    137    129    129    129    129    129    126    126     129     129           -64

Michigan...................................................     12     24     27     30     30     14     14     14     14      14      14           -64
Minnesota \4\..............................................     31     34     35     35     75     81     81     81     81      81      81           -18
Nebraska...................................................     67     75     69     43     38     30     21     12      8       8      27           -87
Nevada.....................................................     55     47     36     36     36     36     36     36     36      36      36           -79
New Hampshire..............................................     12     46     27     27     27     27     27     27     27      27      27           -30

New Jersey.................................................     24     23     31     31     31     31     31     31     31      31      31           -59
New York...................................................     61     63     61     72     86     86     86     86     86      86      87           -55
Oklahoma...................................................     27     79     60     64     64     64     57     54     53      53      53           -39
Oregon.....................................................     17     12      2      2      2      2      2      2      2       2       2           -97
Pennsylvania...............................................     20     32     32     32     32     32     32     27     27      27      27           -57

Rhode Island...............................................     31     42     54     58     64     67     64     64     64      64      64           -35
South Dakota...............................................      0     15     15     15     15     15     15     15     15      15      15            NA
Utah.......................................................      0     10     10      9      6      5      1      0      0       0       0            NA
Vermont....................................................     29     41     53     59     63     65     55     47     55      55      55           -41
Washington \5\.............................................     36     43     38     28     28     28     28     25     28       7      27           -77

Wisconsin..................................................     70    100    100    103    103     93     85     84     84      84      84           -63
Wyoming....................................................      0     20     20     20     20     20     10     10     10      10      10            NA
                                                            --------------------------------------------------------------------------------------------
  Median...................................................     31     43     36     36     37     32     31     31     36   31.25   31.25          -68
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ The percentage change in constant dollars was computed by inflating July 1975 to January 1999 by the Consumer Price Index for All Urban Consumers
  (CPI-U). The July 1975 index value is 51.8 and the January 1999 value is 165.5.
\2\ Through 1982 the State supplement was less if shelter costs were below $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 Congressional Research Service calculations.

                TABLE 3-6.--STATE SSI SUPPLEMENTS FOR AGED COUPLES WITHOUT COUNTABLE INCOME LIVING INDEPENDENTLY, SELECTED YEARS 1975-99
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                                               Percent
                            State                               July   July   Jan.   Jan.   Jan.   Jan.   Jan.   Jan.   Jan.   Jan.   Jan.  change 1975-
                                                                1975   1980   1985   1988   1990   1992   1994   1996   1997   1998   1999     99 \1\
--------------------------------------------------------------------------------------------------------------------------------------------------------
Alabama......................................................     $9      0      0      0      0      0      0      0      0      0      0          -100
Alaska \2\...................................................     43   $338   $371   $444   $484   $528   $528   $528   $528   $528   $528           -10
California...................................................    251    389    448    534    588    557    440    396    396    415    450           -44
Colorado.....................................................    133    229    278    292    309    323    323    323    346    345    321           -23
Connecticut \3\..............................................     NA     NA     86    602    525    461    425  \3\ N    368    353    343            NA
                                                                                                                    A

District of Columbia.........................................      0     30     30     30     30     30     30     15      0      0      0          -100
Hawaii.......................................................     28     24      9      9      9      9      9      9      9    8.8    8.8           -94
Idaho........................................................     49     80     46     44     45     45     21      9     16     17     17            NA
Illinois \3\.................................................     NA     NA     NA     NA     NA     NA     NA     NA     NA      0      0          -100
Maine........................................................     15     15     15     15     15     15     15     15     15     15     15           -97

Massachusetts................................................    173    214    202    202    202    202    202    197    197    202    202           251
Michigan.....................................................     18     36     40     45     45     21     21     28     28     28     28           -77
Minnesota \4\................................................     38     44     66     66     88    129    126    111    111    111    111           -48
Nebraska.....................................................     67    114    100     66     65     48     40     14      3     98     13           -96
Nevada.......................................................    106     90     74     74     74     74     74     74     74     74     74            NA

New Hampshire................................................      0     42     21     21     21     21     21     22     21     21     21           -49
New Jersey...................................................     13     12     25     25     25     25     25     25     25     25     25           -90
New York.....................................................     76     79     76     93    102    103    102    103    103    103    104           -40
Oklahoma.....................................................     54    158    120    128    128    128    114    108    106    106    106            95
Oregon.......................................................     17     10      0      0      0      0      0      0      0      0      0          -100

Pennsylvania.................................................     30     49     49     49     49     49     49     44     44     44     44           -77
Rhode Island.................................................     59     79    102    111    120    127    120    121    121    121    121            NA
South Dakota.................................................      0     15     15     15     15     15     15     15     15     15     15            NA
Utah.........................................................      0     20     20     18     12     11      5      5      5      5      5            NA
Vermont......................................................     61     76     96    106    115    118    103     92    103    103    103           -47

Washington \5\...............................................     40     44     37     22     22     22     22     20     22      0     21           -84
Wisconsin....................................................    105    161    161    166    166    146    134    132    132    132    132           -61
Wyoming......................................................      0     40     40     40     40     40     19     25     25     25     25            NA
                                                              ------------------------------------------------------------------------------------------
  Median.....................................................     57     63     66     66     65     49     39     28     44   43.7     28          -78
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ The percentage change in constant dollars was computed by inflating July 1975 to January 1999 by the CPI-U price index. The July 1975 index value is
  51.8 and the January 1999 value is 165.5.
\2\ Through 1982 the State supplement was less if shelter costs were below $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. State
  supplemental SSI payment for individual whose entitlement began January 1, 1994. State supplement for individuals whose entitlement began before
  January 1, 1994 is an additional $15 per month.
\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 Congressional Research Service calculations.

      Maximum SSI and Food Stamp Benefits For Individuals Living
                             Independently

    Table 3-7 for individuals and table 3-8 for couples
illustrate by State the maximum potential payment from Federal
SSI, State supplements, and food stamps for persons with no
income. Approximately 65 percent of SSI households in the Food
Stamp Program claim a shelter deduction for shelter expenses
exceeding roughly one-third of their monthly income. About 3
percent of SSI households claim a medical cost deduction for
out-of-pocket expenses over $35 per month.

  TABLE 3-7.--MAXIMUM POTENTIAL SSI AND FOOD STAMP BENEFITS FOR AGED INDIVIDUALS LIVING INDEPENDENTLY, JANUARY
                                                    2000 \1\
----------------------------------------------------------------------------------------------------------------
                                                                                               Combined benefits
                              State                                 Maximum SSI   Food stamp -------------------
                                                                      benefit    benefit \2\  Monthly    Annual
----------------------------------------------------------------------------------------------------------------
Alabama..........................................................          $512        $89       $600     $7,200
Alaska...........................................................           874        120        993     11,916
Arizona \3\......................................................           512         89        600      7,200
Arkansas.........................................................           512         89        600      7,200
California.......................................................           692      \4\ 0        726      8,712
Colorado.........................................................           548         78        625      7,500
Connecticut......................................................           747         18    \5\ 765      9,180
Delaware.........................................................           512         89        600      7,200
District of Columbia.............................................           512         89        600      7,200
Florida..........................................................           512         89        600      7,200
Georgia..........................................................           512         89        600      7,200
Hawaii...........................................................           517        159        676      8,112
Idaho............................................................       \6\ 565         73        637      7,644
Illinois.........................................................       \7\ 512         89        600      7,200
Indiana..........................................................           512         89        600      7,200
Iowa.............................................................           534         82        616      7,392
Kansas...........................................................           512         89        600      7,200
Kentucky.........................................................           512         89        600      7,200
Louisiana........................................................           512         89        600      7,200
Maine............................................................           522         86        607      7,284
Maryland.........................................................           512         89        600      7,200
Massachusetts....................................................           641         50        690      8,280
Michigan.........................................................           526         84        610      7,320
Minnesota........................................................       \8\ 593         64        657      7,884
Mississippi......................................................           512         89        600      7,200
Missouri.........................................................           512         89        600      7,200
Montana..........................................................           512         89        600      7,200
Nebraska.........................................................           519         87        605      7,260
Nevada...........................................................           548         78        626      7,512
New Hampshire....................................................           539         81        619      7,428
New Jersey.......................................................           543         79        622      7,464
New Mexico.......................................................           512         89        600      7,200
New York.........................................................           599         63        661      7,932
North Carolina...................................................           512         89        600      7,200
North Dakota.....................................................           512         89        600      7,200
Ohio.............................................................           512         89        600      7,200
Oklahoma.........................................................           565         73        637      7,644
Oregon...........................................................           514         88        601      7,212
Pennsylvania.....................................................           539         80        619      7,428
Rhode Island.....................................................           576         69        645      7,740
South Carolina...................................................           512         89        600      7,200
South Dakota \3\.................................................           527         84        611      7,332
Tennessee........................................................           512         89        600      7,200
Texas............................................................           512         89        600      7,200
Utah.............................................................           512         89        600      7,200
Vermont..........................................................       \9\ 570         71        640      7,680
Virginia.........................................................           512         89        600      7,200
Washington.......................................................      \10\ 539         81        619      7,428
West Virginia....................................................           512         89        600      7,200
Wisconsin........................................................           596         63        659      7,908
Wyoming..........................................................           522         86        607     7,284
----------------------------------------------------------------------------------------------------------------
\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 1999 through September 2000 are $127 in
  the 48 contiguous States and the District of Columbia, $158 in Alaska, and $199 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 deduction of $250 per month (the 1998 average
  deduction based on all claimed values for elderly individuals living alone). For Alaska and Hawaii, higher
  deduction levels were used, as provided by law ($663 and $546, respectively, for combined standard and excess
  shelter allowance).
\3\ January 2000 State supplemental payments unavailable. Calculations based on January 1999 payment rates.
\4\ SSI recipients in California are ineligible for food stamps. California provides increased cash aid in lieu
  of stamps.
\5\ Individual budget process.
\6\ State disregards $20 of SSI payment in determining the State supplementary payment.
\7\ State decides benefits on case-by-case basis.
\8\ Payment level for Hennepin County. State has two geographic payment levels--one for Hennepin County and the
  other for the remainder of the State.
\9\ State has two geographic payment levels--highest are shown in table.
\10\ Sum paid in King, Pierce, Kitsap, Snohomish, and Thurston Counties.

 Source: Table prepared by the Congressional Research Service based on data from the Social Security
  Administration.

         Comparison of SSI Payment Levels to Poverty Thresholds

    Table 3-9 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, 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
1999, benefit levels were 76.8 percent of the poverty level.

  TABLE 3-8.--MAXIMUM POTENTIAL SSI AND FOOD STAMP BENEFITS FOR AGED COUPLES LIVING INDEPENDENTLY, JANUARY 2000
                                                       \1\
----------------------------------------------------------------------------------------------------------------
                                                                                               Combined benefits
                              State                                 Maximum SSI   Food stamp -------------------
                                                                      benefit    benefit \2\  Monthly    Annual
----------------------------------------------------------------------------------------------------------------
Alabama..........................................................          $769       $126       $894    $10,728
Alaska...........................................................         1,297         23      1,320     15,840
Arizona \3\......................................................           769        126        894     10,728
Arkansas.........................................................           769        126        894     10,728
California.......................................................         1,229      \4\ 0      1,216     14,592
Colorado.........................................................         1,096         28      1,123     13,476
Connecticut......................................................     \5\ 1,094         28      1,122     13,464
Delaware.........................................................           769        126        894     10,728
District of Columbia.............................................           769        126        894     10,728
Florida..........................................................           769        126        894     10,728
Georgia..........................................................           769        126        894     10,728
Hawaii...........................................................           778        254      1,031     12,372
Idaho............................................................       \6\ 788        120        908     10,896
Illinois.........................................................       \7\ 769        126        894     10,728
Indiana..........................................................           769        126        894     10,728
Iowa.............................................................           813        113        925     11,100
Kansas...........................................................           769        126        894     10,728
Kentucky.........................................................           769        126        894     10,728
Louisiana........................................................           769        126        894     10,728
Maine............................................................           784        121        905     10,860
Maryland.........................................................           769        126        894     10,728
Massachusetts....................................................           971         65      1,035     12,420
Michigan.........................................................           797        117        914     10,968
Minnesota \8\....................................................       \9\ 880         92        972     11,664
Mississippi......................................................           769        126        894     10,728
Missouri.........................................................           769        126        894     10,728
Montana..........................................................           769        126        894     10,728
Nebraska.........................................................           769        126        894     10,728
Nevada...........................................................           843        103        946     11,352
New Hampshire....................................................           790        119        909     10,908
New Jersey.......................................................           794        118        912     10,944
New Mexico.......................................................           769        126        894     10,728
New York.........................................................           873         95        967     11,604
North Carolina...................................................           769        126        894     10,728
North Dakota.....................................................           769        126        894     10,728
Ohio.............................................................           769        126        894     10,728
Oklahoma.........................................................           875         94        968     11,616
Oregon...........................................................           769        126        894     10,728
Pennsylvania.....................................................           813        113        925     11,100
Rhode Island.....................................................           890         90        979     11,748
South Carolina...................................................           769        126        894     10,728
South Dakota \3\.................................................           784        121        905     10,860
Tennessee........................................................           769        126        894     10,728
Texas............................................................           769        126        894     10,728
Utah.............................................................           774        124        897     10,764
Vermont..........................................................      \10\ 877         93        970     11,640
Virginia.........................................................           769        126        894     10,728
Washington.......................................................      \11\ 790        120        909     10,908
Wisconsin........................................................           769        126        894     10,728
Wyoming..........................................................           644        163        807      9,684
West Virginia....................................................           794        118        912    10,944
----------------------------------------------------------------------------------------------------------------
\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 1999 through September 2000 are $234 in
  the 48 contiguous States and the District of Columbia, $290 in Alaska, and $365 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 deduction of $274 per month (the 1998 average
  deduction based on all claimed values for elderly individuals not living alone). For Alaska and Hawaii, higher
  deduction levels were used, as provided by law ($663 and $546, respectively, for combined standard and excess
  shelter allowance).
\3\ January 2000 State supplemental payments unavailable. Calculations based on January 1999 payment rates.
\4\ SSI recipients in California are ineligible for food stamps. California provides increased cash aid in lieu
  of stamps.
\5\ Individual budget process.
\6\ State disregards $20 monthly of SSI income in determining the State supplementary payment amounts.
\7\ State decides benefits on case-by-case basis.
\8\ State supplemental SSI payment for individual whose entitlement began January 1, 1994. State supplement for
  individuals whose entitlement began before January 1, 1994 is an additional $15 per month.
\9\ Payment level for Hennepin County. State has two geographic payment levels--one for Hennepin County and one
  for the remainder of the State.
\10\ State has two geographic payment levels--highest levels are shown in table.
\11\ Sum paid in King, Pierce, Kitsap, Snohomish, and Thurston Counties.

 Source: Table prepared by the Congressional Research Service based on data from the Social Security
  Administration.

    Table 3-10 presents the same information for a couple. The
Supplemental Security Income (SSI) benefit for a couple is 91.6
percent of the poverty threshold in 1999.

                       TRENDS IN THE SSI CASELOAD

                          Number of Recipients

    As shown in table 3-11, in December 1999, nearly 6.6
million persons received federally administered SSI payments.
Of these, 1.3 million received federally administered payments
on the basis of being aged, 5.2 million on the basis of being
disabled, and 79,000 on the basis of blindness. However,
709,600 of those receiving benefits on the basis of disability
or blindness were over the age of 65. Table 3-11 also indicates
that approximately 4.1 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 282,000 received State supplements only.

   TABLE 3-9.--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 1975-99
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                 Calendar year
            Poverty threshold and benefits            --------------------------------------------------------------------------------------------------
                                                         1975     1980     1984     1986     1988     1990     1992     1994     1996     1998     1999
--------------------------------------------------------------------------------------------------------------------------------------------------------
Poverty threshold....................................   $2,572   $3,941   $4,980   $5,255   $5,672   $6,268   $6,729   $7,107   $7,309   $7,818   $7,990
Federal SSI benefits:
    Dollars per year.................................   $1,822   $2,677   $3,768   $4,032   $4,248   $4,632   $5,064   $5,352   $5,640   $5,928   $6,000
    Percent of poverty...............................     70.8     72.3     75.6     76.7     74.9     73.9     75.3     75.3     77.2     75.8     75.0
Federal SSI and Social Security:
    Dollars per year.................................   $2,062   $2,917   $4,008   $4,272   $4,488   $4,872   $5,304   $5,592   $5,880   $6,168   $6,240
    Percent of poverty...............................     80.2     74.0     80.5     81.3     79.1     77.7     78.8     78.7     80.4     78.8     78.0
Federal SSI, Social Security, and food stamps: \1\
    Dollars per year.................................   $2,350   $3,345   $4,294   $4,488   $4,848   $5,318   $5,820   $6,072   $6,372   $6,672   $6,792
    Percent of poverty...............................     91.4     84.9     86.2     85.4     85.5     84.8     86.5     85.4     87.2     85.3     85.0
--------------------------------------------------------------------------------------------------------------------------------------------------------
\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 among all elderly households is assumed. For 1999 the food stamp benefit calculation is based on the 1998
  average elderly individual deduction, the most current available. For 1996 the applicable standard deduction plus average shelter and medical
  deductions among all SSI households is assumed.

 Source: Congressional Research Service.

     TABLE 3-10.--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 1975-99
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                Calendar year
           Poverty threshold and benefits           ----------------------------------------------------------------------------------------------------
                                                       1975     1980     1984     1986     1988     1990     1992     1994     1996     1998      1999
--------------------------------------------------------------------------------------------------------------------------------------------------------
Poverty threshold..................................   $3,232   $4,954   $6,280   $6,628   $7,156   $7,906   $8,489   $8,964   $9,221    $9,862   $10,070
Federal SSI benefits:
    Dollars per year...............................   $2,734   $4,016   $5,664   $6,048   $6,384   $6,948   $7,596   $8,028   $8,460    $8,892    $9,000
    Percent of poverty.............................     84.6     81.1     90.2     91.2     89.2     87.9     89.5     89.6     91.7      90.1      89.3
Federal SSI and Social Security:
    Dollars per year...............................   $2,974   $4,256   $5,904   $6,288   $6,624   $7,188   $7,836   $8,268   $8,700    $9,132    $9,240
    Percent of poverty.............................     92.0     86.0     94.0     94.9     92.6     90.9     92.3     92.2     94.3      92.5      91.7
Federal SSI, Social Security, and food stamps: \1\
    Dollars per year...............................   $3,430   $4,906   $6,393   $6,696   $7,200   $7,935   $8,700   $9,084   $9,540   $10,056   $10,260
    Percent of poverty.............................    106.1     99.0    101.8    101.0    100.6    100.4    102.5    101.3    103.5     101.9     101.8
--------------------------------------------------------------------------------------------------------------------------------------------------------
\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 1999, the food stamp benefit
  calculation is based on the 1998 average elderly couple deduction, the most current available. For 1996 the applicable standard deduction plus average
  shelter and medical deductions among all SSI households is assumed.

 Source: Congressional Research Service.

   TABLE 3-11.--NUMBER OF PERSONS RECEIVING FEDERALLY ADMINISTERED PAYMENTS, TOTAL AMOUNT AND AVERAGE MONTHLY
                            AMOUNT, BY SOURCE OF PAYMENT AND CATEGORY, DECEMBER 1999
----------------------------------------------------------------------------------------------------------------
                        Source of payment                            Total       Aged    Blind \1\  Disabled \1\
----------------------------------------------------------------------------------------------------------------
                                                                                 Number of persons

                                                                 -----------------------------------------------
Federally administered payments.................................   6,556,634  1,308,062     79,291     5,169,281
    Federal payment only........................................   4,115,152    687,801     43,173     3,384,178
    Both Federal and State supplementation......................   2,159,555    515,255     30,406     1,613,894
    State supplementation only..................................     281,927    105,006      5,712       171,209
                                                                 -----------------------------------------------
      Total Federal payment.....................................   6,274,707  1,203,056     73,579     4,998,072
      Total State supplementation...............................   2,441,482    620,261     36,118     1,785,103

                                                                 -----------------------------------------------
                                                                       Amount of payments [in thousands] \2\

                                                                 -----------------------------------------------
Federal payments................................................  $2,290,591   $304,775    $26,347    $1,959,469
State supplementation...........................................     283,428     79,579      6,246       197,603
                                                                 -----------------------------------------------
      Total.....................................................   2,574,019    384,135     32,593     2,157,072

                                                                -----------------------------------------------
                                                                              Average monthly amount

                                                                 -----------------------------------------------
Federal payments................................................      341.86     249.36     350.72        364.24
State supplementation...........................................      110.92     125.90     167.64        104.52
                                                                 -----------------------------------------------
      Total.....................................................      368.53     289.19     401.99       388.29
----------------------------------------------------------------------------------------------------------------
\1\ Blind includes approximately 19,200 and disabled 690,400 persons aged 65 and older.
\2\ Includes retroactive payments.

 Source: Social Security Administration, Office of Research, Evaluation and Statistics, Division of SSI
  Statistics and Analysis.

    Table 3-12 shows the trends in the numbers of persons
receiving federally administered SSI payments from December
1975 through December 1999, 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 16
years the number of SSI recipients has increased from about 3.9
million to about 6.6 million, an increase of 69 percent.

         Characteristics of Adult Disabled and Blind Recipients

    Major disabling diagnosis.--As shown in table 3-13, of the
SSI disabled ages 18-64, 24.5 percent were eligible on the
basis of mental retardation and 33.9 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 musculoskeletal system and connective tissues--9.6 percent;
diseases of the nervous system and sense

                TABLE 3-12.--NUMBER OF PERSONS RECEIVING FEDERALLY ADMINISTERED SSI PAYMENTS BY CATEGORY AND AGE, SELECTED YEARS 1975-99
                                                                     [In thousands]
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                               Year
                                         ---------------------------------------------------------------------------------------------------------------
     Reason for eligibility and age        Dec.    Sept.   Sept.   Sept.   Sept.   Sept.   Sept.   Sept.   Sept.   Sept.   Sept.   Sept.   Dec.    Dec.
                                           1975    1983    1986    1988    1989    1990    1991    1992    1993    1994    1995    1996    1998    1999
--------------------------------------------------------------------------------------------------------------------------------------------------------
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   1,429   1,332   1,308
  Blind.................................      74      79      83      83      83      84      85      86      86      85      85      83      73      79
    Under 18............................       3       6       7       7       7       7       7       8       8       8       8       8       7       7
    18-21...............................       4       5       5       4       4       4       4       4       4       4       4       4       4       3
    22-64...............................      46      45      48      49      49      50      51      52      52      52      52      51      50      46
    65 or older.........................      22      23      23      22      22      22      22      22      22      21      21      20      19      23
  Disabled..............................   1,933   2,292   2,673   2,917   3,048   3,229   3,502   3,921   4,348   4,692   4,956   5,124   5,154   5,169
    Under 18............................     104     191     231     247     256     287     366     511     683     812     898     950     880     890
    18-21...............................      90     122     138     136     139     143     150     167     186     202     219     232     235     164
    22-64...............................   1,559   1,517   1,787   1,987   2,091   2,218   2,393   2,637   2,864   3,049   3,193   3,285   3,359   3,312
    65 or older.........................     179     462     517     548     563     579     592     606     615     629     646     656     684     853
Age:
  Under 18..............................     107     197     238     254     263     294     373     518     691     820     906     958     887     847
  18-21.................................      93     127     143     140     143     147     154     171     190     206     223     236     236     164
  22-64.................................   1,605   1,562   1,835   2,036   2,140   2,269   2,445   2,690   2,917   3,101   3,245   3,337   3,409   3,377
  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   2,105   2,035   2,018
                                         ---------------------------------------------------------------------------------------------------------------
    Total...............................   4,314   3,898   4,232   4,434   4,570   4,764   5,050   5,486   5,908   6,247   6,495   6,636   6,566   6,556
--------------------------------------------------------------------------------------------------------------------------------------------------------
Source: Office of Research, Evaluation and Statistics, Social Security Administration.

  TABLE 3-13.--DISABILITY DIAGNOSIS OF SSI AND SECTION 1619 DISABILITY
                      RECIPIENTS, DECEMBER 1999 \1\
              [Percentage distribution by diagnostic group]
------------------------------------------------------------------------
                                    Supplemental Security Income (SSI)
                                ----------------------------------------
        Diagnostic group           All SSI     SSI section   SSI section
                                 disabled 18-    1619(a)       1619(b)
                                   64 yrs.    participants  participants
------------------------------------------------------------------------
Infectious and parasitic                 2.2           1.6           2.6
 diseases......................
Neoplasms......................          1.3           1.0           1.3
Endocrine, nutritional, and              5.6           2.4           2.8
 metabolic disorders...........
Mental disorders:
    Schizophrenia..............         10.9           9.7          11.5
    Other psychiatric..........         23.0          20.8          21.5
    Mental retardation.........         24.5          43.7          37.2
Diseases of:
     Nervous system and sense            8.3          12.0          12.3
     organs \2\................
    Circulatory system.........          5.7           1.7           2.0
     Respiratory system........          2.5           1.1           1.0
    Digestive system...........          0.9           0.4           0.5
     Genito-urinary system.....          1.2           1.2           1.5
    Musculoskeletal system and           9.6           3.5           4.9
     connective tissues........
Congenital anomalies...........          0.4           0.8           0.8
Injury and poisoning...........          2.9           2.2           2.9
Other..........................          0.9           1.2           1.1
                                ----------------------------------------
      Total percent \2\........        100.0         100.0         100.0
                                ========================================
      Total individuals \3\....    3,690,970        25,202       67,150
------------------------------------------------------------------------
\1\ Information on diagnosis of all SSI disabled recipients is based on
  universe counts for December 1999. Information on diagnosis for
  section 1619 participants 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
  who are classified as disabled.

 Source: Office of Supplemental Security Income, Social Security
  Administration.

organs--8.3 percent; and diseases of the circulatory system--
5.7 percent.
    In December 1999, 1.3 million or 29.8 percent of the adult
disabled or blind receiving SSI benefits had a representative
payee. Representative payees are individuals, agencies, or
institutions selected by the Social Security Administration
(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 3-14, 19.7 percent of the SSI adult population receiving
benefits on the basis of disability are age 65 or older (32.1
percent of the blind were age 65 or older).
    Sex.--In December 1999, 55.5 percent of those receiving SSI
benefits on the basis of disability were women.
    Race.--In January 1997, the most recent available data
showed that 52.4 percent of those receiving SSI on the basis of
disability were white; 30.9 percent were black; 12.7 percent
were other races; and in 4 percent of the cases, race was not
reported.
    Other income.--In December 1999, 30.4 percent of the
disabled and 34.8 percent of the blind received Social Security
benefits. Table 3-15 shows the number of SSI recipients with
other sources of income, both unearned and earned.

    TABLE 3-14.--NUMBER AND PERCENTAGE DISTRIBUTION OF SSI RECIPIENTS
  RECEIVING FEDERALLY ADMINISTERED PAYMENTS BY CATEGORY AND AGE GROUP,
                              DECEMBER 1999
------------------------------------------------------------------------
          Age group             Total       Aged      Blind     Disabled
------------------------------------------------------------------------
Under 5.....................        1.4  .........  .........  .........
5-9.........................        2.2  .........  .........  .........
10-14.......................        2.8  .........  .........  .........
15-17.......................        1.6  .........  .........  .........
18-21.......................        2.5  .........        4.6        3.8
22-29.......................        5.7  .........        9.3        8.5
30-39.......................       10.2  .........       13.2       15.1
40-49.......................       13.5  .........       15.9       20.0
50-59.......................       14.7  .........       16.4       21.9
60-64.......................        7.4  .........        8.6       11.0
65-69.......................        9.1       14.6        8.4        8.2
70-74.......................        9.4       23.9        8.0        5.3
75-79.......................        8.1       24.3        5.9        3.1
80 or older.................       11.2       37.2        9.8        3.1
                             -------------------------------------------
      Total percent.........      100.0      100.0      100.0      100.0
                             ===========================================
      Total number..........  6,556,634  1,308,062     72,500  4,328,810

------------------------------------------------------------------------
Source: Social Security Administration, Office of Research, Evaluation
  and Statistics, Division of SSI Statistics and Analysis.

  Characteristics of Recipients Receiving Benefits on the Basis of Age

    Age.--In December 1999, of SSI recipients receiving
benefits on the basis of age (65 or older), 37.2 percent were
80 years of age or older (table 3-14).
    Sex.--In January 1997, 72.9 percent of those receiving
benefits on the basis of age were women.
    Race.--In January 1997, 48.6 percent of those receiving SSI
on the basis of age were white; 20.5 percent were black; 27.4
percent were other races; and in 3.5 percent of the cases, race
was not reported.
    Other income.--In December 1996, 59.9 percent of SSI
recipients receiving benefits on the basis of age also received
Social Security benefits. Only 1.6 percent had earned income.
    The number of persons receiving federally administered SSI
payment and unearned income, by type of income, is included in
table 3-16.

   TABLE 3-15.--PERSONS RECEIVING FEDERALLY ADMINISTERED PAYMENTS AND ALSO RECEIVING OTHER INCOME, AND AVERAGE
              MONTHLY AMOUNT OF INCOME, BY SOURCE OF INCOME AND DISABILITY CATEGORY, DECEMBER 1999
----------------------------------------------------------------------------------------------------------------
                         Source of income                            Total       Aged    Blind \1\  Disabled \2\
----------------------------------------------------------------------------------------------------------------
                                                                                 Number with income

                                                                  ----------------------------------------------
Social Security benefits.........................................  2,383,295    783,777     27,579     1,571,939
Other unearned income............................................    766,330    243,766      8,901       513,663
Earned income....................................................    294,525     21,028      5,708       267,789
                                                                  ----------------------------------------------
                                                                                Percent with income

                                                                  ----------------------------------------------
Social Security benefits.........................................       36.3       59.9       34.8          30.4
Other unearned income............................................       11.7       18.6       11.2           9.9
Earned income....................................................        4.5        1.6        7.2           5.2
                                                                  ----------------------------------------------
                                                                               Average monthly income

                                                                  ----------------------------------------------
Social Security benefits.........................................    $383.82    $386.79    $399.54       $382.07
Other unearned income............................................     128.99      99.12     114.53        143.42
Earned income....................................................     286.62     251.83     544.48        283.86
                                                                  ----------------------------------------------
      Total number...............................................  6,556,634  1,308,062     79,291    5,169,281
----------------------------------------------------------------------------------------------------------------
\1\ Includes approximately 19,200 persons aged 65 or older.
\2\ Includes approximately 690,400 persons aged 65 or older.

 Source: Social Security Administration, Office of Research, Evaluation and Statistics, Division of SSI
  Statistics and Analysis.

   TABLE 3-16.--NUMBER OF PERSONS RECEIVING FEDERALLY ADMINISTERED SSI
  PAYMENTS AND UNEARNED INCOME (OTHER THAN SOCIAL SECURITY) AND AVERAGE
        MONTHLY UNEARNED INCOME, BY TYPE OF INCOME, DECEMBER 1999
------------------------------------------------------------------------
                                                                Average
                 Type of income                      Number      income
------------------------------------------------------------------------
Veterans benefits...............................       96,603    $161.60
Income based on need............................       12,560     168.29
Worker's compensation...........................        4,616     317.30
Support from absent parents.....................       89,410     175.25
Employment pensions.............................       59,266     152.51
Support and maintenance in kind.................      230,630     116.21
Asset income....................................      237,692       6.80
Other...........................................       66,293    355.14
------------------------------------------------------------------------
Source: Social Security Administration, Office of Research, Evaluation
  and Statistics, Division of SSI Statistics and Analysis.

             Characteristics of Children Receiving Benefits

     To be eligible for Supplemental Security Income (SSI)
payments as a child, an individual must be under age 18 (or
under age 22 if a full-time student), be unmarried, and meet
the SSI criteria for: disability or blindness; citizenship/
residency; and income and resources.
     At the end of SSI's first year (December 1974), 71,000
disabled and blind children received SSI benefits, less than 2
percent of the total SSI caseload. By December 1980, payments
were made to almost 229,000 blind and disabled children, 5.5
percent of the SSI caseload. By December 1996, 1,018,000 blind
and disabled children were eligible for SSI payments, nearly a
fourteenfold increase over December 1974. These children made
up 15.4 percent of SSI recipients, and represented a fast
growing segment of the SSI population.
     Many analysts attribute the growth in the early and
midnineties to outreach activities, the Supreme Court decision
in the Zebley case (which mandated an individualized functional
assessment process for children under age 18), expansion of the
mental impairment category, and reduction in reviews of
continuing disability.
     The rapid growth in the number of children receiving SSI,
as well as the debate over the procedures by which children's
eligibility should be judged, led Congress to enact provisions
as part of the 1996 welfare reform law that changed the SSI
Program with respect to disabled children (Public Law 104-193).
This law discontinued the individualized functional assessment
disability determination procedure. Under this procedure,
persons whose impairments were not equivalent to those in the
Federal ``Listing of Impairments'' were reviewed under a less
stringent process. The 1996 law established a new (separate)
disability definition for children (under age 18) which
requires a child to have ``a medically determinable physical or
mental impairment which results in marked or severe functional
limitations, and which can be expected to result in death or
which has lasted or can be expected to last for a continuous
period of not less than 12 months.'' Changes in the eligibility
rules applied to new applications and pending requests for
administrative and judicial review effective beginning August
22, 1996.
    The 1996 law also required SSA to conduct one-time
redeterminations of the eligibility of children already on the
rolls who might not meet the new eligibility criteria. SSA is
also required, on an ongoing basis, to conduct continuing
disability reviews (CDRs) of low birth weight babies, all other
children whose impairments are likely to improve, and 18 year
olds.
     The Congressional Budget Office (CBO) estimated that the
1996 SSI reforms affecting children would result in direct
(mandatory) Federal SSI savings of $7.4 billion over 6 years
(fiscal years 1997-2002). However, after writing the
regulations implementing the 1996 children's reforms, SSA
estimated that about 135,000 children (13 percent of SSI child
recipients) would no longer qualify for SSI as a result of the
new regulations. SSA expected the average number of SSI
children to fall to 950,000 in fiscal year 1998, when the law
became fully implemented, before rising again in subsequent
years. SSA estimated that Federal program savings would amount
to $4.8 billion over the 6-year period--not $7.4 billion as
estimated by CBO.
     SSA estimated that 288,000 children receiving SSI needed
to be redetermined under the new law. As of April 1, 2000,
102,000 (35 percent) of children who received notices of
redetermination were found to be ineligible for SSI benefits.
About 21,000 of these cessations are pending appeal at the
reconsideration or administrative law judge level.
     The number of children receiving SSI payments, and the
percentage of the caseload they represent, has declined from
955,174 (14.4 percent) in December 1996 to 879,828 (13.5
percent) in December 1997, 887,066 (13.5 percent) in December
1998, and 847,063 (12.9 percent) in December 1999.
     In December 1999, 65.7 percent of SSI children were 12
years old or younger, and about 15 percent were under 5 years
old. About 34.2 percent, an estimated 288,000 children, were
between the ages of 13 and 17. Child recipients were more
likely to be boys than girls, by about 3 to 2.
     An estimated 82.1 percent of children lived in their
parent's household. Less than 2 percent of the children were
patients in a medical facility where more than half of the cost
of their care was covered by the Medicaid Program. Another 16.6
percent lived in other hospitals, nursing homes, residential
schools, foster care, or independently.
     About 24.8 percent of the children had some type of
unearned income. The three major types of unearned income were:
support from absent parents (10 percent), Social Security
benefits (7.3 percent), and in-kind support and maintenance
(6.8 percent). In addition, about 15.4 percent of children had
income ``deemed'' from their parents.

                   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.
  --A recent decrease in the number of blind and disabled
        children under 18 receiving SSI; from a high of 14.4
        percent of total SSI recipients in December 1996 to
        12.9 percent in December 1999.
  --A continuing increase in the number of persons ages 18-64
        receiving benefits on the basis of disability or
        blindness. Between December 1989 and December 1999,
        this group of beneficiaries grew by more than 1,389,000
        persons (from 50.1 percent to 56.3 percent of the
        recipient population).

               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. Prior to January 1997, drug addiction and
alcoholism (DAA) 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 some of them
were likely to give in to threats, coercion, or persuasion of
the recipient, thereby in some cases 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.
    In 1996, Congress passed legislation that went even further
by terminating 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. The law mandated the Commissioner
of Social Security to require that persons who qualified for
SSI or DI based on some other disabling condition, but who are
nonetheless determined to have a drug or alcohol condition and
are incapable of managing their own benefits, have a
representative payee and be referred for treatment. The
preferred representative payee for persons with a drug or
alcohol condition who are not capable of managing their own
benefits is an organization. Public Law 104-121 also authorized
$50 million for fiscal year 1997 and $50 million for fiscal
year 1998 for drug treatment services. Recipients classified
solely as drug addicts or alcoholics became ineligible for SSI
beginning January 1, 1997. Applicants were no longer eligible
for benefits beginning March 29, 1996 if they were disabled
solely on the basis of drug or alcohol addiction.
     Following the passage of Public Law 104-121, SSA notified
209,372 individuals who were receiving SSI or DI benefits based
on drug addiction and/or alcoholism. (According to SSA,
approximately 90,000 recipients of DI--about 47,000 of whom
were also SSI beneficiaries--were identified as drug addict and
alcoholic beneficiaries in 1996. However, historical data on DI
beneficiaries does not exist as the drug addict and alcoholic
provisions of the Social Security Act were not applicable until
1995.) As of April 2, 1999, approximately 140,978 beneficiaries
responded to the notices. About 10,000 of these responses did
not require medical determination because of erroneous coding
of disability diagnosis or cessation of benefits before January
1, 1997.
     Of all beneficiaries identified as having a drug or
alcohol addiction, SSA terminated benefits for 124,746 (59.6
percent) and continued benefits based on another disability for
83,746 (39.9 percent). Another 859 individuals qualified for
benefits based on age. These figures will change as the agency
processes more appeals and hearing decisions.

                   ELIGIBILITY OF NONCITIZENS FOR SSI

    Although the 1996 welfare reform law (Public Law 104-193)
barred most noncitizens from receiving SSI, this prohibition
was modified by Public Law 105-33, the Balanced Budget Act of
1997, for legal immigrants who were receiving SSI on August 22,
1996 and disabled legal immigrants who were living in the
United States on August 22, 1996. The Noncitizen Benefit
Clarification and Other Technical Amendments Act of 1998
(Public Law 105-306) provided continuing eligibility for SSI
for nonqualified aliens who were receiving benefits on August
22, 1996. For more information on provisions and issues related
to noncitizens, see appendix J.

                      ELIGIBILITY OF THE HOMELESS

    SSA has developed several 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
(Quigley, 1992).
    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.
    In response, SSA has initiated a wide range of outreach
activities. 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.

            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 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, all work-related expenses are
disregarded in the case of blind persons and impairment-related
work expenses are disregarded in the case of disabled persons.
Finally, income and resources set aside under a plan for
achieving self-support (PASS) are excluded.

                     Eliminating Work Disincentives

    Prior to enactment of the section 1619 program in 1980 on a
temporary 3-year basis (see below), a disabled SSI recipient
who worked faced a substantial risk of losing both SSI cash
benefits and Medicaid. Work was treated the same way it was
under the Social Security Disability Insurance Program: after a
trial work period, work at the level of substantial gainful
activity ($700 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. Thus, disabled
individuals had a disincentive to work because of their fear of
losing SSI and Medicaid.
    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 3-2, this earned income
eligibility limit is $1,109 per month in 2000 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 granted by 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 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 this
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 earnings. In determining a person's
income to compare to the individualized threshold, any
applicable exclusions are deducted from 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 both medical care and
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 causes a pattern of erratic work.
This protection is not indefinite, but SSA cannot terminate the
disability status of an individual for 12 months after her most
recent determination of 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 once
the individual has been off the rolls for 12 months or more.
    The ticket to work law enacted in 1999 (Public Law 106-170)
contains a number of provisions designed to eliminate work
disincentives that existed in the SSI Program. Under this law
an individual whose eligibility for SSI benefits (including
eligibility under section 1619(b) has been terminated due to 12
consecutive months of suspension for excess income from work
activity, may request reinstatement of SSI benefits without
filing a new application. To be eligible for this expedited
reinstatement of benefits, an individual must have become
unable to continue working due to a medical condition and must
file the application for reinstatement within 60 months of the
termination of benefits.
    The ticket to work law also requires SSA to establish a
community-based Work Incentive Planning and Assistance Program
to provide individuals with information on SSI work incentives.
Specifically, SSA must establish a corps of work incentive
specialists within the agency and a program of grants,
cooperative agreements, and contracts to provide benefit
planning and assistance to individuals with disabilities and
outreach to individuals who may be eligible for the Work
Incentive Program.
     SSA is authorized by the ticket to work law to make grants
directly to qualified protection and advocacy programs to
provide services and advice about vocational rehabilitation,
employment services, and obtaining employment to SSI
beneficiaries.
     States have the option of covering additional groups of
working individuals under Medicaid. The ticket to work law
allows States to provide Medicaid coverage to working
individuals with disabilities who, except for their earnings,
would be eligible for SSI and to working individuals with
disabilities whose medical conditions have improved.
Individuals covered under this new option could buy into
Medicaid coverage by paying premiums or other cost-sharing
charges on a sliding fee scale based on income established by
the State. States are permitted to allow working individuals
with incomes above 250 percent of the Federal poverty level to
buy into the Medicaid Program.

           Special Benefits for Certain World War II Veterans

    Section 251 of Public Law 106-169, enacted on December 14,
1999, provides special benefits to certain World War II
veterans who served in the U.S. military during the period
beginning September 16, 1940 and through July 24, 1947, or who
served in the organized military of the Philippines during the
period beginning July 26, 1941 and through December 30, 1946.
The special benefits are payable each month after April 2000
that these veterans reside outside the United States.
    In order to be eligible for the special benefits, an
individual must: (1) be age 65 or older on December 14, 1999
(the date Public Law 106-169 was enacted); (2) be a World War
II veteran as described above; (3) file an application for the
special veterans benefits and be eligible for SSI for that
month; (4) be eligible for SSI in December 1999; and (5) not
have other benefit income above 75 percent of the current SSI
Federal benefit rate.
    Qualified veterans receive a monthly benefit equal to 75
percent of the current SSI Federal benefit rate less the amount
of their benefit income for the month. The maximum benefit
under this formula for 2000 is $384. There is no provision for
the payment of benefits to dependents or survivors. ``Benefit
income'' means any recurring payments such as annuities,
pensions, retirement or disability benefits that the veteran
received during the 12-month period immediately before applying
for special benefits, or payments received later that are
similar to benefits received during the 12-month period.

                MEASURES OF SSI PARTICIPATION AND GROWTH

                        SSI Participation Rates

    Table 3-17 shows several measures of Federal SSI
participation among the elderly and the total population. The
numerator in the first three columns is the sum of columns 2
and 4 in table 3-19. Thus, the number of SSI aged participants
includes the disabled and blind population over age 65. Column
1 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 5.9 percent in 1998. Column 2 presents
the number of elderly SSI recipients divided by the number of
poor elderly. This rate declined from 76 percent in 1975 to 54
percent in 1982. Between 1982 and 1984, this percent-

                     TABLE 3-17.--PERCENTAGE OF GENERAL POPULATION ENROLLED IN SSI, 1975-96
----------------------------------------------------------------------------------------------------------------
                                                                                           Among
                                                               Among all      Among     pretransfer     Among
                            Year                                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         56.7          2.2
1993........................................................          6.7         56.3         56.4          2.3
1994........................................................          6.4         57.8         55.8          2.4
1995........................................................          6.3         63.7         58.9          2.5
1996........................................................          6.2         60.9         57.5          2.5
1995........................................................          5.9         59.9         56.6          2.4
1996........................................................          5.9         60.0         54.4         2.4
----------------------------------------------------------------------------------------------------------------
NA--Not available.

 Source: Congressional Research Service.

age 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 52.7 percent in
1992, and increased to 60.0 percent in 1998. 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.
    The denominator for column 3 is the number of individuals
age 65 and older who live in aged-only households and who would
be in poverty without SSI benefits. This rate has declined from
68.7 percent in 1979 to 54.4 percent in 1998.
    The final column of table 3-17 shows the number of SSI
participants as a percentage of the total population. The
numerator for this calculation is the first column of table 3-
19. The percentage of the entire population receiving SSI
benefits declined from 2.0 percent in 1975 to 1.7 percent for
the 1982-85 time period, but increased to 2.5 percent--its
highest level ever--in 1995 and 1996. In 1998, 2.4 percent of
the population received SSI benefits.
    Table 3-18 shows the percentage of a given State's
population receiving SSI benefits for selected years.

         TABLE 3-18.--PERCENTAGE OF GENERAL POPULATION ENROLLED IN SSI BY STATE, SELECTED YEARS 1975-99
----------------------------------------------------------------------------------------------------------------
                                                                                   Year
                          State                          -------------------------------------------------------
                                                           1975   1985   1990   1992   1993   1996   1998   1999
----------------------------------------------------------------------------------------------------------------
Alabama.................................................   3.98   3.29   3.29   3.43   3.64   3.91   3.74   3.71
Alaska..................................................   0.81   0.65   0.84   0.90   0.96   1.20   1.27   1.33
Arizona.................................................   1.24   1.04   1.22   1.42   1.54   1.71   1.63   1.69
Arkansas................................................   4.09   3.14   3.23   3.47   3.66   3.80   3.53   2.72
California..............................................   3.09   2.59   2.93   3.10   3.14   3.29   3.14   3.24
Colorado................................................   1.37   0.93   1.14   1.29   1.38   1.52   1.39   1.41
Connecticut.............................................   0.76   0.83   0.98   1.10   1.19   1.41   1.43   1.46
Delaware................................................   1.19   1.21   1.21   1.27   1.34   1.58   1.57   1.59
District of Columbia....................................   2.23   2.51   2.67   3.00   3.21   3.76   3.80   3.83
Florida.................................................   1.86   1.62   1.71   1.90   2.06   2.44   2.39   2.45
Georgia.................................................   3.27   2.56   2.46   2.55   2.65   2.74   2.56   2.59
Hawaii..................................................   1.08   1.08   1.25   1.30   1.40   1.64   1.66   1.70
Idaho...................................................   1.06   0.84   1.03   1.21   1.28   1.46   1.40   1.44
Illinois................................................   1.22   1.18   1.55   1.78   2.00   2.28   2.10   2.14
Indiana.................................................   0.83   0.87   1.09   1.26   1.39   1.56   1.51   1.51
Iowa....................................................   1.00   0.96   1.18   1.29   1.37   1.49   1.42   1.43
Kansas..................................................   1.05   0.87   0.99   1.14   1.26   1.51   1.38   1.39
Kentucky................................................   2.83   2.65   3.11   3.42   3.71   4.37   4.34   4.37
Louisiana...............................................   3.90   2.87   3.15   3.49   3.84   4.21   3.99   3.92
Maine...................................................   2.31   1.89   1.93   2.03   2.17   2.23   2.31   2.35
Maryland................................................   1.17   1.16   1.25   1.35   1.44   1.67   1.67   1.69
Massachusetts...........................................   2.30   1.91   1.98   2.23   2.40   2.73   2.70   2.72
Michigan................................................   1.31   1.35   1.54   1.71   1.93   2.23   2.15   2.16
Minnesota...............................................   1.00   0.78   0.92   1.05   1.17   1.38   1.33   1.36
Mississippi.............................................   5.21   4.28   4.42   4.68   4.98   5.23   4.88   4.83
Missouri................................................   2.10   1.58   1.66   1.83   1.96   2.18   2.05   2.06
Montana.................................................   1.12   0.92   1.25   1.38   1.44   1.63   1.57   2.14
Nebraska................................................   1.06   0.88   0.99   1.09   1.19   1.33   1.27   1.27
Nevada..................................................   1.00   0.85   0.95   1.04   1.14   1.36   1.29   1.37
New Hampshire...........................................   0.67   0.62   0.62   0.71   0.77   0.95   0.94   0.96
New Jersey..............................................   1.11   1.23   1.36   1.52   1.66   1.84   1.78   1.80
New Mexico..............................................   2.29   1.83   2.08   2.25   2.39   2.67   2.62   2.65
New York................................................   2.24   2.00   2.31   2.60   2.85   3.33   3.34   3.35
North Carolina..........................................   2.71   2.21   2.24   2.36   2.47   2.67   2.54   2.56
North Dakota............................................   1.25   0.96   1.17   1.30   1.34   1.41   1.34   1.33
Ohio....................................................   1.22   1.19   1.44   1.63   1.84   2.28   2.21   2.19
Oklahoma................................................   3.03   1.81   1.92   2.02   2.13   2.28   2.18   2.19
Oregon..................................................   1.12   0.95   1.11   1.24   1.35   1.52   1.48   1.53
Pennsylvania............................................   1.24   1.39   1.60   1.77   1.90   2.23   2.30   2.31
Rhode Island............................................   1.72   1.62   1.74   1.91   2.05   2.53   2.64   2.71
South Carolina..........................................   2.84   2.60   2.59   2.67   2.80   3.04   2.83   2.84
South Dakota............................................   1.32   1.19   1.45   1.62   1.72   1.92   1.80   1.77
Tennessee...............................................   3.24   2.71   2.87   3.06   3.22   3.40   3.10   3.09
Texas...................................................   2.23   1.57   1.73   1.87   2.00   2.16   2.04   2.07
Utah....................................................   0.76   0.53   0.73   0.84   0.94   1.05   0.95   0.97
Vermont.................................................   1.93   1.76   1.79   1.99   2.08   2.19   2.14   2.15
Virginia................................................   1.53   1.49   1.54   1.67   1.76   2.00   1.93   1.95
Washington..............................................   1.46   1.09   1.27   1.39   1.50   1.72   1.69   1.73
West Virginia...........................................   2.37   2.24   2.63   2.91   3.17   3.78   3.91   3.92
Wisconsin...............................................   1.44   1.50   1.75   1.88   2.04   1.86   1.71   1.70
Wyoming.................................................   0.67   0.45   0.76   0.92   1.04   1.24   1.20   1.22
                                                         -------------------------------------------------------
      Total \1\.........................................   2.00   1.74   1.94   2.11   2.26   2.50   2.43   2.41
----------------------------------------------------------------------------------------------------------------
\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. For 1996-99, percentages are calculated
  as the number of SSI recipients in July 1996 divided by the total population of each State in July 1996.

  TABLE 3-19.--NUMBER OF PERSONS RECEIVING FEDERALLY ADMINISTERED SSI PAYMENTS, 1974-2005; AND ADULT ASSISTANCE
                                          UNDER PRIOR PROGRAMS, 1970-73
                                                 [In thousands]
----------------------------------------------------------------------------------------------------------------
                                                                     Blind or disabled
                                                                 ------------------------- Federal      State
                  Year \1\                   Total \2\  Aged \3\              65 or 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          312
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.......................................     5,984      1,475     4,507            638    5,636          348
1994.......................................     6,296      1,466     4,830            653    5,965          331
1995.......................................     6,514      1,446     5,068            669    6,194          320
1996.......................................     6,614      1,413     5,201            678    6,326          288
1997.......................................     6,495      1,332     5,132            691    6,212          287
1998.......................................     6,566      1,332     5,154            701    6,289          277
1999.......................................     6,557      1,308     5,249            711    6,275          282
2000 \9\...................................     6,710      1,288     5,422            724    6,425          285
2001 \9\...................................     6,790      1,266     5,523            736    6,502          288
2002 \9\...................................     6,868      1,247     5,621            753    6,578          290
2003 \9\...................................     6,942      1,229     5,713            770    6,650          292
2004 \9\...................................     7,011      1,213     5,798            785    6,718          293
2005 \9\...................................     7,074      1,199     5,875            800    6,781         293
----------------------------------------------------------------------------------------------------------------
\1\ Data are as of December of each year.
\2\ All persons with Federal SSI payments and/or federally administered State supplementation for 1974-2005. 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\ Number of age 65 or older individuals included in the blind or disabled category.
\6\ All persons with Federal SSI payments, including 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 2000-2005, data are projections based on the President's budget estimates of February 2000.

 Source: Office of the Actuary, Social Security Administration.

                Changes in Number of Recipients, 1970-99

    Supplemental Security Income (SSI) is one of the largest
cash assistance programs for the poor and, until recently, was
one of the fastest growing entitlement programs (see table 3-12
above); program costs grew 20 percent annually from 1991
through 1994. According to GAO, three groups accounted for
nearly 90 percent of the SSI Program's growth between 1986 and
1993: 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 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 the Social Security
Administration (SSA); lack of 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 3-19 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 number 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 1999, there were nearly 6.6 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 and blind persons over age 65 are
counted as aged) to 1.3 million individuals in 1999 (2.0
million if disabled and blind persons over 65 are counted).
Meanwhile, the number of blind or disabled receiving assistance
increased sharply.
    The number of persons receiving SSI payments, by State, in
December 1999 is provided in table 3-20.

                           SSI Program Costs

    Table 3-21 shows total expenditures for the SSI Program in
each State in 1999, including not only the federally
administered Federal and State supplementation payments but
also the State-administered State supplementation payments.
Table 3-22 shows the total (Federal- and State-administered)
State supplementation payments by State for SSI for selected
fiscal years, 1986-98.
    Table 3-23 presents the total amount of Federal and State
benefit payments from calendar years 1970-87 and fiscal years
1988-2005. From 1970-73, 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 1999, Federal
benefit payments totaled $28.1 billion and State payments
totaled $3.2 billion, amounting to an overall total of $31.3
billion. In fiscal year 2000, total (Federal and State) SSI
benefits are estimated to total $29.5 billion and are projected
to increase to $32.7 billion in fiscal year 2002.

                 TABLE 3-20.--NUMBER OF PERSONS RECEIVING SSI PAYMENTS, BY STATE, DECEMBER 1999
----------------------------------------------------------------------------------------------------------------
                                                                  Federally administered               State-
                        State                         --------------------------------------------- administered
                                                          Total       Aged      Blind    Disabled     total \1\
----------------------------------------------------------------------------------------------------------------
Alabama..............................................     160,208      28,584    1,217     130,407        1,683
Alaska...............................................       8,156       1,348      124       6,684        4,726
Arizona..............................................      79,306      13,179      941      65,186          610
Arkansas.............................................      87,686      15,453      976      71,257  ............
California...........................................   1,066,486     330,386   21,983     714,117  ............
Colorado.............................................      54,588       8,990      552      45,046       31,462
Connecticut..........................................      47,609       7,079      499      40,031       29,153
Delaware.............................................      11,840       1,414      116      10,310  ............
District of Columbia.................................      20,020       2,631      195      17,194  ............
Florida..............................................     366,517      94,254    3,146     269,117       14,223
Georgia..............................................     196,784      35,843    2,340     158,601  ............
Hawaii...............................................      20,404       7,300      160      12,944  ............
Idaho................................................      17,761       1,829      172      16,760        2,985
Illinois.............................................     251,112      32,841    2,361     215,910       44,137
Indiana..............................................      88,315       7,577    1,073      79,665        1,139
Iowa.................................................      40,450       4,716      843      34,891  ............
Kansas...............................................      36,290       3,493      383      31,964  ............
Kentucky.............................................     172,225      19,906    1,485     150,834        5,680
Louisiana............................................     167,927      26,107    1,936     139,884  ............
Maine................................................      29,341       3,517      238      25,586  ............
Maryland.............................................      86,684      15,644      761      70,279        1,680
Massachusetts........................................     167,050      46,074    4,289     116,687  ............
Michigan.............................................     210,022      19,950    1,939     188,133  ............
Minnesota............................................      63,626      10,122      713      52,791   \4\ 21,339
Mississippi..........................................     131,247      24,166    1,290     105,791  ............
Missouri.............................................     111,003      13,391      974      96,638       10,026
Montana..............................................      13,697       1,390      127      12,180  ............
Nebraska.............................................      21,036       2,450      244      18,342        5,717
Nevada...............................................      24,303       6,840      641      16,822  ............
New Hampshire........................................      11,404       1,055      121      10,228        6,678
New Jersey...........................................     145,565      33,852    1,056     110,657  ............
New Mexico...........................................      45,861       8,989      559      36,313          243
New York.............................................     609,459     138,987    3,425     487,047  ............
North Carolina.......................................     191,743      36,237    2,170     153,336       20,209
North Dakota.........................................       8,278       1,400       80       6,798      \4\ 355
Ohio.................................................     242,733      18,207    2,278     222,248  ............
Oklahoma.............................................      72,562      11,541      879      60,142       72,741
Oregon...............................................      50,515       7,148      635      42,732   \4\ 16,971
Pennsylvania.........................................     278,196      37,599    2,520     238,077  ............
Rhode Island.........................................      26,897       4,692      239      21,966  ............
South Carolina.......................................     108,093      18,364    1,640      88,089        4,351
South Dakota.........................................      12,735       2,105      103      10,527        3,576
Tennessee............................................     166,327      24,755    1,703     139,869  ............
Texas................................................     407,872     116,874    5,657     285,341  ............
Utah.................................................      19,968       2,072      282      17,614  ............
Vermont..............................................      12,551       1,629      125      10,797  ............
Virginia.............................................     131,910      24,921    1,516     105,473        6,776
Washington...........................................      98,314      13,874      937      83,503           82
West Virginia........................................      70,993       5,869      590      64,534  ............
Wisconsin............................................      86,544      10,229      988      75,327  ............
Wyoming..............................................       5,784         573       55       5,156        2,923
Other:
  Northern Mariana Islands...........................         635         164       15         456  ............
                                                      ----------------------------------------------------------
      Total \2\......................................   6,556,634   1,308,062   79,291   5,169,281     309,383
----------------------------------------------------------------------------------------------------------------
\1\ In 1997, Iowa, Louisiana, Maine, and Michigan began reporting data to the Social Security Administration.
\2\ Includes recipients not distributed by State.

 Source: Social Security Administration, Office of Research, Evaluation and Statistics, Division of SSI
  Statistics and Analysis.

    TABLE 3-21.--SUPPLEMENTAL SECURITY INCOME: TOTAL PAYMENTS, FEDERAL SSI PAYMENTS, AND FEDERAL- AND STATE-
                          ADMINISTERED STATE SUPPLEMENTARY PAYMENTS, CALENDAR YEAR 1999
                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                                     State supplementation
                                                                 Federal SSI -----------------------------------
                      State                           Total          \1\          Federally           State
                                                                              administered \1\  administered \2\
----------------------------------------------------------------------------------------------------------------
Alabama.........................................      $659,976      $659,321  ................          $655
Alaska..........................................        51,354        34,663  ................        16,691
Arizona.........................................       340,568       340,318  ................           250
Arkansas........................................       410,567       339,065  ................  ................
California......................................     6,258,380     3,900,708      $2,266,934    ................
Colorado........................................       229,519       229,519  ................        71,502
Connecticut.....................................       210,934       210,934  ................        90,738
Delaware........................................        49,523        48,583             940    ................
District of Columbia............................        91,130        87,884           3,246    ................
Florida.........................................     1,588,501     1,564,220              10          24,271
Georgia.........................................       772,792       772,782              10    ................
Hawaii..........................................        97,546        84,722          12,824    ................
Idaho...........................................        83,951        73,216  ................        10,735
Illinois........................................     1,205,453     1,177,260  ................        28,193
Indiana.........................................       384,576       380,000  ................         4,576
Iowa............................................       173,432       153,845           2,745          16,842
Kansas..........................................       150,723       150,723  ................  ................
Kentucky........................................       736,917       719,935  ................        16,982
Louisiana.......................................       727,754       727,238  ................           516
Maine...........................................       119,450       110,690  ................         8,760
Maryland........................................       395,695       389,015              12           6,668
Massachusetts...................................       788,296       623,107         165,189    ................
Michigan........................................       997,231       953,887          28,761          14,583
Minnesota.......................................       336,541       266,246  ................        70,295
Mississippi.....................................       517,090       517,081               9    ................
Missouri........................................       488,832       463,435  ................        25,397
Montana.........................................        55,593        54,810             783    ................
Nebraska........................................        89,823        83,622  ................         6,201
Nevada..........................................       100,977        96,147           4,830    ................
New Hampshire...................................        58,190        46,972  ................        11,218
New Jersey......................................       665,113       586,359          78,754    ................
New Mexico......................................       187,105       186,871  ................           234
New York........................................     3,118,358     2,573,094  ................
North Carolina..................................       843,399       719,909  ................       123,490
North Dakota....................................        31,708        29,683  ................         2,025
Northern Mariana Islands........................         2,937         2,937  ................  ................
Ohio............................................     1,124,699     1,124,684              15    ................
Oklahoma........................................       334,708       297,354  ................        37,354
Oregon..........................................       239,459       219,117  ................        20,342
Pennsylvania....................................     1,339,319     1,208,955         130,364    ................
Rhode Island....................................       123,595       101,043          22,552    ................
South Carolina..................................       436,684       423,301  ................        13,383
South Dakota....................................        50,961        48,653               7           2,301
Tennessee.......................................       666,082       666,080               2    ................
Texas...........................................     1,556,804     1,556,804  ................  ................
Utah............................................        86,511        86,456              55    ................
Vermont.........................................        51,130        41,954           9,176    ................
Virginia........................................       551,881       529,962  ................        21,919
Washington......................................       469,541       440,462          28,731             348
West Virginia...................................       315,748       315,748  ................  ................
Wisconsin.......................................       488,907       362,718  ................       126,189
Wyoming.........................................        23,916        23,230  ................           686
                                                 ---------------------------------------------------------------
      Total.....................................    30,959,475    26,805,157       3,300,975        853,343
----------------------------------------------------------------------------------------------------------------
\1\ Includes data not distributed by State.
\2\ Includes amounts for six States not distributed by category.

Source: Social Security Administration, Office of Research, Evaluation and Statistics, Division of SSI
  Statistics and Analysis.

                                             TABLE 3-22.--STATE SSI SUPPLEMENTATION PAYMENTS, SELECTED FISCAL YEARS 1986-96, CALENDAR YEARS 1997-99
                                                                                    [In thousands of dollars]
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                               Year
             State              ----------------------------------------------------------------------------------------------------------------------------------------------------------------
                                      1986           1988           1990          1992          1993          1994          1995          1996          1997          1998            1999
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Alabama........................  $13,659......  $10,436......  $6,594.......  $3,845......  $2,083......  $1,673......  $1,370......  $1,027......  $987........  $764........  $655
Alaska.........................  12,970.......  12,970.......  12,972.......  12,972......  12,972......  12,972......  12,972......  12,972......  12,972......  12,977......  16,691
Arizona........................  2,668........  3,309........  2,560........  3,129.......  3,129.......  411.........  409.........  374.........  312.........  278.........  250
Arkansas.......................  28...........  20...........  15...........  8...........  0...........  6...........  4...........   5..........  (\1\).......  (\1\).......  (\1\)
California.....................  1,466,079....  1,862,170....  2,274,296....  2,433,459...  2,212,330...  2,014,831...  1,981,002...  1,994,313...  1,919,293...  1,988,594...  2,266,934
Colorado.......................  38,320.......  24,132.......  42,649.......  53,309......  55,057......  53,376......  56,703......  59,114......  66,600......  70,151......  71,502
Connecticut....................  36,578.......  54,584.......  67,670.......  94,725......  96,836......  99,424......  100,330.....  98,235......  92,809......  93,353......  90,738
Delaware.......................  671..........  730..........  708..........  750.........  747.........  819.........  817.........  836.........  874.........  924.........  940
District of Columbia...........  4,202........  4,538........  4,365........  4,694.......  4,899.......  5,095.......  4,342.......  2,879.......  2,743.......  2,968.......  3,246
Florida........................  9,718........  11,309.......  14,656.......  18,899......  18,608......  18,608......  18,380......  18,384......  18,392......  18,392......  24,281
Georgia........................  8............  18...........  16...........  12..........  19..........  18..........  15..........  21..........  (\2\).......  6...........  10
Hawaii.........................  3,740........  4,263........  10,885.......  10,698......  11,066......  11,299......  11,305......  11,479......  11,306......  13,237......  12,824
Idaho..........................  4,136........  4,205........  4,212........  4,212.......  4,212.......  4,212.......  9,459.......  4,753.......  10,416......  10,726......  10,735
Illinois.......................  51,197.......  59,573.......  57,137.......  64,241......  65,836......  73,398......  69,450......  31,890......  29,180......  28,326......  28,193
Indiana........................  1,744........  3,619........  3,285........  3,563.......  3,817.......  3,884.......  3,786.......  3,540.......  3,576.......  3,576.......  4,576
Iowa...........................  1,908........  2,204........  2,408........  2,672.......  2,859.......  2,940.......  2,951.......  3,018.......  14,330......  19,675......  19,587
Kansas.........................  27...........  25...........  21...........  12..........  0...........  2...........  1...........  1...........  (\2\).......  (\1\).......  (\1\)
Kentucky.......................  9,795........  10,467.......  11,611.......  15,492......  15,313......  16,612......  16,843......  16,327......  15,576......  16,609......  16,982
Louisiana......................  42...........  33...........  25...........  12..........  4...........  (\1\).......  (\1\).......  (\1\).......  532.........  530.........  516
Maine..........................  5,413........  7,540........  7,494........  7,325.......  7,233.......  7,415.......  7,542.......  3,916.......  646.........  8,370.......  8,760
Maryland.......................  5,252........  6,159........  6,155........  6,542.......  6,269.......  6,102.......  6,235.......  6,430.......  6,688.......  5,014.......  6,680
Massachusetts..................  109,452......  120,010......  117,113......  137,516.....  147,866.....  153,034.....  160,080.....  159,629.....  160,524.....  154,085.....  165,189
Michigan.......................  66,338.......  69,833.......  74,682.......  61,636......  62,683......  61,955......  37,296......  27,387......  31,492......  121,304.....  43,344
Minnesota......................  19,818.......  24,667.......  43,924.......  55,224......  53,860......  53,860......  63,720......  63,720......  53,297......  53,297......  70,295
Mississippi....................  29...........  27...........  22...........  12..........  11..........  7...........  6...........  8...........  (\1\).......  8...........  9
Missouri.......................  5,132........  4,009........  2,808........  26,158......  25,866......  24,286......  29,549......  25,154......  25,193......  24,400......  25,397
Montana........................  834..........  839..........  864..........  909.........  902.........  960.........  940.........  905.........  832.........  807.........  783
Nebraska.......................  5,348........  5,454........  5,793........  6,175.......  6,705.......  5,990.......  5,970.......  6,293.......  6,199.......  6,199.......  6,201
Nevada.........................  2,531........  2,704........  2,928........  3,184.......  3,586.......  3,717.......  3,885.......  4,083.......  4,261.......  4,542.......  4,830
New Hampshire..................  7,326........  5,865........  6,843........  7,948.......  8,512.......  9,573.......  11,039......  10,489......  11,088......  11,209......  11,218
New Jersey.....................  48,124.......  50,446.......  53,697.......  64,765......  71,965......  74,242......  76,655......  77,380......  76,823......  77,377......  78,754
New Mexico.....................  216..........  248..........  263..........  333.........  329.........  321.........  293.........  287.........  268.........  255.........  234
New York.......................  277,035......  317,504......  388,150......  440,374.....  476,029.....  494,345.....  510,096.....  527,128.....  523,123.....  533,372.....  545,264
North Carolina.................  41,091.......  52,745.......  63,135.......  91,925......  95,445......  106,493.....  115,245.....  85,274......  92,568......  109,407.....  123,490
North Dakota...................  1,518........  1,480........  1,390........  1,408.......  1,220.......  1,676.......  1,928.......  1,917.......  1,916.......  1,916.......  2,025
Ohio...........................  35...........  31...........  34...........  31..........  28..........  18..........  13..........  1...........  2...........  13..........  15
Oklahoma.......................  31,380.......  34,045.......  34,168.......  36,012......  36,557......  34,987......  35,811......  36,988......  37,412......  37,270......  37,354
Oregon.........................  9,767........  11,843.......  17,946.......  20,169......  20,169......  20,169......  28,045......  28,045......  20,174......  20,174......  20,342
Pennsylvania...................  69,186.......  74,670.......  79,571.......  94,971......  109,947.....  128,339.....  136,153.....  129,618.....  125,666.....  128,514.....  130,364
Rhode Island...................  9,402........  10,263.......  11,729.......  14,967......  16,097......  17,384......  18,811......  19,650......  10,643......  20,832......  22,552
South Carolina.................  4,812........  5,004........  8,897........  11,685......  12,377......  11,880......  12,750......  13,258......  13,043......  13,783......  13,383
South Dakota...................  591..........  587..........  567..........  652.........  681.........  709.........  73..........  1,630.......  1,911.......  1,939.......  2,308
Tennessee......................  0............  1............  4............  1...........  0...........  (\2\).......  (\2\).......  (\2\).......  (\2\).......  1...........  2
Texas..........................  0............  0............  0............  0...........  0...........  (\3\).......  (\3\).......  (\3\).......  (\3\).......  (\3\).......  (\2\)
Utah...........................  872..........  1,086........  808..........  959.........  878.........  201.........  60..........  57..........  59..........  55..........  55
Vermont........................  7,236........  7,841........  8,685........  10,299......  9,927.......  9,715.......  10,396......  9,402.......  9,569.......  9,412.......  9,176
Virginia.......................  12,164.......  14,432.......  15,296.......  16,782......  17,317......  17,752......  19,156......  19,632......  19,257......  21,161......  21,919
Washington.....................  17,443.......  18,058.......  19,915.......  24,043......  26,808......  28,374......  28,516......  26,795......  28,670......  28,689......  29,079
West Virginia..................  0............  0............  0............  0...........  0...........  (\3\).......  (\3\).......  (\3\).......  (\3\).......  (\3\).......  (\2\)
Wisconsin......................  80,288.......  90,642.......  100,276......  118,063.....  132,761.....  125,789.....  123,693.....  32,510......  124,002.....  125,664.....  126,189
Wyoming........................  216..........  226..........  279..........  440.........  527.........  597.........  660.........  690.........  697.........  678.........  686
                                ----------------------------------------------------------------------------------------------------------------------------------------------------------------
    Total......................  2,496,275....  3,006,796....  3,589,348....  3,987,110...  3,862,151...  3,719,314...  3,735,250...  3,577,102...  3,594,702...  3,811,552...  \3\ 54,154,318
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ Less than $500.
\2\ Amount not shown; negative adjustment exceeds amount paid.
\3\ Texas and West Virginia do not pay State supplementation.

 Source: Social Security Administration, Office of Research, Evaluation and Statistics, Division of SSI Statistics and Analysis.

  TABLE 3-23.--FEDERAL AND STATE BENEFIT PAYMENTS UNDER SSI AND PRIOR ADULT ASSISTANCE PROGRAMS, CALENDAR YEARS
                                      1970-87 AND FISCAL YEARS 1988-2005\1\
                                            [In millions of dollars]
----------------------------------------------------------------------------------------------------------------
                                          Total                             State payments              SSI
                                        constant   Federal    Total  ---------------------------- administrative
           Year \2\             Total     1999    payments    State     Federally       State      costs (fiscal
                                         dollars            payments  administered  administered       year)
----------------------------------------------------------------------------------------------------------------
1970.........................   $2,939    $8,321    $1,801    $1,138  ............  ............  ..............
1971.........................    3,206    13,180     (\3\)     (\3\)  ............  ............  ..............
1972.........................    3,392    13,392     1,993     1,398  ............  ............  ..............
1973.........................    3,418    12,818     1,987     1,432  ............  ............  ..............

1974.........................    5,246    17,717     3,833     1,413      $1,264         $149           $285
1975.........................    5,878    18,191     4,314     1,565       1,403          162            399
1976.........................    6,066    17,750     4,512     1,554       1,388          166            500
1977.........................    6,306    17,326     4,703     1,603       1,431          172             NA

1978.........................    6,552    16,732     4,881     1,671       1,491          180            539
1979.........................    7,075    16,226     5,279     1,796       1,590          207            610
1980.........................    7,941    16,046     5,866     2,074       1,848          226            668
1981.........................    8,593    15,740     6,518     2,076       1,839          237            718

1982.........................    8,981    15,496     6,907     2,074       1,798          276            779
1983.........................    9,404    15,721     7,423     1,981       1,711          270            830
1984.........................   10,372    16,621     8,281     2,091       1,792          299            864
1985.........................   11,060    17,114     8,777     2,283       1,973          311            953

1986.........................   12,081    18,353     9,498     2,583       2,243          340          1,022
1987.........................   12,951    18,982    10,029     2,922       2,563          359            976
1988.........................   14,375    21,427    11,368     3,007       2,645          362            975
1989.........................   14,707    19,973    11,399     3,308       2,881          427          1,051

1990.........................   16,095    20,822    12,507     3,589       3,159          431          1,075
1991.........................   17,979    22,141    14,228     3,751       3,235          516          1,257
1992.........................   21,258    25,409    17,270     3,987       3,431          556          1,538
1993.........................   24,173    28,047    20,312     3,862       3,298          564          1,467

1994 \4\.....................   28,288    31,975    24,461     3,827       3,219          608          1,781
1995 \4\<SUP>,</SUP> \5\................   28,124    30,929    24,443     3,681       3,060          621          1,978
1996 \4\.....................   27,429    29,350    24,038     3,391       2,845          546          1,949
1997 \4\.....................   30,120    31,383    26,580     3,540       2,918          622          2,055

1998 \4\<SUP>,</SUP> \6\................   31,154    31,941    27,390     3,764       2,987          777          2,304
1999 \4\<SUP>,</SUP> \6\................   32,153    32,153    28,117     4,036       3,219          817          2,493
2000 \4\<SUP>,</SUP> \6\................       NA  ........    29,189        NA       3,310           NA          2,343
2001 \4\<SUP>,</SUP> \6\................       NA  ........    30,482        NA       3,410           NA          2,569

2002 \4\<SUP>,</SUP> \6\................       NA  ........    31,826        NA       3,515           NA          2,569
2003 \4\<SUP>,</SUP> \6\................       NA  ........    33,191        NA       3,625           NA          2,596
2004 \4\<SUP>,</SUP> \6\................       NA  ........    34,596        NA       3,735           NA          2,658
2005 \4\<SUP>,</SUP> \6\................       NA  ........    38,617        NA       3,880           NA         2,717
----------------------------------------------------------------------------------------------------------------
\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;
  1974-2005 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 1994-95 and the automation investment in fiscal years 1994-2002.
\5\ Fiscal year 1995 administrative expenses included funds to pay back the Old-Age and Survivors Insurance
  Trust Fund with interest for SSI administrative funding shortfalls in prior years.
\6\ SSA does not collect the information necessary for making a forecast of State-administered benefit payments.
  For 2000-2005, data are projections based on the President's budget estimates of February 2000.

 NA--Not available.

Source: Office of the Actuary, Social Security Administration and Office of Budget, Social Security
  Administration.

                          LEGISLATIVE HISTORY

                             104th Congress

    Public Law 104-121, the Contract with America Advancement
Act of 1996, among other changes, 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
also applies to current beneficiaries on January 1, 1997. It
stipulates that SSI must: (1) notify current DAA beneficiaries
of the 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. The
Social Security Administration (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, the new law
retains the $50 fee that representatives can collect for
beneficiaries who have a DAA condition. The legislation also
authorizes an appropriation of $50 million for each of fiscal
years 1997 and 1998 to carry out activities relating to the
treatment of drug and alcohol abuse under the Public Health
Service Act.
    Further, Public Law 104-121 authorizes additional funds to
SSA for fiscal years 1996-2002 for the purpose of conducting
Social Security disability insurance continuing disability
reviews (CDRs) and Supplemental Security Income CDRs and
disability eligibility redeterminations. This new funding level
is achieved by increasing the amount of funds available for
appropriations under the discretionary spending cap. The
Commissioner of Social Security must 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, the Commissioner is
required to report annually, for fiscal years 1996-2002, 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.
    Public Law 104-193, the Personal Responsibility and Work
Opportunity Reconciliation Act (PRWORA) of 1996, signed on
August 22, 1996, makes several major changes in SSI law. These
include:
    Limited eligibility of noncitizens for SSI benefits.--
PRWORA prohibits SSI eligibility for all noncitizens except:
refugees, asylees, and noncitizens whose deportation has been
withheld (limited to their first 5 years of residence); certain
active duty Armed Forces personnel, honorably discharged
veterans, and their spouses and dependent children; and lawful
permanent residents who have worked for 10 years or more. For
purposes of the exception based on work, children are credited
with all quarters worked by their parents, and married
individuals (including widows) are credited with work performed
by spouses during their marriage. However, after December 31,
1996, quarters of work during which an individual received
Federal public assistance are not countable toward this
exception.
    Deeming of sponsors' incomes and resources.--For purposes
of eligibility for sponsored noncitizens admitted under new,
legally enforceable affidavits of support, PRWORA deems all of
the sponsors' (and sponsors' spouses') incomes and resources to
the noncitizen until citizenship. However, deeming is not
required for lawful permanent residents who have worked for 10
or more years (not counting quarters of work after 1996 during
which the individual received Federal public assistance), or
for children and spouses of workers credited with work
performed by them.
    Requirements for affidavits of support for sponsorship.--
Affidavits of support are made legally enforceable against the
sponsor until the noncitizen becomes a U.S. citizen. The agency
that provides assistance to a noncitizen must request
reimbursement from the sponsor for assistance provided.
    Reporting of illegal immigrants to the Immigration and
Naturalization Service.--The Commissioner of Social Security
must furnish to the Immigration and Naturalization Service the
name, address, and other identifying information of any
individual that SSA knows is unlawfully present in the United
States.
    SSI eligibility based on childhood disability.--The
comparable severity standard is eliminated and replaced by the
standard that a child is considered disabled if she has a
medically determinable impairment which results in ``marked and
severe'' functional limitations and which can be expected to
result in death or which has lasted or can be expected to last
for a continuous period of not less than 12 months. The Social
Security Administration is directed to eliminate references to
maladaptive behavior in the domain of personal/behavioral
function in the listing of impairments for children and to
discontinue the use of individualized functional assessments in
evaluating a child's disability. SSA is also required to
redetermine, using the new criteria and by no later than August
22, 1997, the eligibility of recipients who may be affected by
the new criteria. Benefits for those recipients who do not meet
the new criteria would end on or after the later of July 1,
1997, or the date of the redetermination.
    CDRs must be conducted once every 3 years for child
recipients with nonpermanent impairments, and not later than 12
months after birth for low birth weight babies. Representative
payees must present evidence to SSA that the recipient is
receiving treatment that is medically necessary and available,
unless SSA determines that such treatment would be
inappropriate or unnecessary. An eligibility redetermination,
using the adult initial eligibility criteria, must be performed
within 1 year after child recipients turn 18.
    Funding.--PRWORA authorizes the appropriation of an
additional $150 million in fiscal year 1997 and $100 million in
fiscal year 1998 for the costs of performing CDRs and
redeterminations.
    Prisoner reporting.--The law provides for incentive
payments ($400 for information received within 30 days of
confinement or $200 for information received from 31 to 90 days
after confinement) to State and local penal institutions that
furnish identifying information to SSA which results in
suspension of SSI benefits to prisoners.
    Modifying the effective date of applications.--An
individual's application for SSI benefits would be effective on
the first day of the month following the date on which the
application is filed, or on which the individual first becomes
eligible, whichever is later. (This change effectively
eliminates prorated payments for the month of application,
while continuing emergency advance payments and subsequent
repayments over several months in certain cases.)
    Reduction in cash benefits payable to institutionalized
individuals whose medical costs are covered by private
insurance.--PRWORA limits to not more than $30 a month, cash
benefits payable to children who are in an institution
receiving medical care covered by private insurance.
    Installment payments of large past-due SSI payments.--A
schedule for paying large retroactive SSI benefit amounts at 6-
month intervals is established.
    Dedicated savings accounts.--PRWORA requires the
establishment of a bank account to maintain large retroactive
SSI benefits, to be used for education or job skill training,
special equipment, medical rehabilitation, or other appropriate
items or services related to the impairment of the child.
    Public Law 104-208, the Department of Defense
Appropriations Act for fiscal year 1997, includes the Illegal
Immigration Reform and Immigrant Responsibility Act of 1996,
which amends Public Law 104-193 with regard to noncitizens'
eligibility for SSI benefits. Noncitizen individuals and their
children who are battered or abused are added to the list of
``qualified aliens.'' Sponsorship affidavits of support are
made legally binding and sponsor-to-immigrant deeming of income
and resources in the SSI Program continues until noncitizens
become U.S. citizens or they, their spouses, or parents work 40
quarters in the United States. The law also provides additional
exceptions to sponsor-to-immigrant deeming for indigent
noncitizens whose sponsors do not provide them with income
sufficient to obtain food and shelter and for battered
individuals and their children.
    In addition, Public Law 104-208 requires several reports to
Congress. The Commissioner of Social Security is required to
report the aggregate number of Social Security numbers issued
to noncitizens not authorized to work but under which earnings
were reported and the extent to which Social Security numbers
and Social Security cards are used by noncitizens for
fraudulent purposes. These two reports are due no later than 3
months after the end of each fiscal year, and within 1 year
after the date of enactment, respectively. The General
Accounting Office also is required to report to Congress and
the Department of Justice within 180 days after the date of
enactment on the extent to which means-tested benefits are
being paid to noncitizens acting as representative payees who
are not ``qualified aliens.''

                             105th Congress

    Public Law 105-18, an emergency supplemental appropriations
bill, provides a 1-month extension for noncitizens who were
receiving benefits on the date of enactment of Public Law 104-
193--August 22, 1996--and who would not continue to be eligible
under the noncitizen restrictions in that law by changing the
date by which SSI redeterminations of eligibility had to be
completed from August 22, 1997 to September 30, 1997.
    Public Law 105-33, the Balanced Budget Act of 1997, made
several major changes in SSI. These include:
    SSI eligibility for aliens receiving SSI on August 22, 1996
and certain disabled legal aliens.--Public Law 105-33 provides
that, despite restrictions in the 1996 welfare reform law,
noncitizens lawfully residing in the United States who were
receiving SSI on August 22, 1996, remain eligible for SSI. In
addition, noncitizens lawfully residing in the United States on
August 22, 1996, are eligible for SSI if they become disabled
in the future. The law also provides that members of Native
American Indian tribes who are noncitizens are not affected by
the SSI restrictions in Public Law 104-193. In addition,
individuals who received SSI prior to January 1, 1979, continue
to be eligible for benefits if the Commissioner of Social
Security lacks clear and convincing evidence that such
individuals are noncitizens ineligible for benefits.
    Extension of eligibility period for refugees and certain
other qualified aliens from 5 to 7 years for SSI and Medicaid;
status of Cuban/Haitian entrants and certain Amerasians.--
Public Law 105-33 extends from 5 years to 7 years the initial
eligibility period for SSI and Medicaid for refugees, asylees,
and noncitizens who have had their deportations withheld. In
addition, Cuban and Haitian entrants and Amerasian immigrants
are added to the categories of noncitizens who are considered
``qualified aliens.'' These groups are eligible for SSI for
their initial 7 years, and are exempt from the 5-year
eligibility ban on noncitizens entering the United States after
August 22, 1996.
    Exceptions for certain Indians from noncitizen limitations
on eligibility for Supplemental Security Income and Medicaid
benefits.--Public Law 105-33 exempts noncitizen members of
federally recognized Indian tribes or noncitizen Native
Americans from the SSI and Medicaid restrictions in the 1996
act.
    Exemption from noncitizen restrictions on SSI Program
participation by certain recipients eligible on the basis of
very old applications.--Public Law 105-33 exempts certain
individuals who have been on SSI rolls since before January 1,
1979, from the noncitizen restrictions in the 1996 act.
    Derivative eligibility for noncitizens for Medicaid and
food stamp benefits.--Public Law 105-33 provides that
noncitizens who are otherwise ineligible for Medicaid under the
1996 act may be eligible for Medicaid if they receive SSI
benefits and if the State's Medicaid plan provides Medicaid
eligibility for SSI recipients. The legislation also clarifies
that noncitizens who are otherwise ineligible under the 1996
act for food stamps would not be made eligible for food stamps
because they receive SSI benefits.
    Fees for Federal administration of State supplementary
payments.--Public Law 105-33 increases fees for SSA's
administering State supplementary payments, with added
collections available for SSA administrative purposes.
    Timing of delivery of October 1, 2000, SSI benefit
payments.--In order to meet budget targets, Public Law 105-33
provides that the October 2000 SSI check be paid on October 2,
which is a Monday, rather than on the last Friday in September.
    In addition, Public Law 105-33 gives the States the option
of permitting individuals who had been receiving SSI disability
benefits, but are working, to buy into Medicaid if their family
income is less than 250 percent of poverty. In addition, States
are required to continue Medicaid coverage for children who
were receiving SSI disability benefits as of August 22, 1996,
but whose eligibility would end because they do not meet the
new, more strict SSI childhood disability eligibility criteria.
    Technical amendments to the 1996 welfare reform law.--The
legislation makes a number of technical clarifications with
regard to the disabled children's redetermination and
continuing disability review requirements. Technical changes
also clarify the meaning of the term ``final adjudication''
with regard to SSI disability cases based on drug addiction or
alcoholism and expands the applicability of provisions in
Public Law 104-121 that require treatment referrals and
authorization of fees for organizations serving as
representative payees for SSI beneficiaries who have a DAA
condition.
    Technical corrections also are made that clarify when the
reporting incentives involving prisoners apply and that allow
SSA to charge a fee as a condition of processing requests for
information by law enforcement authorities regarding SSI
recipients who are fugitive felons and probation or parole
violators. Clarifications are made concerning SSI dedicated
savings account funds and terminology relating to medical
treatment facilities and the applicability of the $30 SSI
payment limit are updated. Noncitizens technical correction
provisions include adding battered parents to the definition of
``qualified alien'' and the exemptions from sponsor-to-
immigrant deeming, clarifying that veterans widow(er)s may be
eligible for benefits, and authorizing SSA to disclose
noncitizens' quarters of coverage information to other
governmental agencies for the purpose of carrying out the
noncitizen restriction provisions.
    Public Law 105-306, the Noncitizen Benefit Clarification
and Other Technical Amendments Act of 1998 provided continuing
eligibility for SSI for nonqualified aliens who were receiving
benefits on August 22, 1996.

                             106th Congress

     Public Law 106-169, the Foster Care Independence Act of
1999, contains numerous provisions related to SSI fraud
reduction and overpayment recovery. These provisions are
summarized below.
     Overpayments and debt collection.--The law amends the
Social Security Act to make representative payees liable for
the repayment of Social Security benefit checks distributed
after the recipient's death. SSA will monitor these repayments
using representative payees' Social Security numbers. Beginning
on December 14, 2000, SSA is authorized to recover up to 50
percent of lump sum SSI benefit payments made to individuals
(or eligible spouses) who are themselves liable for the
repayment of SSI benefits. The law also authorizes SSA to
intercept Federal and State payments owed to individuals, use
debt collection agencies, and other techniques to collect
overpayments.
     Treatment of assets.--Public Law 106-169 changes the way
assets held in trusts are treated when determining SSI Program
eligibility and benefit amounts. (A trust is defined by SSA as
a legal arrangement involving property and ownership
interests.) Assets and income in irrevocable trusts may not be
revoked or used by an individual for personal support and
maintenance. These trusts, previously exempt from SSI resource
limit calculations, will be counted toward the resource limit
for program eligibility and used to determine benefit amounts.
All trusts established after January 1, 2000--regardless of the
purpose of the trust, degree of trustee discretion, or
restrictions on distribution--will be affected by the law.
However, the new law allows the Commissioner of Social Security
to waive the consideration of a trust if doing so would create
an undue hardship for an individual. The criteria for undue
hardship will be determined by the Commissioner.
     Disposal of resources.--The law also imposes new rules
regarding resources disposed of at less than fair market value.
Individuals or their spouses who dispose of resources at less
than fair market value will be ineligible for SSI benefits from
the ``look-back'' date (the date the individual applied for
benefits or, if later, the date the individual disposed of
resources for less than fair market value) for a length of time
calculated by SSA. The ineligibility period is determined by
dividing the total value of the disposed resources by the
maximum monthly benefit and the maximum applicable State
supplementary payment. This ineligibility period may not exceed
36 months. Similar restrictions on the treatment of assets and
the disposal of resources were already in effect for the
Medicaid Program before enactment of Public Law 106-169.
     Certain resources are exempt from this provision:
resources transferred to a trust, if the trust is considered a
resource available to the individual; the transfer of a home to
family members under certain conditions; the transfer of
resources to a spouse for the spouse's sole benefit; or the
transfer of resources to an individual's blind or disabled
child (under age 65). Furthermore, a resource may be exempt if
an individual proves to the Commissioner that he intended to
dispose of the resource at fair market value; or that the
resource was transferred for reasons other than to qualify for
the SSI Program; or if the Commissioner determines that denial
of eligibility would cause an undue hardship.
     Penalties for false or misleading statements.--The law
contains provisions authorizing SSA to establish a new
administrative process to determine whether individuals have
fraudulently claimed benefits in cases considered too small to
prosecute in court. The law provides for increasing penalties
of 6, 12, and 24 months of ineligibility depending on the
nature of the case. However, the imposition of these penalties
will not impact an individual's receipt of other assistance.
The penalty procedure applies only to false and misleading
statements made after the date of the law's enactment, December
14, 1999. The Commissioner is mandated to develop regulations
detailing the administrative process for imposing the penalties
within 6 months of enactment.
     Health care providers and attorneys convicted of fraud or
administratively fined for fraud involving SSI eligibility
determinations are barred from participating in the SSI Program
for at least 5 years. SSA will provide individuals with
reasonable notice and opportunity for a hearing and judicial
review. SSA will also notify the State agencies that employ
such individuals and the State licensing agencies that license
or certify them. Attorneys and health care providers are
required to inform SSA of any past violations or convictions.
The Commissioner or Inspector General of Social Security may
waive the exclusion from involvement with the SSI Program for
an individual who is the only provider of services to a
community and may terminate exclusions on a case-by-case basis.
     Information sharing requirements.--There are a number of
provisions regarding information sharing between Federal and
State agencies in the new law. SSA is authorized to obtain
financial records for SSI recipients to ensure that they meet
SSI's resource restrictions and remain eligible for benefits.
     States are required to provide the Commissioner with
information for determining individuals' eligibility for Social
Security and SSI benefit programs. State prisons are also
required to provide inmate information to Federal and federally
assisted benefit programs. To help reduce fraudulent benefit
payments to prisoners of food stamps, veterans benefits,
unemployment benefits, and educational aid, SSA is required to
share its prisoner database with other Federal agencies and
departments.
    The law directs SSA to conduct computer matches with
Medicare and Medicaid data maintained by the Department of
Health and Human Services on individuals who are residents of
public institutions. Data obtained from these matches may be
used as a substitute for a physician's certification that an
individual's stay in an institution will be less than 3 months.
The Commissioner and the Secretary of the Department of Health
and Human Services will mutually determine the terms of the
data matching.
     Future study and reporting requirements.--The law requires
the Commissioner, in consultation with the SSA Inspector
General and the Attorney General, to study and report to
Congress on legislative and administrative reforms that would
reduce or prevent SSI and Social Security DI fraud and
overpayments. Furthermore, the Commissioner must include an
itemized account of the amount of funds required to support
efforts to combat fraud by applicants and beneficiaries in the
SSA annual budget. This requirement is effective for annual
budgets prepared after fiscal year 1999.
     Public Law 106-170, the Ticket to Work and Work Incentives
Improvement Act of 1999, expands Medicaid coverage and provides
work incentives for disabled beneficiaries of SSI. The law also
creates a ``ticket to work'' system whose purpose is to expand
the numbers and types of providers that SSI beneficiaries may
choose to assist them in receiving employment and vocational
rehabilitation services. In addition, the law has several other
provisions:
     Greater accessibility to vocational rehabilitation
providers.--Individuals on the SSI rolls are given access to a
broader pool of vocational rehabilitation providers. SSI
recipients are provided with ``tickets'' that they can use as
vouchers to obtain employment services, case management,
vocational rehabilitation, and support services from the
providers of their choice, including State vocational
rehabilitation agencies. This program will be implemented on a
gradual basis within 1 year of enactment at test sites and
within 4 years in every State.
    The law also authorizes the Commissioner to make grants of
up to $7 million each year for fiscal years 2000-2004 to
protection and advocacy organizations providing information and
advice about obtaining vocational rehabilitation and employment
services. The Secretary of Health and Human Services is
authorized to award grants to States to design, establish, and
operate infrastructures providing items and services to support
working individuals with disabilities, and to conduct outreach
campaigns to publicize the new benefits under the legislation
($20 million, $25 million, $30 million, $35 million, and $40
million for fiscal years 2001-5, respectively; for fiscal years
2006-11, the law authorizes the prior year's amount adjusted
for inflation.)
     Creation of employment networks.--Employment networks are
required to consist of a single public or private provider or
an association of providers combined into a single entity which
assumes responsibility for the coordination and delivery of
services. Employment networks, which must be experienced in
providing relevant employment and support services to
individuals with disabilities will work with beneficiaries to
develop employment plans and employment goals. The employment
networks are responsible for providing periodic performance
reports to beneficiaries holding tickets and periodic quality
assurance reviews. The Commissioner will establish mechanisms
for resolving disputes between employment networks and
beneficiaries. State vocational rehabilitation agencies and
employment networks must enter into agreements with individuals
referred by an employment network to a State vocational
rehabilitation agency for services.
     Payment to employment networks is based on one of two
payment systems. Under the outcome payment system, employment
networks are provided with up to 40 percent of the average
monthly disability benefit for each month (up to 60 months)
benefits are not payable to the beneficiary due to work. Under
the outcome-milestone payment system, employment networks
receive early payments based on the achievement of one or more
milestones toward permanent employment. The total amount
payable under this system may not exceed the total amount
payable under the outcome payment system. Regardless of the
system used, beneficiaries forgo their SSI benefit and instead
receive earnings from work. The cost effectiveness of the
payment systems will be evaluated by the Commissioner.
     Limitations on continuing disability reviews (CDRs) for
ticket to work participants.--The law prohibits the
Commissioner from initiating a CDR for a beneficiary
participating in the Ticket to Work and Self-Sufficiency
Program. Further, if beneficiaries do not succeed at their work
effort, the law provides for the reinstatement of SSI benefits
without requiring re-application.
     Medicaid expansion.--Under Public Law 106-170, States can
opt to cover persons with disabilities at higher income and
resource levels than otherwise permitted (i.e., over 250
percent of the Federal poverty level and over $2,000,
respectively), and whose medical condition would not otherwise
permit them to be covered. States can require these individuals
to ``buy into'' Medicaid coverage by paying premiums or other
cost-sharing charges on a sliding fee scale based on income, as
established by the State.
     Demonstration projects and studies.--The law extends
Social Security demonstration projects relating to disabled
beneficiaries and establishes a new demonstration project to
test phasing out disability benefits for earnings above a
certain level of income. Further, the General Accounting Office
is required to study the effects of the substantial gainful
activity level on recipients who return to work, and report on
whether disregarding certain income for calculating benefits is
appropriate.
     Other.--The law permits the Commissioner to withhold an
assessment charge of 6.3 percent of the attorney's fees for the
purpose of recovering costs to SSA of withholding and payment
of attorneys fees. SSA is authorized to penalize States that
are late in paying administrative fees to SSA.

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Social Security Administration. (1999, December). Supplemental
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Sullivan v. Zebley, et al., No. 88-1377 (U.S. filed February
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