SECTION 3. SUPPLEMENTAL SECURITY INCOME (SSI)

                                CONTENTS

Background
Trends
Basic Eligibility
  Categorical Requirements
  Citizenship and Residency Requirements
  Prohibition of Payment to 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
Vocational Rehabilitation 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
  Overview of Section 1619 Provisions
Measures of SSI Participation


  SSI Participation Rates
  Changes in Number of Recipients, 1970-96
  SSI Program Costs
Legislative History
  Legislative Changes Made in the 103d Congress
  Legislative Changes Made in the 104th Congress
  Legislative Changes Made in the 105th 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 from their dependent situations (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 areas such as the conditions
of eligibility and the method of determining payments. In
addition, States have the option of supplementing the basic
Federal SSI payment. In some cases, State supplementary
payments are administered by the State instead of the Federal
Government (i.e., the Social Security Administration).

                                 TRENDS

    Table 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 6.6 million in December 1996. The
        number of SSI recipients declined early in the program
        as the number of aged individuals on SSI declined, but
        that trend reversed in the mid-1980s as rapid growth in
        disabled recipients outstripped the minimal change in
        the elderly and blind SSI populations.
 2. Total annual benefits paid under the SSI Program rose from
        about $5.2 billion in 1974 to $28.3 billion in 1996.
 3. The monthly Federal benefit rates for individuals and
        couples rose from $140 and $210 in 1974 to $484 and
        $726 in 1997 (1997 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 1974-96
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                            Year
                           Item                            -------------------------------------------------------------------------------------------------------------------------------------
                                                               1974       1978       1980       1984        1986        1988       1990       1992       1993       1994       1995       1996
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
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  1,474,852  1,465,905  1,446,122  1,412,632
    Blind.................................................     74,616     77,135     78,401      80,524      83,115     82,864     83,686     85,400     85,456     84,911     83,545     82,137
    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  4,424,022  4,744,470  4,984,467  5,118,949
                                                           -------------------------------------------------------------------------------------------------------------------------------------
      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  5,984,300  6,295,786  6,514,134  6,613,718
                                                           =====================================================================================================================================
Number with section 1619(a)...............................         NA         NA         NA  406 (8/84)  992 (1/86)     19,920  \2\ 13,99
                                                                                                                                        4     17,603     18,597     24,315     28,060     31,085
Number with section 1619(b)...............................         NA         NA         NA       6,804       8,106     15,625     23,517     31,649     34,293     40,683     47,002     51,905
Annual payments (in millions):
    Federal benefits......................................     $3,833     $4,881     $5,866      $8,281      $9,498    $10,734    $12,894    $18,247    $20,722    $22,175    $23,919    $25,265
    Federal admin. State supp.............................      1,264      1,491      1,848       1,792       2,243      2,671      3,239      3,435      3,270      3,116      3,118      2,988
    State admin. State supp...............................        149        180        226         299         340        381        466    \3\ 556        564        579    \4\ 620      4,546
                                                           -------------------------------------------------------------------------------------------------------------------------------------
      Total...............................................     $5,246     $6,552     $7,940     $10,372     $12,081    $13,786    $16,599    $22,238    $23,991    $25,870    $27,037    $28,252
                                                           =====================================================================================================================================
Annual payments (in millions of 1996 dollars).............    $16,696    $15,767    $15,119     $15,663     $17,295    $18,284    $19,926    $24,869    $26,050    $27,389    $27,835    $28,252
Monthly Federal benefits rates:
    Individuals...........................................    $140.00    $177.80    $208.20     $314.00     $336.00    $354.00    $386.00    $422.00    $434.00    $446.00    $458.00    $470.00
    Couples...............................................     210.00     266.70     312.30      472.00      504.00     532.00     579.00     633.00     652.00     687.00     687.00     705.00
Average Federal SSI payments: \1\
    All recipients........................................     $95.11    $111.98    $143.35     $196.16     $215.40    $227.49    $261.47    $329.74    $317.41    $325.26    $334.12    $339.24
    Aged individuals......................................      78.48      91.22     112.45      143.24      151.38     159.36     175.29     195.86     204.45     211.55     219.13     227.42
    Aged couples..........................................      93.02     120.48     157.56      221.98      246.07     273.18     322.82     448.61     478.42     505.64     534.00     563.39
Average federally administered: \1\
    State supplementation.................................     $70.92     $75.00     $99.15      $97.61     $115.41    $122.68    $139.79    $118.08    $108.50    $101.46    $105.24    $104.58
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       40.1       39.1       37.9       37.0
    Other unearned income.................................       10.5       11.5       11.0        11.2        12.1       12.4       13.0       14.5       13.4       13.1       12.8       12.4
    Earnings..............................................        2.8        3.1        3.2         3.5         3.9        4.4        4.7        4.4        4.3        4.2        4.3        4.4
Average amount of: \1\
    Social Security benefits..............................    $130.01    $156.50    $196.94     $250.61     $263.29    $286.49    $318.57    $335.72    $338.85    $345.20    $354.47    $382.56
    Other unearned income.................................      61.10      66.93      74.35       84.56       86.40      85.92      98.13      91.96     100.44     101.13     105.32     112.46
    Earnings..............................................      80.00      99.32     106.95      126.47      142.17     173.09     195.64     207.55     210.22     225.01     234.94     258.42
Poverty thresholds (age 65 and over):
    Individual............................................     $2,364     $3,127     $3,949      $4,979      $5,255     $5,674     $6,268     $6,729     $6,930     $7,108     $7,309     $7,525
    Couple................................................      2,982      3,944      4,983       6,282       6,630      7,158      7,905      8,489      8,741      8,967      9,221      9,491
Federal benefit rate as a percent of poverty:
    Individual............................................       74.1       72.7       72.3        75.6        76.7       74.9       73.9       75.3       75.2       75.3       75.2       75.0
    Couple................................................       88.1       86.4       86.0        90.2        91.2       89.2       87.9       89.5       89.5       89.5       89.4      89.1
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ December data.
\2\ The decrease in 1619(a) participants in 1990 was caused by the increase in the substantial gainful activity level to $500 monthly.
\3\ Fiscal year 1992 data.
\4\ Fiscal year 1996 data.

 NA--Not available.

 Source: Social Security Administration (1995 and various years) and unpublished data.

 4. The proportion of SSI recipients receiving Social Security
        benefits declined from nearly 53 percent in 1974 to 37
        percent in 1996. The fraction of SSI recipients
        receiving some other type of unearned income rose
        slightly from about 11 percent in 1974 to 12 percent in
        1996, and the fraction with earnings increased from
        about 3 percent in 1974 to more than 4 percent in
        December 1996.
 5. The Federal benefit rate as a percent of the appropriate
        poverty level for individuals has ranged from 72 to 77
        percent and is currently 75 percent; for couples it has
        ranged from 86 to 91 percent and is currently at 89
        percent. Most States supplement the Federal benefit for
        at least some participants.
 6. The SSI Program pays benefits to children who are blind or
        have other disabilities. Some of the increases in
        participation since 1991 reflect the revised definition
        of disability for children as a result of the Supreme
        Court's decision in the Sullivan v. Zebley case. 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
$500 monthly in counted income, with impairment-related
expenses subtracted from earnings. Generally, the individual
must be unable to do any kind of work that exists in the
national economy, taking into account age, education, and work
experience.
     Children may qualify for SSI if they are under age 18 (or
under age 22 if a full-time student), unmarried, and meet the
applicable SSI disability or blindness, income, and resource
requirements. Public Law 104-193, the Personal Responsibility
and Work Opportunity Reconciliation Act 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 previous 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 (Public Law 104-193)
discontinues the individualized functional assessment
disability determination procedure 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 Public Law 104-193, 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 Fugitives

    The Personal Responsibility and Work Opportunity
Reconciliation Act of 1996 (Public Law 104-193) provides that,
as of August 22, 1996, SSI benefits may not be paid to
individuals who are fleeing to avoid prosecution for a crime
which is a felony, or fleeing to avoid custody or confinement
after conviction for a crime which is a felony, 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 $484 for an individual and $726 for a couple
(calendar year 1997 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 is deemed to that
immigrant.
    Income includes cash, checks, and items received ``in
kind'' such as food and shelter. Wages, net earnings from self-
employment, and income from sheltered workshops are considered
earned income. Social Security benefits, workers' or veterans'
compensation annuities, rent, and interest are counted as
unearned income.
    An individual does not have to be totally without income to
be eligible for SSI benefits. Maximum SSI benefits are paid,
assuming the other conditions of eligibility are met, if the
individual or couple has no ``countable'' income in that
particular month. If the individual or couple has ``countable''
income, a dollar-for-dollar reduction is made against the
maximum payment. Not all income is counted for SSI purposes.
Major exclusions include the first $20 of monthly income from
virtually any source (such as Social Security benefits, but not
needs-tested income such as veterans' pensions) and the first
$65 of monthly earned income plus one-half of remaining
earnings.
    Income received in sheltered workshops and work activity
centers is considered earned income and qualifies for 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, 1997
----------------------------------------------------------------------------------------------------------------
                                                                   Receiving only Social    Receiving only wage
                                                                         Security                 income
                                                                 -----------------------------------------------
                                                                    Monthly    Annually     Monthly    Annually
----------------------------------------------------------------------------------------------------------------
Individual......................................................        $504      $6,048      $1,053     $12,636
Couple..........................................................         746       8,952       1,537     18,444
----------------------------------------------------------------------------------------------------------------
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 her, the SSI benefit standard for such an
individual is reduced by one-third. By regulation, SSA has also
ruled that the value of any in-kind support and maintenance
received (other than in-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 (plan for achieving self-support) 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 not 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,
the matches totaled 508,000. SSA has evaluated and adjusted the
tolerance levels several times over the years. Effective
October 1993, the tolerance level for income from resources--
e.g., interest and dividends--is $60. The tolerance level for
other nonwage income not from resources--e.g., unemployment
compensation and pensions--is $1,000. Also, a special tolerance
was developed for cases that had been matched before; if the
current year's resources are less than $10 more than the prior
year's resource indicators, the IRS report is not examined. All
match information is sent to Social Security offices for
verification of the information. For fiscal years 1994 and 1995
there were 297,000 and 181,000 matches, respectively.
    Based on a study of the 1993 matches, SSA decided to apply
a statistical profiling technique to the IRS matches.
Statistical profiling increases the cost effectiveness of the
IRS process by targeting the more error-prone matches and
eliminating the less productive matches. The resulting savings
to the SSI Program were $45 million.
    Prior to the 1984 Deficit Reduction Act, if in any month a
recipient's assets exceeded the asset limit, the individual was
ineligible for benefits in that month and the entire amount of
the benefit paid for that month was considered an overpayment
subject to recovery. Effective October 1, 1984, SSI law
provides that in cases where there is an overpayment based
solely on an excess of assets of $50 or less, the recipient is
deemed to be without fault for purposes of waiving the
overpayment and the overpayment is not recovered unless the
Secretary finds that the failure to accurately and timely
report the excess was knowing and willful on the part of the
recipient.
    An individual may receive SSI benefits for a limited time
even though he has certain nonliquid property that, if counted,
would make him ineligible. These benefits are conditioned upon
the disposal of the property, and are subject to recovery as
overpayments when the property is sold. The 1987 Budget
Reconciliation Act provides, in addition, for the exclusion of
real property if it cannot be sold because it is jointly owned
and sale would cause undue hardship to the joint owner due to
loss of housing, because 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 while in medical institutions, and who otherwise
would be ineligible for SSI because of their parents' income or
resources, have been eligible for the $30 monthly personal
needs allowance that would be payable if they were
institutionalized, without regard to their parents' income and
resources. Effective October 1, 1993, an ineligible parent or
spouse who is absent from a household due solely to a duty
assignment as a member of the Armed Forces is considered,
absent evidence to the contrary, to be living in the same
household as the SSI applicant or recipient for deeming
purposes.
    By regulation, the Commissioner of Social Security has
provided that in determining the amount of the income of an
ineligible spouse or parent to be deemed to the SSI applicant
or recipient, the needs of the spouse or parent and other
children in the household are taken into account. In addition,
the SSI earned and unearned income exclusions are applied in
determining the amount of income to be deemed to the SSI
applicant or recipient. If the combined countable income of an
SSI applicant and an ineligible spouse does not exceed the SSI
benefit standard for an eligible couple in that State
(including any federally administered State supplementary
payment), the SSI applicant would be eligible to receive an SSI
and/or State supplementary benefit.
    For example, in 1997 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 ($485).................      -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...........................       726.00
Less countable income......................................      -447.50
                                                            ------------
      Benefit payable to eligible individual...............       278.50


    Thus, the benefit for the eligible individual will be $278
(SSI law requires that benefits be rounded down to the next
lower dollar). Without deeming and as an individual, the
recipient would have received $304 [$484 - ($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 1996, there were about 128,000 children's cases
in which deeming reduced benefits. This figure does not take
into account, however, the number of children who were not
eligible because of the deeming provision. (For a discussion of
deeming rules for noncitizens, see appendix J.)

       Presumptive SSI Eligibility for Persons with AIDS and HIV

    SSI law permits benefits to be paid to a person applying
for SSI benefits on the basis of disability or blindness before
a formal determination of disability or blindness has been made
when available information indicates a high probability that
the person will be eligible.
    Section 1631(a)(4)(B) of the Social Security Act provides
that the Commissioner of Social Security may pay up to 6 months
of SSI benefits to a person applying for SSI based on
disability or blindness prior to the determination of the
individual's disability or blindness if the individual is
presumptively disabled or blind and otherwise eligible. A
finding of presumptive disability or blindness may be made at
the Social Security field offices only for specified impairment
categories because the field office employees generally are not
trained disability adjudicators; however, at the State agencies
where there are disability adjudicators 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 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

    In general, 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: Overview of Section 1619
        Provisions'') in the month preceding the first full
        month of residency in a medical or psychiatric
        institution which agrees to permit the individual to
        retain benefit payments. Payment may be made for the
        first full month of institutionalization and the
        subsequent month.
 6. A physician certifies that the recipient's stay in a
        medical facility is likely not to exceed 3 months and
        the recipient needs to continue to maintain and provide
        for the expenses of the home to which 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 was 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 covered about 73
percent 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. According to the Congressional Budget
Office, this requirement is expected to save $100 million over
the 6-year period (1997-2002).

               APPLICATION TO OTHER PROGRAMS REQUIREMENT

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

                    Eligibility for Social Security

    As noted, SSI law requires that applicants file for all
other benefits for which they may be entitled. Since its
inception SSI has been viewed as the ``program of last
resort.'' That is, after evaluating all other income, SSI pays
what is necessary to bring an individual to the statutorily
prescribed income ``floor.'' As of December 1996, 37 percent of
all SSI recipients also received Social Security benefits (62
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, 1996, 32
States and the District of Columbia chose this option, and SSI
recipients in these States account for approximately 78 percent
of all SSI recipients nationwide.
    Under the second option, States elect to provide Medicaid
eligibility for all SSI recipients, but only if the recipient
completes a separate application with the State agency which
administers the Medicaid Program. The seven States of Alaska,
Idaho, Kansas, Nebraska, Nevada, Oregon, and Utah and the
Commonwealth of the Northern Mariana Islands, affecting about
2.6 percent of SSI recipients nationwide, have elected this
option.
    The third and most restrictive option is known as the
``209(b)'' option, under which States may impose Medicaid
eligibility criteria which are more restrictive than SSI
criteria, so long as the criteria chosen are not more
restrictive than the State's approved Medicaid State plan in
January 1972. The 209(b) States may be more restrictive in
defining blindness or disability, and/or more restrictive in
their financial requirements for eligibility, and/or require a
Medicaid application with the State. However, aged, blind, and
disabled SSI recipients who are Medicaid applicants must be
allowed to spend down in 209(b) States, regardless of whether
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 19.3 percent of the SSI
recipient population nationwide lives in these 209(b) States.
The 11 States that use this option are:

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

    An amendment included in the 1986 SSI Disability Amendments
(Public Law 99-643) required, effective July 1, 1987, that
209(b) States continue Medicaid coverage for individuals in
section 1619 status if they had been eligible for Medicaid for
the month preceding their becoming eligible under section 1619
(see section below on ``Special SSI Provisions for the Working
Disabled: Overview of Section 1619 Provisions'').
    The same legislation required States to provide for
continued Medicaid coverage for those individuals who lose
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.

                   VOCATIONAL REHABILITATION 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.

                              SSI BENEFITS

                      Federal SSI Benefit Standard

    The Federal SSI benefit standard for an individual for 1997
is $484 a month and $726 for a couple. As is discussed later,
most States supplement the Federal SSI benefit. The result is a
combined Federal SSI/State supplemental benefit against which
countable income is compared in determining eligibility and
benefit amount. However, many States limit their
supplementation to certain categories of individuals based on
specific indicators of need--especially special housing needs.
    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.
     In fiscal year 1996, about 781,000 people 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 1996 for those determined to be living
in the household of another is $322.67 for an individual and
$484 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.

                                 TABLE 3-3.--FEDERAL SSI BENEFIT LEVELS, 1974-97
                                                  [In dollars]
----------------------------------------------------------------------------------------------------------------
                                                                   Eligibility status
                                       -------------------------------------------------------------------------
                                                             Own household              Household of another
                 Year                     Medicaid  ------------------------------------------------------------
                                        institution                      Essential                     Essential
                                                      Single    Couple     person    Single   Couple     person
----------------------------------------------------------------------------------------------------------------
Initial...............................      $25.00    $130.00   $195.00    $65.00    $86.67   $130.00    $43.34
Jan. 1974.............................       25.00     140.00    210.00     70.00     93.34    140.00     46.67
July 1974.............................       25.00     146.00    219.00     73.00     97.34    146.00     48.67
July 1975.............................       25.00     157.70    236.60     78.90    105.14    157.74     52.60
July 1976.............................       25.00     167.80    251.80     84.00    111.87    167.87     56.00
July 1977.............................       25.00     177.80    266.70     89.00    118.54    177.80     59.34
July 1978.............................       25.00     189.40    284.10     94.80    126.27    189.40     63.20
July 1979.............................       25.00     208.20    312.30    104.20    138.80    208.20     69.47
July 1980.............................       25.00     238.00    357.00    119.20    158.67    238.00     79.47
July 1981.............................       25.00     264.70    397.00    132.60    176.47    264.67     88.40
July 1982.............................       25.00     284.30    426.40    142.50    189.54    284.27     95.00
July 1983.............................       25.00     304.30    456.40    152.50    202.87    304.27    101.67
Jan. 1984 \1\.........................       25.00     314.00    472.00    157.00    209.34    314.67    104.67
Jan. 1985.............................       25.00     325.00    488.00    163.00    216.67    325.34    108.67
Jan. 1986.............................       25.00     336.00    504.00    168.00    224.00    336.00    112.00
Jan. 1987.............................       25.00     340.00    510.00    170.00    226.67    340.00    113.34
Jan. 1988.............................       25.00     354.00    532.00    177.00    236.00    354.67    118.00
Jan. 1989.............................       30.00     368.00    553.00    184.00    245.34    368.67    122.67
Jan. 1990.............................       30.00     386.00    579.00    193.00    257.34    386.00    128.67
Jan. 1991.............................       30.00     407.00    610.00    204.00    271.34    406.67    136.00
Jan. 1992.............................       30.00     422.00    633.00    211.00    281.34    422.00    140.67
Jan. 1993.............................       30.00     434.00    652.00    217.00    289.34    434.67    144.67
Jan. 1994.............................       30.00     446.00    669.00    223.00    297.34    446.00    148.67
Jan. 1995.............................       30.00     458.00    687.00    229.00    305.34    458.00    152.66
Jan. 1996.............................       30.00     470.00    705.00    235.00    313.34    470.00    152.57
Jan. 1997.............................       30.00     484.00    726.00    242.00    322.67    484.00   161.33
----------------------------------------------------------------------------------------------------------------
\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 December 1996 4.2 percent, or about 277,800 SSI
recipients, had their benefits determined on the basis of this
``one-third reduction'' benefit standard. Sixty-three percent
of those recipients were receiving benefits on the basis of
disability (see table 3-4).

         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
personal needs allowance, 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 personal needs allowance. 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.

   TABLE 3-4.--NUMBER AND PERCENTAGE DISTRIBUTION OF PERSONS RECEIVING
  FEDERALLY ADMINISTERED PAYMENTS, BY LIVING ARRANGEMENT AND CATEGORY,
                              DECEMBER 1996
------------------------------------------------------------------------
                                               Reason for eligibility
    Living arrangement \1\        Total   ------------------------------
                                              Aged     Blind    Disabled
------------------------------------------------------------------------
Own household.................       93.5       91.0     92.4       94.2
Another's household...........        4.2        6.7      4.8        3.5
Institutional care covered by
 Medicaid.....................        2.3        2.2      2.8        2.3
                               -----------------------------------------
    Total percent.............      100.0      100.0    100.0      100.0
                               =========================================
    Total number..............  6,613,718  1,412,632   82,137  5,118,949

------------------------------------------------------------------------
\1\ As used for determination of Federal SSI payment standard.

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

    Approximately 152,120 or 2.3 percent of SSI recipients
received benefits in December 1996 on the basis of this
personal needs allowance. For those individuals whose income
from non-SSI sources exceeds the $30 benefit standard
(including those who were receiving both Social Security and
SSI before entering an institution), Medicaid regulations
require States to allow them (and other non-SSI Medicaid
eligibles) to retain no less than $30 a month of their income
as a ``personal needs allowance'' when their income is applied,
along with Medicaid reimbursement, to pay for their
institutional medical care.
    Sixteen State programs have exercised their option to
supplement the PNA. Prior to the 1985 Budget Reconciliation
Act, SSI regulations would not allow for Federal administration
of State PNA supplements. An amendment included in that
legislation now requires SSA, at the request of a State, to
administer such State supplementary payments. As of December
1996, California, the District of Columbia, Maine,
Massachusetts, Michigan, New Jersey, New York, Rhode Island,
and Vermont had opted for Federal administration. Approximately
28 States allow some or all of those individuals affected by
the Medicaid personal needs allowance regulations to retain
more than $30 a month.

           Benefits of Former Recipients of State Assistance

    Another benefit affecting some persons involves Federal
payments to an individual who was transferred to SSI from a
former State Program of Aid to the Aged, Blind, or Disabled. As
shown in table 3-3, the Federal benefits of these persons are
increased by up to $242 monthly in 1997 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 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 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 1996, Social Security offices made 6,871 emergency advance
payments using their third-party drafts in these new claims
situations totaling $3,074,542 with an average payment amount
of $447.
    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 1996, 48,235 Social Security and
51,516 SSI immediate payments were issued under this procedure.
The total amount of these payments equalled $35,233,014 for an
average of $353 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 his or her other
income. Thus, States must provide a supplementary payment to
any individual who, because of special needs or other reasons,
had a December 1973 payment higher than the amount she received
under the basic Federal SSI Program.
    To remain eligible for Medicaid Federal matching funds,
States were required to adopt a mandatory State supplementation
program. In December 1996, approximately 2,800 recipients or
less than 0.1 percent of all recipients were receiving payments
based in part on or solely because of the mandatory
supplementation rule.

Optional State supplementation

    In addition to any mandatory supplementation States must
provide, a State (or political subdivision) may choose to
provide an optional supplement to Federal SSI payments. This
optional supplement also is intended to help individuals meet
needs which are not fully met by the Federal payment. The State
determines whether it will make such a payment, to whom, and in
what amount. States have the option of covering recipients of
mandatory supplementation under their program of optional
supplementation.
    At the present time, all but eight States and jurisdictions
provide some form of optional State supplementation. States
that provide no supplement are: Arkansas, Georgia, Kansas,
Mississippi, Commonwealth of the Northern Mariana Islands,
Tennessee, Texas, and West Virginia. States (or local
jurisdictions) may elect to administer their supplementary
payments themselves or may contract with SSA for Federal
administration. 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 encourage
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. As a result, SSI
recipients in those States received no increase in the combined
Federal/State benefit amount when the Federal payment rose.
Congress responded by enacting the pass-along/maintenance-of-
effort provision for State supplementary payments (that is,
section 1618).
    Section 1618 allows States to comply with the pass along/
maintenance-of-effort 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 $484 a month in 1997, 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 a variety of other terms. The amount of supplementation by
the State also varies a great deal. For example, in the State
of Maryland under a State-administered supplementation program,
a ``specialized and intensive supervision'' group living
facility has a State supplementation of $666 a month in
addition to the Federal benefit level of $484. Thus the maximum
total Federal and State SSI payment in a month in Maryland is
$1,150. 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)
increases the amount of the fee charged by the SSA to
administer a State's supplementary SSI payments. The current
fee is $5 per check. It will be increased to $6.20 in fiscal
year 1998, $7.60 in fiscal year 1999, $7.80 in fiscal year
2000, $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.

State SSI supplement levels over time

     Throughout the entire period from July 1975 to January
1997, 23 States have continuously provided supplemental SSI
payments to aged individuals living independently.
    During the period from July 1975 to January 1997, no State
increased supplements faster than inflation for aged
individuals living independently or aged couples living
independently (see tables 3-5 and 3-6).

              TABLE 3-5.--STATE SSI SUPPLEMENTS FOR AGED INDIVIDUALS WITHOUT COUNTABLE INCOME LIVING INDEPENDENTLY, SELECTED YEARS 1975-97
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                                               Percent
                                                                                                                                               change
                         State                           July   July   Jan.   Jan.   Jan.   Jan.   Jan.   Jan.   Jan.   Jan.   Jan.   Jan.    (constant
                                                         1975   1980   1985   1988   1990   1991   1992   1993   1994   1995   1996   1997    dollars)
                                                                                                                                             1975-97 \1\
--------------------------------------------------------------------------------------------------------------------------------------------------------
Alaska \2\............................................   $142   $235   $261   $305   $331   $349   $362   $374   $362   $362   $362   $362           -13
California............................................    101    182    179    221    244    223    223    186    157    157    156    156           -47
Colorado..............................................     27     55     58     58     54     45     56     56     56     56     56     62           -22
Connecticut \3\.......................................     NA    102    141    403    366    359    325    313    301     NA  \3\ N
                                                                                                                                  A    243            NA
District of Columbia..................................      0     15     15     15     15     15     15     15     15      5      5      0            NA
Hawaii................................................     17     15      5      5      5      5      5      5      5      5      5      5           -90
Idaho.................................................     63     74     78     73     73     70     70     65     45     37     37     48           -74
Illinois \3\..........................................     NA     NA     NA     NA     NA     NA     NA     NA     NA     NA     NA     NA            NA
Maine.................................................     10     10     10     10     10     10     10     10     10     10     10     10           -66
Massachusetts.........................................    111    137    129    129    129    129    129    129    129    129    126    126           -61
Michigan..............................................     12     24     27     30     30     31     14     14     14     14     14     14           -60
Minnesota \4\.........................................     31     34     35     35     75     81     81     81     81     81     81     81           -11
Nebraska..............................................     67     75     69     43     38     24     30     28     21     19     12      8           -96
Nevada................................................     55     47     36     36     36     36     36     36     36     36     36     36           -78
New Hampshire.........................................     12     46     27     27     27     27     27     27     27     27     27     27           -23
New Jersey............................................     24     23     31     31     31     31     31     31     31     31     31     31           -56
New York..............................................     61     63     61     72     86     86     86     86     86     86     86     86           -52
Oklahoma..............................................     27     79     60     64     64     64     64     60     57     55     54     53           -33
Oregon................................................     17     12      2      2      2      2      2      2      2      2      2      2           -96
Pennsylvania..........................................     20     32     32     32     32     32     32     32     32     32     27     27           -54
Rhode Island..........................................     31     42     54     58     64     64     67     64     64     64     64     64           -30
South Dakota..........................................      0     15     15     15     15     15     15     15     15     15     15     15            NA
Utah..................................................      0     10     10      9      6      6      5      5      1      0      0      0            NA
Vermont...............................................     29     41     53     59     63     65     65     57     55     59     47     55           -35
Washington \5\........................................     36     43     38     28     28     28     28     28     28     28     25     28           -74
Wisconsin.............................................     70    100    100    103    103    103     93     93     85     84     84     84           -59
Wyoming...............................................      0     20     20     20     20     20     20     10     10     10     10     10            NA
                                                       -------------------------------------------------------------------------------------------------
  Median..............................................     31     43     36     36     37     36     32     31     31     32     31     36          -60
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ The percentage change in constant dollars was computed by inflating July 1975 to January 1996 by the CPI-U price index. The July 1975 index value is
  54.2 and the January 1997 value is 159.1.
\2\ 1975 and 1980--less if shelter costs less than $35 monthly.
\3\ State decides benefit on a case-by-case basis.
\4\ State has two geographic payment levels--Hennepin County and the remainder of Minnesota. Level shown is for Hennepin County, the area with the
  largest number of SSI recipients.
\5\ State has two geographic payment levels--highest levels are shown in table. Sum paid in King, Pierce, Kitsap, Snohomish, and Thurston Counties.

 NA--Not available.

 Source: Office of Supplemental Security Income, Social Security Administration, and Committee on Ways and Means staff calculations.

                TABLE 3-6.--STATE SSI SUPPLEMENTS FOR AGED COUPLES WITHOUT COUNTABLE INCOME LIVING INDEPENDENTLY, SELECTED YEARS 1975-97
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                                               Percent
                                                                                                                                               change
                         State                           July   July   Jan.   Jan.   Jan.   Jan.   Jan.   Jan.   Jan.   Jan.   Jan.   Jan.    (constant
                                                         1975   1980   1985   1988   1990   1991   1992   1993   1994   1995   1996   1997    dollars)
                                                                                                                                             1975-97 \1\
--------------------------------------------------------------------------------------------------------------------------------------------------------
Alabama...............................................     $9      0      0      0      0      0      0      0      0      0      0      0          -100
Alaska \2\............................................    183   $338   $371   $444   $484   $510   $528   $544   $528   $528   $528   $528            -2
California............................................    251    389    448    534    588    557    557    488    440    415    396    396           -46
Colorado..............................................    133    229    278    292    309    293    323    328    323    323    323    346           -11
Connecticut \3\.......................................     NA     NA     86    602    525    522    461    442    425     NA  \3\ N
                                                                                                                                  A    368            NA
District of Columbia..................................      0     30     30     30     30     30     30     30     30     15     15      0            NA
Hawaii................................................     28     24      9      9      9      9      9      9      9      9      9      9           -89
Idaho.................................................     49     80     46     44     45     44     45     40     21      9      9     16           -89
Illinois \3\..........................................     NA     NA     NA     NA     NA     NA     NA     NA     NA     NA     NA     NA            NA
Maine.................................................     15     15     15     15     15     15     15     15     15     15     15     15           -66
Massachusetts.........................................    173    214    202    202    202    202    202    202    202    202    197    197           -61
Michigan..............................................     18     36     40     45     45     46     21     21     21     28     28     28           -47
Minnesota \4\.........................................     38     44     66     66     88    132    129    126    126    126    111    111            -1
Nebraska..............................................     67    114    100     66     65     34     48     39     40     22     14      3           -99
Nevada................................................    106     90     74     74     74     74     74     74     74     74     74     74           -76
New Hampshire.........................................      0     42     21     21     21     21     21     21     21     21     22     21            NA
New Jersey............................................     13     12     25     25     25     25     25     25     25     25     25     25           -35
New York..............................................     76     79     76     93    102    103    103    102    102    102    103    103           -54
Oklahoma..............................................     54    158    120    128    128    128    128    120    114    110    108    106           -33
Oregon................................................     17     10      0      0      0      0      0      0      0      0      0      0          -100
Pennsylvania..........................................     30     49     49     49     49     49     49     49     49     49     44     44           -50
Rhode Island..........................................     59     79    102    111    120    121    127    120    120    120    121    121           -30
South Dakota..........................................      0     15     15     15     15     15     15     15     15     15     15     15            NA
Utah..................................................      0     20     20     18     12     12     11     10      5      5      5      5            NA
Vermont...............................................     61     76     96    106    115    118    118    110    103    110     92    103           -43
Washington \5\........................................     40     44     37     22     22     22     22     22     22     22     20     22           -81
Wisconsin.............................................    105    161    161    166    166    166    146    146    134    132    132    132           -57
Wyoming...............................................      0     40     40     40     40     40     40     19     19     25     25     25            NA
                                                       -------------------------------------------------------------------------------------------------
  Median..............................................     57     63     66     66     65     49     49     30     39     28     28     44          -74
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ The percentage change in constant dollars was computed by inflating July 1975 to January 1996 by the CPI-U price index. The July 1975 index value is
  54.2 and the January 1997 value is 159.1.
\2\ 1975 and 1980--less if shelter costs less than $35 monthly.
\3\ State decides benefit on a case-by-case basis.
\4\ State has various geographic payment levels. Level shown is for Hennepin County, the area with the largest number of SSI recipients.
\5\ State has two geographic payment levels--highest levels are shown in table. Sum paid in King, Pierce, Kitsap, Snohomish, and Thurston Counties.

 NA--Not available.

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

    Approximately 37 percent of SSI recipients receive a State
supplement. For those SSI recipients, other than those
receiving a State supplement because they are living in some
type of group living arrangement, the amount of State
supplement ranges from $2 a month to $362 a month for an
individual. At present, 25 States supplement the Federal
standard for individuals living independently.

      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. These tables assume that the elderly individual or
couple receive an excess shelter deduction of $250 (the maximum
for nonelderly) and an excess medical cost deduction of $4 in
the Food Stamp Program. Approximately 66 percent of SSI
households in the Food Stamp Program claim a shelter deduction;
it is estimated that approximately 17 percent of them are
allowed a deduction that exceeds the excess shelter expense
ceiling for nonelderly or nondisabled households ($250 per
month). About 4 percent of SSI households claim a medical cost
deduction.

  TABLE 3-7.--MAXIMUM POTENTIAL SSI AND FOOD STAMP BENEFITS FOR AGED INDIVIDUALS LIVING INDEPENDENTLY, JANUARY
                                                    1997 \1\
----------------------------------------------------------------------------------------------------------------
                                                                                               Combined benefits
                              State                                 Maximum SSI   Food stamp -------------------
                                                                      benefit    benefit \2\  Monthly    Annual
----------------------------------------------------------------------------------------------------------------
Alabama..........................................................          $484        $91       $575     $6,900
Alaska...........................................................           846         99        945     11,340
Arizona..........................................................           484         91        575      6,900
Arkansas.........................................................           484         91        575      6,900
California.......................................................           640      \3\ 0        640      7,680
Colorado.........................................................           546         72        618      7,416
Connecticut......................................................           747         12     \4\ NA         NA
Delaware.........................................................           484         91        575      6,900
District of Columbia.............................................           484         91        575      6,900
Florida..........................................................           484         91        575      6,900
Georgia..........................................................           484         91        575      6,900
Hawaii...........................................................           489        198        687      8,244
Idaho............................................................       \5\ 532         82        614      7,368
Illinois.........................................................        \6\ NA         NA         NA         NA
Indiana..........................................................           484         91        575      6,900
Iowa.............................................................           484         91        575      6,900
Kansas...........................................................           484         91        575      6,900
Kentucky.........................................................           484         91        575      6,900
Louisiana........................................................           484         91        575      6,900
Maine............................................................           494         88        582      6,984
Maryland.........................................................           484         91        575      6,900
Massachusetts....................................................           610         53        663      7,956
Michigan.........................................................           498         87        585      7,020
Minnesota........................................................       \7\ 565         66        631      7,572
Mississippi......................................................           484         91        575      6,900
Missouri.........................................................           484         91        575      6,900
Montana..........................................................           484         91        575      6,900
Nebraska.........................................................           492         88        580      6,960
Nevada...........................................................           520         80        600      7,200
New Hampshire....................................................           511         83        594      7,128
New Jersey.......................................................           515         81        596      7,152
New Mexico.......................................................           484         91        575      6,900
New York.........................................................           570         65        635      7,620
North Carolina...................................................           484         91        575      6,900
North Dakota.....................................................           484         91        575      6,900
Ohio.............................................................           484         91        575      6,900
Oklahoma.........................................................           537         75        612      7,344
Oregon...........................................................           486         90        576      6,912
Pennsylvania.....................................................           511         83        594      7,128
Rhode Island.....................................................           548         72        620      7,440
South Carolina...................................................           484         91        575      6,900
South Dakota.....................................................           499         86        585      7,020
Tennessee........................................................           484         91        575      6,900
Texas............................................................           484         91        575      6,900
Utah.............................................................           484         91        575      6,900
Vermont..........................................................       \8\ 539         74        613      7,356
Virginia.........................................................           484         91        575      6,900
Washington.......................................................       \9\ 512         82        594      7,128
West Virginia....................................................           484         91        575      6,900
Wisconsin........................................................           568         66        634      7,608
Wyoming..........................................................           494         88        582     6,984
----------------------------------------------------------------------------------------------------------------
\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 1996 through September 1997 are $120 in
  the 48 contiguous States and the District of Columbia, $153 in Alaska, and $198 in Hawaii.
For the 48 contiguous States and the District of Columbia, the calculation of benefits assumes: (1) a
  ``standard'' deduction of $134 per month; (2) an excess shelter deduction of $250 per month (the maximum
  allowable for nonelderly, nondisabled households); and (3) an excess medical expense deduction of $4 monthly
  (estimated from 1995 medical expense information). If smaller excess shelter costs were assumed, food stamp
  benefits would be smaller. For Alaska and Hawaii, higher deduction levels were used, as provided by law ($663
  and $546, respectively, for combined standard and excess shelter allowance).
\3\ SSI recipients in California are ineligible for food stamps. California provides increased cash aid in lieu
  of stamps.
\4\ Individual budget process.
\5\ State disregards $20 of SSI payment in determining the State supplementary payment.
\6\ State decides benefits on case-by-case basis.
\7\ Payment level for Hennepin County. State has two geographic payment levels--one for Hennepin County and the
  other for the remainder of the State.
\8\ State has two geographic payment levels--highest are shown in table.
\9\ Sum paid in King, Pierce, Kitsap, Snohomish, and Thurston Counties.

 NA--Not available.

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

  TABLE 3-8.--MAXIMUM POTENTIAL SSI AND FOOD STAMP BENEFITS FOR AGED COUPLES LIVING INDEPENDENTLY, JANUARY 1997
                                                       \1\
----------------------------------------------------------------------------------------------------------------
                                                                                               Combined benefits
                              State                                 Maximum SSI   Food stamp -------------------
                                                                      benefit    benefit \2\  Monthly    Annual
----------------------------------------------------------------------------------------------------------------
Alabama..........................................................          $726       $118       $844    $10,128
Alaska...........................................................         1,254        103      1,357     16,284
Arizona..........................................................           726        118        844     10,128
Arkansas.........................................................           726        118        844     10,128
California.......................................................         1,122      \3\ 0      1,122     13,464
Colorado.........................................................         1,072         14      1,086     13,032
Connecticut......................................................     \4\ 1,094          8         NA         NA
Delaware.........................................................           726        118        844     10,128
District of Columbia.............................................           726        118        844     10,128
Florida..........................................................           726        118        844     10,128
Georgia..........................................................           726        118        844     10,128
Hawaii...........................................................           735        308      1,043     12,516
Idaho............................................................       \5\ 742        119        861     10,332
Illinois.........................................................       \6\ 726        118        844     10,128
Indiana..........................................................           726        118        844     10,128
Iowa.............................................................           726        118        844     10,128
Kansas...........................................................           726        118        844     10,128
Kentucky.........................................................           726        118        844     10,128
Louisiana........................................................           726        118        844     10,128
Maine............................................................           741        114        855     10,260
Maryland.........................................................           726        118        844     10,128
Massachusetts....................................................           923         59        982     11,784
Michigan.........................................................           754        110        864     10,368
Minnesota........................................................       \7\ 837         85        922     11,064
Mississippi......................................................           726        118        844     10,128
Missouri.........................................................           726        118        844     10,128
Montana..........................................................           726        118        844     10,128
Nebraska.........................................................           729        117        846     10,152
Nevada...........................................................           800         96        896     10,752
New Hampshire....................................................           747        112        859     10,308
New Jersey.......................................................           751        111        862     10,344
New Mexico.......................................................           726        118        844     10,128
New York.........................................................           829         87        916     10,992
North Carolina...................................................           726        118        844     10,128
North Dakota.....................................................           726        118        844     10,128
Ohio.............................................................           726        118        844     10,128
Oklahoma.........................................................           832         86        918     11,016
Oregon...........................................................           726        118        844     10,128
Pennsylvania.....................................................           770        105        875     10,500
Rhode Island.....................................................           847         82        929     11,148
South Carolina...................................................           726        118        844     10,128
South Dakota.....................................................           741        114        855     10,260
Tennessee........................................................           726        118        844     10,128
Texas............................................................           726        118        844     10,128
Utah.............................................................           731        117        848     10,176
Vermont..........................................................       \8\ 829         87        916     10,992
Virginia.........................................................           726        118        844     10,128
Washington.......................................................       \9\ 748        112        860     10,320
Wisconsin........................................................           726        118        844     10,128
Wyoming..........................................................           858         79        937     11,244
West Virginia....................................................           751        111        862    10,344
----------------------------------------------------------------------------------------------------------------
\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 1996 through September 1997 are $220 in
  the 48 contiguous States and the District of Columbia, $280 in Alaska, and $364 in Hawaii.
For the 48 contiguous States and the District of Columbia, the calculation of benefits assumes: (1) a
  ``standard'' deduction of $134 per month, (2) an excess shelter deduction of $250 per month (the maximum
  allowable for nonelderly, nondisabled households); and (3) an excess medical expense deduction of $4 monthly
  (estimated from 1995 medical expense information). If smaller excess shelter costs were assumed, food stamp
  benefits would be smaller. For Alaska and Hawaii, higher deduction levels were used, as provided by law ($663
  and $546, respectively, for combined standard and excess shelter allowance).
\3\ SSI recipients in California are ineligible for food stamps. California provides increased cash aid in lieu
  of stamps.
\4\ Individual budget process.
\5\ State disregards $20 monthly of SSI income in determining the State supplementary payment amounts.
\6\ State decides benefits on case-by-case basis.
\7\ Payment level for Hennepin County. State has two geographic payment levels--one for Hennepin County and one
  for the remainder of the State.
\8\ State has two geographic payment levels--highest levels are shown in table.
\9\ Sum paid in King, Pierce, Kitsap, Snohomish, and Thurston Counties.

 NA--Not available.

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

         Comparison of SSI Payment Levels to Poverty Thresholds

    Table 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, the SSI benefit levels were increased by $20
per month for individuals and $30 per month for couples in July
1983. They were further increased by 3.5 percent in January
1984. This explains why SSI benefits, in relation to the
poverty level, increased to approximately 75 percent in 1984
and 1985 compared to 71 percent in the 1975 to 1982 period. In
1997, benefit levels were 77.2 percent of the poverty level.
    Table 3-10 presents the same information for a couple. The
SSI benefit for a couple is 91.8 percent of the poverty
threshold in 1997.

   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 1975-97
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                 Calendar year
            Poverty threshold and benefits            --------------------------------------------------------------------------------------------------
                                                         1975     1980     1984     1986     1988     1990     1992     1993     1994     1996     1997
--------------------------------------------------------------------------------------------------------------------------------------------------------
Poverty threshold....................................   $2,572   $3,941   $4,980   $5,255   $5,672   $6,268   $6,729   $6,930   $7,107   $7,309   $7,525
Federal SSI benefits:
    Dollars per year.................................   $1,822   $2,677   $3,768   $4,032   $4,248   $4,632   $5,064   $5,208   $5,352   $5,640   $5,808
    Percent of poverty...............................     70.8     72.3     75.6     76.7     74.9     73.9     75.3     75.2     75.3     77.2     77.2
Federal SSI and Social Security:
    Dollars per year.................................   $2,062   $2,917   $4,008   $4,272   $4,488   $4,872   $5,304   $5,448   $5,592   $5,880   $6,048
    Percent of poverty...............................     80.2     74.0     80.5     81.3     79.1     77.7     78.8     78.6     78.7     80.4     80.4
Federal SSI, Social Security, and food stamps: \1\
    Dollars per year.................................   $2,350   $3,345   $4,294   $4,488   $4,848   $5,318   $5,820   $5,952   $6,072   $6,372   $6,600
    Percent of poverty...............................     91.4     84.9     86.2     85.4     85.5     84.8     86.5     85.9     85.4     87.2    87.7
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ In computing the food stamp benefit for 1975, average deductions among all elderly households are assumed. For later years (except 1996 and 1997),
  the applicable standard deduction plus average shelter and medical deductions among all elderly households is assumed. For 1996 and 1997, 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 1975-97
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                 Calendar year
            Poverty threshold and benefits            --------------------------------------------------------------------------------------------------
                                                         1975     1980     1984     1986     1988     1990     1992     1993     1994     1996     1997
--------------------------------------------------------------------------------------------------------------------------------------------------------
Poverty threshold....................................   $3,232   $4,954   $6,280   $6,628   $7,156   $7,906   $8,489   $8,741   $8,964   $9,221   $9,491
Federal SSI benefits:
    Dollars per year.................................   $2,734   $4,016   $5,664   $6,048   $6,384   $6,948   $7,596   $7,824   $8,028   $8,460   $8,712
    Percent of poverty...............................     84.6     81.1     90.2     91.2     89.2     87.9     89.5     89.5     89.6     91.7     91.8
Federal SSI and Social Security:
    Dollars per year.................................   $2,974   $4,256   $5,904   $6,288   $6,624   $7,188   $7,836   $8,064   $8,268   $8,700   $8,952
    Percent of poverty...............................     92.0     86.0     94.0     94.9     92.6     90.9     92.3     92.3     92.2     94.3     94.3
Federal SSI, Social Security, and food stamps: \1\
    Dollars per year.................................   $3,430   $4,906   $6,393   $6,696   $7,200   $7,935   $8,700   $8,880   $9,084   $9,540   $9,828
    Percent of poverty...............................    106.1     99.0    101.8    101.0    100.6    100.4    102.5    101.6    101.3    103.5   103.6
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ In computing the food stamp benefit for 1975, average deductions among all elderly households are assumed. For later years (except 1996 and 1997),
  the applicable standard deduction plus average shelter and medical deductions among all elderly households is assumed. For 1996 and 1997, the
  applicable standard deduction plus average shelter and medical deductions among all SSI households is assumed.

 Source: Congressional Research Service.

                       TRENDS IN THE SSI CASELOAD

                          Number of Recipients

    As shown in table 3-11, in December 1996, 6.6 million
persons received federally administered SSI payments. Of these,
1.4 million received federally administered payments on the
basis of being aged, 5.1 million on the basis of being
disabled, and 82,137 on the basis of blindness. However,
677,519 of those receiving benefits on the basis of disability
or blindness were over the age of 65. Table 3-11 also indicates
that approximately 4.2 million of those receiving federally
administered SSI payments received only Federal SSI payments,
2.1 million received a combination of Federal and State
payments, and 288,187 received State supplements only.
    Table 3-12 shows the trends in the numbers of persons
receiving federally administered SSI payments from December
1975 through September 1996, both by reason for eligibility and
by age categories. There was a steady decline in the number of
SSI recipients from 1975 until 1983. However, in the last 12
years the number of SSI recipients has increased from about 3.9
million to more than 6.6 million, an increase of 70 percent.

         Characteristics of Adult Disabled and Blind Recipients

    Major disabling diagnosis.--As shown in table 3-13, of the
SSI disabled ages 18-64, 28.4 percent were eligible on the
basis of mental retardation and 30 percent on the basis of
other mental disorders. Therefore, over one-half of all SSI
disabled recipients are eligible on the basis of a mental
disability. The next three largest categories are: diseases of
the nervous system and sense organs--10.1 percent; diseases of
musculoskeletal and connective tissues--7.3 percent; and
diseases of the circulatory system--4.9 percent. In December
1995, 1.3 million or 23.8 percent of the adult disabled or
blind receiving SSI benefits had a representative payee.
Representative payees are individuals, agencies, or
institutions selected by SSA to receive and use SSI payments on
behalf of the SSI recipient when it has been found necessary by
reason of the mental or physical limitations of the recipient.
    Age.--When a person who is receiving SSI on the basis of
blindness or disability becomes age 65, SSA does not convert
the individual to eligibility on the basis of age. As shown in
table 3-14, 16.1 percent of the SSI adult population receiving
benefits on the basis of disability are age 65 or over (27.2
percent of the blind were age 65 or over).
    Sex.--In January 1997, 54.8 percent of those receiving SSI
benefits on the basis of disability and 55.6 percent on the
basis of blindness were women (table 3-15).
    Race.--In January 1997, 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 (table 3-15).

   TABLE 3-11.--NUMBER OF PERSONS RECEIVING FEDERALLY ADMINISTERED PAYMENTS, TOTAL AMOUNT AND AVERAGE MONTHLY
                            AMOUNT, BY SOURCE OF PAYMENT AND CATEGORY, DECEMBER 1996
----------------------------------------------------------------------------------------------------------------
                        Source of payment                             Total       Aged      Blind      Disabled
----------------------------------------------------------------------------------------------------------------
                                                                                 Number of persons

                                                                  ----------------------------------------------
Federally administered payments \1\..............................   6,613,718  1,412,632  \2\ 82,13
                                                                                                  7  \3\ 5,118,9
                                                                                                              49
    Federal payment only.........................................   4,192,248    774,459     45,378    3,372,411
    Both Federal and State supplementation.......................   2,133,283    522,003     30,802    1,580,478
    State supplementation only...................................     288,187    116,170      5,957      166,060
                                                                  ----------------------------------------------
      Total Federal payment \4\..................................   6,325,531  1,296,462     76,180    4,952,889
      Total State supplementation \5\............................   2,421,470    638,173     36,759    1,746,538

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

                                                                  ----------------------------------------------
Federal payments.................................................  $2,145,851   $296,665    $25,477   $1,823,709
State supplementation............................................     253,242     71,678      5,653      175,911
                                                                  ----------------------------------------------
      Total......................................................   2,399,093    368,343     31,130    1,999,620

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

                                                                  ----------------------------------------------
Federal payments.................................................      339.24     228.83     334.44       368.21
State supplementation............................................      104.58     112.32     153.78       100.72
                                                                  ----------------------------------------------
      Total......................................................      362.75     260.75     379.00      390.63
----------------------------------------------------------------------------------------------------------------
\1\ All persons with Federal SSI payments and/or federally administered State supplementation.
\2\ Includes an estimated 20,747 persons age 65 or older.
\3\ Includes an estimated 646,149 persons age 65 or older.
\4\ All persons with a Federal SSI payment whether receiving a Federal payment only or both a Federal and State
  supplementation.
\5\ All persons with federally administered State supplementation whether receiving State supplementation only
  or both a Federal SSI payment and a State supplementation.

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

    Other income.--In December 1996, 30.2 percent of the
disabled and 35.4 percent of the blind received Social Security
benefits. Table 3-16 shows the number of SSI recipients with
other sources of income, both unearned and earned.

  Characteristics of Recipients Receiving Benefits on the Basis of Age

    Age.--In December 1996, of SSI recipients receiving
benefits on the basis of age (65 or older), 33.9 percent were
80 years of age or older (table 3-14).

                TABLE 3-12.--NUMBER OF PERSONS RECEIVING FEDERALLY ADMINISTERED SSI PAYMENTS BY CATEGORY AND AGE, SELECTED YEARS 1975-96
                                                                     [In thousands]
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                       Year
                                                         -----------------------------------------------------------------------------------------------
             Reason for eligibility and age                Dec.    Sept.   Sept.   Sept.   Sept.   Sept.   Sept.   Sept.   Sept.   Sept.   Sept.   Sept.
                                                           1975    1983    1986    1988    1989    1990    1991    1992    1993    1994    1995    1996
--------------------------------------------------------------------------------------------------------------------------------------------------------
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
  Blind.................................................      74      79      83      83      83      84      85      86      86      85      85      83
    Under 18............................................       3       6       7       7       7       7       7       8       8       8       8       8
    18-21...............................................       4       5       5       4       4       4       4       4       4       4       4       4
    22-64...............................................      46      45      48      49      49      50      51      52      52      52      52      51
    65 or older.........................................      22      23      23      22      22      22      22      22      22      21      21      20
  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
    Under 18............................................     104     191     231     247     256     287     366     511     683     812     898     950
    18-21...............................................      90     122     138     136     139     143     150     167     186     202     219     232
    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
    65 or older.........................................     179     462     517     548     563     579     592     606     615     629     646     656
Age:
  Under 18..............................................     107     197     238     254     263     294     373     518     691     820     906     958
  18-21.................................................      93     127     143     140     143     147     154     171     190     206     223     236
  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
  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
                                                         -----------------------------------------------------------------------------------------------
    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
--------------------------------------------------------------------------------------------------------------------------------------------------------
Source: Office of Research, Evaluation and Statistics, Social Security Administration.

  TABLE 3-13.--DISABILITY DIAGNOSIS OF SSI AND SECTION 1619 DISABILITY
                      RECIPIENTS, DECEMBER 1996 \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
 diseases......................          1.7           1.1           1.5
Neoplasms......................          1.4           1.3           1.6
Endocrine, nutritional, and
 metabolic disorders...........          4.3           2.1           2.7
Mental disorders:
    Schizophrenia..............          8.9           9.6          11.6
    Other psychiatric..........         21.5          19.3          20.0
    Mental retardation.........         28.4          46.6          38.6
Diseases of:
     Nervous system and sense
     organs \2\................         10.1          12.1          13.3
    Circulatory system.........          4.9           1.5           2.3
     Respiratory system........          2.7           1.0           1.0
    Digestive system...........          0.7           0.4           0.6
     Genito-urinary system.....          0.9           1.1           1.6
    Musculoskeletal system and
     connective tissues........          7.3           3.0           4.4
Congenital anomalies...........          1.7           0.9           0.8
Injury and poisoning...........          2.7           2.2           3.3
Other..........................          2.7           1.3           1.2
                                ----------------------------------------
      Total percent............        100.0         100.0         100.0
                                ========================================
      Total individuals \3\....    4,375,650        23,101       34,909
------------------------------------------------------------------------
\1\ Information on diagnosis of SSI disabled recipients under age 65 is
  from the December 1995 SSI 10-percent disability file. Information on
  diagnosis for section 1619 recipients is available from SSI source
  files.
\2\ Most of the section 1619(b) participants who are classified as blind
  individuals are included in this category. A few section 1619(b) blind
  participants have a primary impairment other than diseases of the eye
  and are coded in other categories in this table. Also, there are a few
  participants classified as having diseases of the eye who are not
  blind, whose impairment does not meet the definition of blindness, and
  are classified as disabled.
\3\ Includes only recipients whose diagnosis information is specifically
  identified on the source files.

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

    Sex.--In January 1997, 72.9 percent of those receiving
benefits on the basis of age were women (table 3-15).
    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 (table 3-15).
    Other income.--In December 1996, 61.7 percent of SSI
recipients receiving benefits on the basis of age also received
Social Security benefits. Only 1.8 percent had earned income
(table 3-16).
    The number of persons receiving federally administered SSI
payment and unearned income, by type of income, is included in
table 3-17.

    TABLE 3-14.--NUMBER AND PERCENTAGE DISTRIBUTION OF SSI RECIPIENTS
  RECEIVING FEDERALLY ADMINISTERED PAYMENTS BY CATEGORY AND AGE GROUP,
                              DECEMBER 1996
------------------------------------------------------------------------
          Age group             Total       Aged      Blind     Disabled
------------------------------------------------------------------------
Children:
    Under 5.................       14.5  .........       12.7       14.5
    5-9.....................       28.1  .........       27.0       28.1
    10-14...................       32.8  .........       30.0       32.8
    15-17...................       18.4  .........       17.9       18.4
    18-21 \1\...............        6.2  .........       12.4        6.1
                             -------------------------------------------
      Total percent.........      100.0  .........      100.0      100.0
                             ===========================================
      Total number..........  1,017,992  .........      8,752  1,009,240
                             ===========================================
Adults:
    18-21 \1\...............        3.1  .........        3.8        4.2
    22-29...................        8.5  .........       12.4       11.3
    30-39...................       14.3  .........       16.9       19.2
    40-49...................       14.8  .........       16.4       19.8
    50-59...................       14.5  .........       14.9       19.5
    60-64...................        7.4  .........        8.3       10.0
    65-69...................       10.2       19.1        8.0        7.2
    70-74...................        9.6       25.8        6.6        4.1
    75-79...................        7.2       21.2        4.8        2.5
    80 or older.............       10.3       33.9        7.8        2.3
                             -------------------------------------------
      Total percent.........      100.0      100.0      100.0      100.0
                             ===========================================
      Total number..........  5,595,726  1,412,632     73,385  4,109,709

------------------------------------------------------------------------
\1\ Persons aged 18-21 can be classified as either children or adults
  depending on their student status.

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

             Characteristics of Children Receiving Benefits

    At the end of its first year (December 1974), the SSI
Program paid benefits to 71,000 disabled and blind children,
less than 2 percent of the SSI caseload. By comparison, in
December 1980 payments were made to almost 229,000 blind and
disabled children, 5.5 percent of the 4.1 million recipients in
that month. 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 the over 6.6 million SSI recipients, and represent a
fast growing segment of the SSI population.

TABLE 3-15.--NUMBER AND PERCENTAGE DISTRIBUTION OF ALL PERSONS RECEIVING
 FEDERALLY ADMINISTERED PAYMENTS, BY CATEGORY, RACE, AND SEX, JANUARY 1,
                                  1997
------------------------------------------------------------------------
        Race and sex            Total       Aged      Blind     Disabled
------------------------------------------------------------------------
Race:
  White.....................       51.6       48.6       53.3       52.4
  Black.....................       28.5       20.5       26.8       30.9
  Other.....................       16.0       27.4       15.6       12.7
  Not reported..............        3.9        3.5        4.3        4.0
Sex and race:
  Men.......................       41.3       27.1       44.4       45.2
    White...................       20.7       12.0       23.5       23.1
    Black...................       11.8        4.3       11.5       13.9
    Other...................        6.8        9.8        7.2        6.0
    Not reported............        2.0        1.0        2.3        2.3
   Women....................       58.7       72.9       55.6       54.8
    White...................       30.9       36.6       29.8       29.4
     Black..................       16.8       16.2       15.3       16.9
    Other...................        9.1       17.6        8.4        6.7
     Not reported...........        1.9        2.4        2.0        1.7
                             -------------------------------------------
      Total percent.........      100.0      100.0      100.0      100.0
                             ===========================================
      Total number..........  6,504,900  1,412,600     83,500  5,008,800

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

    Most notable has been the growth since 1989. Many analysts
attribute the growth to outreach activities, the Supreme Court
decision in the Zebley case (see below), expansion of the
mental impairment category, and reduction in reviews of
continuing disability.
    To be eligible for SSI payments as a child, an individual
must be under age 18 (or under 22 if a full-time student), be
unmarried, and meet the SSI disability or blindness,
citizenship/residency, and income and resources criteria.
    In December 1996, 62 percent of SSI children were 12 years
old or younger, and about 19 percent of the children were under
age 6. About 32 percent, an estimated 316,000 children, were
between the ages of 13 and 17. Child recipients were more
likely to be boys than girls, by about 3 to 2. Approximately 45
percent were nonwhite.
    Eighty-one percent of children live in their parents' home.
Less than 2 percent are patients in a medical facility where
more than half of the cost of their care is covered by the
Medicaid Program. Another 16 percent live in other hospitals,
nursing homes, residential schools, foster care, or
independently.
    About 24 percent of the children had some type of unearned
income. The three major types of unearned income were: support
from absent parents (8.3 percent), Social Security benefits
(8.2 percent), and in-kind support and maintenance (6.8
percent). In addition, about 13 percent of children had income
``deemed'' from their parents.

   TABLE 3-16.--PERSONS RECEIVING FEDERALLY ADMINISTERED PAYMENTS AND ALSO RECEIVING OTHER INCOME, AND AVERAGE
                        AMOUNT OF INCOME, BY SOURCE OF INCOME AND CATEGORY, DECEMBER 1996
----------------------------------------------------------------------------------------------------------------
                         Source of income                            Total       Aged      Blind      Disabled
----------------------------------------------------------------------------------------------------------------
                                                                                 Number with income

                                                                  ----------------------------------------------
Social Security benefits.........................................  2,446,307    871,719     29,043     1,545,545
Other unearned income............................................    823,058    289,622      9,736       523,700
Earned income....................................................    289,469     25,642      6,012       257,815
                                                                  ----------------------------------------------
                                                                                Percent with income

                                                                  ----------------------------------------------
Social Security benefits.........................................       37.0       61.7       35.4          30.2
Other unearned income............................................       12.4       20.5       11.9          10.2
Earned income....................................................        4.4        1.8        7.3           5.0
                                                                  ----------------------------------------------
                                                                               Average monthly income

                                                                  ----------------------------------------------
Social Security benefits.........................................    $362.56    $368.45    $378.98       $358.92
Other unearned income............................................     112.46      84.96      98.74        127.91
Earned income....................................................     258.42     243.96     534.75        253.41
                                                                  ----------------------------------------------
      Total number...............................................  6,613,718  1,412,632  \1\ 82,13
                                                                                                 7  \2\ 5,118,94
                                                                                                              9
----------------------------------------------------------------------------------------------------------------
\1\ Includes 20,747 persons aged 65 or over.
\2\ Includes 646,149 persons aged 65 or older.

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

   TABLE 3-17.--NUMBER OF PERSONS RECEIVING FEDERALLY ADMINISTERED SSI
  PAYMENTS AND UNEARNED INCOME (OTHER THAN SOCIAL SECURITY) AND AVERAGE
        MONTHLY UNEARNED INCOME, BY TYPE OF INCOME, DECEMBER 1996
------------------------------------------------------------------------
                Type of income                   Number \1\  Average \2\
------------------------------------------------------------------------
Veterans' benefits............................      108,697     $157.44
Railroad retirement...........................        4,409      338.10
Black lung benefits...........................        1,588      321.77
Employment pensions \3\.......................       54,131      130.49
Worker's compensation.........................        4,618      306.98
Support and maintenance in kind...............      237,899      107.41
Support from absent parents...................       88,159      159.23
Asset income..................................      235,707        7.71
Assistance based on need......................       16,003      104.65
Other \4\.....................................       64,489      327.33
                                               -------------------------
       Total..................................      823,058     112.46
------------------------------------------------------------------------
\1\ With unearned income other than Social Security benefits.
\2\ Monthly amount of unearned income.
\3\ Includes civil service pension.
\4\ Includes military and demonstration projects.

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

    Given the rapid growth in the number of children receiving
SSI, as well as a growing debate over the procedures by which
children's eligibility should be judged, Congress established
the National Commission on Childhood Disability to review the
definition of childhood disability and examine several related
issues, and report its findings to Congress by November 30,
1995 (Public Law 103-296). The Commission, which reported in
October of 1995, recommended that the SSI statute be amended to
state that the purpose of the SSI Childhood Disability Program
is to: help low-income families (and other individuals and
organizations) who care for eligible children with disabilities
in providing basic necessities to maintain the child at home or
in another appropriate setting; cover the additional costs of
caring for and raising a child with a disability; enhance the
child's opportunity to develop; and offset lost family income
because a parent remains out of the labor force or
underemployed to care for the child. The Commission also
recommended that the SSI definition of childhood disability be
tightened; that a benefit scale be created which reduces SSI
benefits for multiple children in the same family to reflect
economies of scale in the consumption of food, clothing, and
shelter; that continuing disability reviews be performed at
least every 2 years for children whose impairment is likely to
improve; that appropriate health care treatment be required as
a condition of continuing eligibility for SSI children; that
parents or the child's representative payee be required to
report financial expenditures on a periodic random basis; and
that categorical eligibility for Medicaid be afforded all SSI
children.
    In May 1995, a report on the Children's SSI Program was
released by the Committee on Childhood Disability of the
National Academy of Social Insurance (responding to a study
request from the House Committee on Ways and Means in the 102d
Congress). The Academy's expert group contended that the basic
purpose of SSI cash benefits for children is to support and
preserve the capacity of families to care for their disabled
children in their own homes. Thus, the SSI benefit was intended
to provide for some of the additional, nonmedical, but
disability-related, costs of raising a disabled child; to
compensate for some of the income lost because of the everyday
necessities of caring for a disabled child; and to meet the
child's basic needs for food, clothing, and shelter. The
Committee also urged that SSI childhood eligibility criteria be
tightened, that family benefits in cases where there are
multiple eligible children in the household be limited, that
disabled teens be encouraged to work, and that children be
periodically reviewed (National Academy of Social Insurance,
1995).
    The General Accounting Office (GAO) also examined the
growing children's caseload and attempted to understand why the
caseload was growing so rapidly. GAO compared the results of
SSA's decisions regarding children by type of disability and
basis of award 2 years before and 2 years after the medical
listings were expanded and a new procedure for determining
disability called the individualized functional assessment had
been initiated. The study found that the number of children
receiving SSI disability benefits more than doubled between
1989 and 1992, from almost 300,000 to 770,500. According to the
report, although the new individualized functional assessment
process mandated by the Supreme Court in Sullivan v. Zebley
added 87,900 children to the rolls, most of the children who
received new awards during the 2 years after the IFA went into
effect in 1991 met the medical listing. The report indicated
that the huge increases in the diagnosis of mental
impairments--including mental retardation and attention deficit
hyperactivity disorder--accounted for more than two-thirds of
the growth in awards.
    Given the rapidly growing number of children in SSI, GAO
assessed the implementation of the individualized functional
assessment (IFA). The GAO study found that from 1991 to 1994
about 219,000 IFA awards were made to children who did not meet
SSA's more restrictive listing of impairments. These awards
accounted for one-third of all awards made during this period
and about $1 billion a year in benefit payments. GAO also found
that the IFA process relies too heavily on adjudicator's
judgments, rather than on objective criteria. The study found
little evidence that parents' coaching their children to act
out in disruptive behaviors to improve chances of obtaining SSI
was widespread. However, as the GAO report stated, ``measuring
the extent to which coaching may actually occur is extremely
difficult.''
     In December 1996, there were 1,017,992 children enrolled
in the SSI Program. As a result of the changes made by Public
Law 104-193, the administration estimates that 135,000 disabled
children who were receiving SSI on the date of enactment will
no longer qualify because of the new rules. The average number
of SSI children is expected to fall to 950,000 in fiscal year
1998, when the new law is fully implemented, before rising
again in subsequent years.

                   Overview of Caseload Developments

    In summary, the trends in the nature of the SSI population
show the following:
  --A steady decline in the number of persons receiving SSI
        benefits on the basis of old age.
  --An increase from 107,000 in December 1975 to 1,017,992 in
        December 1996 of the number of disabled and blind
        children under 18 receiving SSI benefits.
  --A sharp increase of 1,774,000 between 1983 and 1996 in the
        number of persons ages 22-64 receiving benefits on the
        basis of disability or blindness.

               ELIGIBILITY OF DRUG ADDICTS AND ALCOHOLICS

    Under both the SSI and the Social Security Disability
Insurance (DI) Programs, disability is defined as a mental or
physical impairment that is so severe that it prevents an
individual from doing any kind of work that exists in the
national economy, taking into account age, education, and work
experience. Until recently, drug addiction and alcoholism were
qualifying medical impairments under both SSI and DI. Thus, a
person whose drug addiction or alcoholism was a contributing
factor material to his disability was eligible for SSI. The SSI
Program required that payments for drug addicts and alcoholics
be made to a representative payee (i.e., a person or agency
responsible for managing the recipient's finances), that
recipients participate in treatment if available, and that the
treatment be monitored.
    SSI provisions relating to drug addicts and alcoholics were
contained in the original SSI law (Public Law 92-603).
Initially, the Senate sought to exclude these individuals from
SSI by putting them in a separate services program. During
debate on the 1972 legislation, Members of the Senate argued
that these drug addicts and alcoholics would need treatment,
case management, and close monitoring so that they would not
use the SSI benefits to ``support their alcoholism or
addiction.'' The Senate provision that excluded drug addicts
and alcoholics from the SSI Program was deleted in favor of the
House provision that required recipients to undergo treatment.
The Senate's concern about providing direct payments to
substance abusers was accommodated by the provision requiring
that benefits be provided through representative payees.
Although virtually all SSI recipients diagnosed as drug addicts
or alcoholics received their payments via a representative
payee, most representative payees were family members or
friends of recipients, and it is suspected that 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 March 1996, Congress passed legislation that ended drug
and alcohol addiction as conditions that qualify individuals
for SSI benefits. Under Public Law 104-121, individuals would
not be considered disabled for either SSI or DI if drug
addiction or alcoholism were the contributing factor material
to their disability. Thus, eligibility for SSI and DI benefits
ended for persons classified as substance abusers. The law
mandates the Commissioner of Social Security to require that
persons who qualify for SSI or DI based on some other disabling
condition, but who are 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
authorizes $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.
    In June 1996, there were about 119,000 SSI recipients whose
disability was based solely on their drug addiction or
alcoholism. The Congressional Budget Office (CBO) estimated
that perhaps as many of 75 percent of them would be eligible
for SSI based on another sufficiently disabling condition. Even
so, by January 1997, 9 months after the end of eligibility for
addicted applicants and 1 month after the termination of
benefits of the 119,000 SSI recipients whose sole disability
was addiction, only 56,000 (47 percent) continued to receive
SSI based on some other disabling condition.

                   ELIGIBILITY OF NONCITIZENS FOR SSI

    Although the 1996 welfare reform law (Public Law 104-193)
barred most noncitizens from receiving SSI, this prohibition
was in effect repealed 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. 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.
    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.
    Because homelessness is a barrier to filing for SSI
benefits, SSA has initiated a wide range of outreach activities
aimed at this population. For example, local field offices have
established ongoing programs in which local social service
agencies, soup kitchens, shelters, and churches screen homeless
people for possible SSI eligibility, refer them to SSA, and
help them through the application process. Many of SSA's
outreach demonstration programs deal specifically with the
homeless or concentrate on the homeless in addition to other
target populations, especially individuals who suffer from
mental illness or AIDS.
    SSA is also participating in the Interagency Council on
Homelessness (ICH) established by the Congress in 1987 to
assist homeless individuals and families.

            SPECIAL SSI PROVISIONS FOR THE WORKING DISABLED

                        Earned Income Disregards

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

                     Eliminating Work Disincentives

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

                  Overview of Section 1619 Provisions

    In response to this work disincentive, in 1986 Congress
enacted Public Law 99-643 which added section 1619 to the
Social Security Act. Under this provision, SSI recipients who
work can continue to receive benefits even if their earnings
are at or above the level of substantial gainful activity and
as long as there is not a medical improvement in the disabling
condition. Under the income disregard formula, the amount of
their cash benefits is gradually reduced as earnings increase
until their countable earnings reach the SSI benefit standard
or what is known as the ``break-even point.'' In a State with
no supplementation, as shown in table 3-2, this earned income
eligibility limit is $1,053 per month in 1997 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 she did not have those
earnings.
    In making an initial determination under the fourth
criterion, SSA decided to compare the individual's gross
earnings to a ``threshold'' amount. The threshold amount is the
amount of gross earnings, after the monthly $20 general income,
$65 earned income, and one-half of the remainder exclusions are
applied, that it would take to reduce to zero the Federal SSI
benefit and State supplementary payment plus the average
Medicaid expenditures for disabled SSI cash recipients for the
State of residence. If the individual's earnings exceed 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 (PASS).
    In other words, Medicaid eligibility continues until the
individual's earnings reach a higher plateau which takes into
account the person's ability to afford medical care as well as
normal living expenses.
    A disabled individual also has the ongoing protection of
being able to be reinstated to eligibility for cash assistance
benefits under regular SSI or 1619(a), or Medicaid only
eligibility under 1619(b) if her work attempt fails or the
physical or mental disability 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.

                     MEASURES OF SSI PARTICIPATION

                        SSI Participation Rates

    Table 3-18 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 3-20. 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 6.2 percent in 1996. 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 percentage
increased, perhaps as a result of outreach efforts mandated by
the 1983 Social Security Amendments (Public Law 98-21). After
1984, the rate declined to 56.5 percent in 1987, increased to
60.1 percent in 1989, declined to 52.7 percent in 1992, and
increased to 63.7 percent in 1995. 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.

                                  TABLE 3-18.--SSI PARTICIPATION RATES, 1975-96
                                                  [In percent]
----------------------------------------------------------------------------------------------------------------
                                                                                           Among
                                                               Among all      Among     pretransfer     Among
                                                                elderly      elderly      elderly       entire
                                                                               poor         poor      population
----------------------------------------------------------------------------------------------------------------
1975........................................................         11.1         75.6           NA          2.0
1976........................................................         10.3         72.4           NA          1.9
1977........................................................          9.8         74.1           NA          1.9
1978........................................................          9.4         71.5           NA          1.9
1979........................................................          9.0         61.3         68.7          1.8
1980........................................................          8.7         57.5         64.7          1.8
1981........................................................          8.1         55.0         63.3          1.8
1982........................................................          7.5         53.6         62.3          1.7
1983........................................................          7.3         55.2         61.9          1.7
1984........................................................          7.3         61.2         66.3          1.7
1985........................................................          7.1         58.7         64.5          1.7
1986........................................................          6.9         57.9         63.4          1.8
1987........................................................          6.8         56.5         64.7          1.8
1988........................................................          6.6         57.6         64.3          1.8
1989........................................................          6.5         60.1         64.6          1.9
1990........................................................          6.6         56.3         63.3          1.9
1991........................................................          6.8         55.0         61.1          2.0
1992........................................................          6.5         52.7           NA          2.2
1993........................................................          6.7         56.3           NA          2.3
1994........................................................          6.4         57.8           NA          2.4
1995........................................................          6.3         63.7           NA          2.5
1996........................................................          6.2           NA           NA         2.5
----------------------------------------------------------------------------------------------------------------
NA--Not available.

 Note.--The denominator for columns 1 and 4 is in table 15, appendix N, the denominator for column 3 is shown in
  table 3 of appendix J, and the denominator for column 3 is in table 19 of appendix J.

 Source: Staff of the Committee on Ways and Means.

    The final column of table 3-18 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-
20. 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 has since steadily increased to
2.5 percent--its highest level ever--in 1995 and 1996.
    Table 3-19 shows the percentage of a given State's
population receiving SSI benefits for selected years.

                       TABLE 3-19.--SSI RECIPIENCY RATES BY STATE, SELECTED YEARS 1975-96
----------------------------------------------------------------------------------------------------------------
                      State                        1975    1985    1990    1991    1992    1993    1995    1996
----------------------------------------------------------------------------------------------------------------
Alabama.........................................    3.98    3.29    3.29    3.35    3.43    3.64    3.86    3.91
Alaska..........................................    0.81    0.65    0.84    0.87    0.90    0.96    1.09    1.20
Arizona.........................................    1.24    1.04    1.22    1.33    1.42    1.54    1.77    1.71
Arkansas........................................    4.09    3.14    3.23    3.34    3.47    3.66    3.86    3.80
California......................................    3.09    2.59    2.93    3.03    3.10    3.14    3.17    3.29

Colorado........................................    1.37    0.93    1.14    1.23    1.29    1.38    1.52    1.52
Connecticut.....................................    0.76    0.83    0.98    1.05    1.10    1.19    1.36    1.41
Delaware........................................    1.19    1.21    1.21    1.23    1.27    1.34    1.51    1.58
District of Columbia............................    2.23    2.51    2.67    2.83    3.00    3.21    3.63    3.76
Florida.........................................    1.86    1.62    1.71    1.82    1.90    2.06    2.34    2.44

Georgia.........................................    3.27    2.56    2.46    2.51    2.55    2.65    2.80    2.74
Hawaii..........................................    1.08    1.08    1.25    1.27    1.30    1.40    1.52    1.64
Idaho...........................................    1.06    0.84    1.03    1.10    1.21    1.28    1.44    1.46
Illinois........................................    1.22    1.18    1.55    1.67    1.78    2.00    2.25    2.28
Indiana.........................................    0.83    0.87    1.09    1.17    1.26    1.39    1.52    1.56

Iowa............................................    1.00    0.96    1.18    1.23    1.29    1.37    1.47    1.49
Kansas..........................................    1.05    0.87    0.99    1.05    1.14    1.26    1.44    1.51
Kentucky........................................    2.83    2.65    3.11    3.27    3.42    3.71    4.23    4.37
Louisiana.......................................    3.90    2.87    3.15    3.29    3.49    3.84    4.18    4.21
Maine...........................................    2.31    1.89    1.93    1.97    2.03    2.17    2.47    2.23

Maryland........................................    1.17    1.16    1.25    1.30    1.35    1.44    1.61    1.67
Massachusetts...................................    2.30    1.91    1.98    2.12    2.23    2.40    2.72    2.73
Michigan........................................    1.31    1.35    1.54    1.61    1.71    1.93    2.19    2.23
Minnesota.......................................    1.00    0.78    0.92    0.99    1.05    1.17    1.84    1.38
Mississippi.....................................    5.21    4.28    4.42    4.56    4.68    4.98    5.33    5.23

Missouri........................................    2.10    1.58    1.66    1.75    1.83    1.96    2.15    2.18
Montana.........................................    1.12    0.92    1.25    1.33    1.38    1.44    1.61    1.63
Nebraska........................................    1.06    0.88    0.99    1.05    1.09    1.19    1.30    1.33
Nevada..........................................    1.00    0.85    0.95    0.98    1.04    1.14    1.37    1.36
New Hampshire...................................    0.67    0.62    0.62    0.68    0.71    0.77    0.92    0.95

New Jersey......................................    1.11    1.23    1.36    1.44    1.52    1.66    1.81    1.84
New Mexico......................................    2.29    1.83    2.08    2.19    2.25    2.39    2.65    2.67
New York........................................    2.24    2.00    2.31    2.46    2.60    2.85    3.20    3.33
North Carolina..................................    2.71    2.21    2.24    2.33    2.36    2.47    2.65    2.67
North Dakota....................................    1.25    0.96    1.17    1.25    1.30    1.34    1.42    1.41

Ohio............................................    1.22    1.19    1.44    1.55    1.63    1.84    2.19    2.28
Oklahoma........................................    3.03    1.81    1.92    1.97    2.02    2.13    2.27    2.28
Oregon..........................................    1.12    0.95    1.11    1.18    1.24    1.35    1.43    1.52
Pennsylvania....................................    1.24    1.39    1.60    1.69    1.77    1.90    2.16    2.23
Rhode Island....................................    1.72    1.62    1.74    1.83    1.91    2.05    3.27    2.53

South Carolina..................................    2.84    2.60    2.59    2.61    2.67    2.80    2.97    3.04
South Dakota....................................    1.32    1.19    1.45    1.53    1.62    1.72    1.87    1.92
Tennessee.......................................    3.24    2.71    2.87    2.98    3.06    3.22    3.42    3.40
Texas...........................................    2.23    1.57    1.73    1.81    1.87    2.00    2.17    2.16
Utah............................................    0.76    0.53    0.73    0.79    0.84    0.94    1.06    1.05

Vermont.........................................    1.93    1.76    1.79    1.89    1.99    2.08    2.25    2.19
Virginia........................................    1.53    1.49    1.54    1.61    1.67    1.76    1.95    2.00
Washington......................................    1.46    1.09    1.27    1.34    1.39    1.50    1.66    1.72
West Virginia...................................    2.37    2.24    2.63    2.78    2.91    3.17    3.66    3.78
Wisconsin.......................................    1.44    1.50    1.75    1.83    1.88    2.04    2.17    1.86
Wyoming.........................................    0.67    0.45    0.76    0.85    0.92    1.04    1.19    1.24
                                                 ---------------------------------------------------------------
      Total \1\.................................    2.00    1.74    1.94    2.03    2.11    2.26    2.46   2.50
----------------------------------------------------------------------------------------------------------------
\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, percentages are calculated as
  the number of SSI recipients in July 1996 divided by the total population of each State in July 1996.

                Changes in Number of Recipients, 1970-96

    SSI is one of the largest cash assistance programs for the
poor and one of the fastest growing entitlement programs;
program costs grew 20 percent annually from 1991 through 1994.
According to GAO, three groups have accounted for nearly 90
percent of the SSI Program's growth since 1991: adults with
mental impairments, children, and noncitizens. These groups
grew at an annual average rate of 11.0, 16.4, and 15.5 percent,
respectively, from 1986 through 1993, compared with 4.9 percent
for all SSI recipients. The SSI recipient population has also
changed dramatically: disabled recipients now account for
nearly 80 percent of recipients. The GAO report found that SSI
recipients now tend to be younger, stay on SSI longer, receive
larger benefits, and depend more on SSI as a primary source of
income. Factors contributing to caseload growth include the
following: expansion in disability eligibility, notably for
mentally impaired adults and for children; increased outreach
by SSA; 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 3-20 illustrates the changes in the number of
individuals receiving assistance under the federally
administered SSI Program and prior programs. The total number
of individuals receiving assistance was 3.1 million in 1970;
this 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 1996, there were over 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 1.4 million individuals in 1996 (2.1
million if disabled and blind persons over 65 are counted).
Meanwhile, the number of blind or disabled receiving assistance
increased sharply from 1.0 million in 1970 to 5.2 million in
1996 (4.5 million if persons over age 65 are excluded).
    The number of persons receiving SSI payments, by State, in
December 1996 is provided in table 3-21.

  TABLE 3-20.--NUMBER OF PERSONS RECEIVING FEDERALLY ADMINISTERED SSI PAYMENTS, 1974-2002; AND ADULT ASSISTANCE
                                          UNDER PRIOR PROGRAMS, 1970-73
                                                 [In thousands]
----------------------------------------------------------------------------------------------------------------
                                                                     Blind or disabled
                                                                 ------------------------- Federal      State
                  Year \1\                   Total \2\  Aged \3\             65 and older  SSI \6\  supplemental
                                                                  Total \4\       \5\                   only
----------------------------------------------------------------------------------------------------------------
1970.......................................     3,098      2,082     1,016   ............  .......  ............
1971.......................................     3,172      2,024     1,148   ............  .......  ............
1972.......................................     3,182      1,934     1,248   ............  .......  ............
1973.......................................     3,173      1,820     1,353   ............  .......  ............
1974.......................................     3,996      2,286     1,710          (\7\)    (\8\)        (\8\)
1975.......................................     4,314      2,307     2,007            201    3,893          421
1976.......................................     4,236      2,148     2,088            249    3,799          437
1977.......................................     4,238      2,051     2,187            302    3,778          460
1978.......................................     4,217      1,968     2,249            344    3,755          462
1979.......................................     4,150      1,872     2,278            386    3,687          462
1980.......................................     4,142      1,808     2,334            419    3,682          460
1981.......................................     4,019      1,678     2,341            443    3,590          429
1982.......................................     3,858      1,549     2,309            462    3,473          384
1983.......................................     3,901      1,515     2,386            485    3,590          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 \9\...................................     6,140      1,136     5,003         (\10\)    5,863          283
1998 \9\...................................     6,161      1,120     5,041         (\10\)    5,891          277
1999 \9\...................................     6,221      1,105     5,116         (\10\)    5,956          270
2000 \9\...................................     6,277      1,092     5,185         (\10\)    6,018          265
2001 \9\...................................     6,331      1,080     5,251         (\10\)    6,076          260
2002 \9\...................................     6,380      1,070     5,310         (\10\)    6,130         255
----------------------------------------------------------------------------------------------------------------
\1\ Data are for December of each year.
\2\ All persons with Federal SSI payments and/or federally administered State supplementation for 1974-2002. 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 1997-2002, data are projections based on the President's budget estimates of February 1997.
\10\ Estimates not available.

 Source: Office of the Actuary, Social Security Administration.

                 TABLE 3-21.--NUMBER OF PERSONS RECEIVING SSI PAYMENTS, BY STATE, DECEMBER 1996
----------------------------------------------------------------------------------------------------------------
                                                                Federally administered                 State-
                       State                       ------------------------------------------------ administered
                                                       Total       Aged        Blind     Disabled     total \1\
----------------------------------------------------------------------------------------------------------------
Alabama \2\.......................................     166,975      35,595       1,416     129,964        1,683
Alaska \2\........................................       7,346       1,227         114       6,005        4,726
Arizona \2\.......................................      75,763      13,533         910      61,320          610
Arkansas..........................................      94,368      19,474       1,118      73,776  ............
California........................................   1,044,753     332,007      21,786     690,960  ............
Colorado \2\......................................      57,501       9,542         545      47,414       31,462
Connecticut \2\...................................      46,121       7,483         517      38,121       29,153
Delaware..........................................      11,447       1,560         125       9,762  ............
District of Columbia..............................      20,270       3,050         185      17,035  ............
Florida \3\.......................................     352,775      99,546       3,213     250,016       14,223
Georgia...........................................     200,894      41,686       2,512     156,696  ............
Hawaii............................................      19,513       7,611         165      11,737  ............
Idaho \2\.........................................      17,417       1,932         166      15,319        2,985
Illinois \2\......................................     268,422      35,107       2,439     230,876       44,137
Indiana \2\.......................................      90,656       8,989       1,072      80,595        1,139
Iowa..............................................      41,936       5,694         935      35,307  ............
Kansas............................................      38,263       4,437         399      33,427  ............
Kentucky \2\......................................     170,007      23,675       1,681     144,651        5,680
Louisiana.........................................     182,403      31,646       2,113     148,644  ............
Maine.............................................      27,830       4,143         241      23,446  ............
Maryland \3\......................................      84,747      16,727         823      67,197        1,680
Massachusetts.....................................     165,563      46,602       4,511     114,450  ............
Michigan..........................................     213,546      22,208       2,037     189,301  ............
Minnesota \2\.....................................      63,823      10,463         752      52,608   \4\ 21,339
Mississippi.......................................     141,197      29,972       1,413     109,812  ............
Missouri \2\......................................     116,446      16,450       1,043      98,953       10,026
Montana...........................................      14,213       1,628         140      12,445  ............
Nebraska \2\......................................      21,831       2,943         247      18,641        5,717
Nevada............................................      21,902       6,296         587      15,019  ............
New Hampshire \2\.................................      11,040       1,258         115       9,667        6,678
New Jersey........................................     145,707      35,363       1,098     109,246  ............
New Mexico \2\....................................      45,740       9,718         637      35,385          243
New York..........................................     606,000     145,860       3,653     456,487  ............
North Carolina \2\................................     195,134      42,387       2,361     150,386       20,209
North Dakota \2\..................................       8,899       1,731          80       7,088      \4\ 355
Ohio..............................................     254,184      20,897       2,426     230,861  ............
Oklahoma \2\......................................      75,160      14,290         937      59,933       72,741
Oregon \2\........................................      48,481       7,177         630      40,674   \4\ 16,971
Pennsylvania......................................     270,221      41,809       2,664     225,748  ............
Rhode Island......................................      25,283       4,860         248      20,175  ............
South Carolina \3\................................     112,187      22,442       1,732      88,013        4,351
South Dakota \3\..................................      13,750       2,406         140      11,204        3,576
Tennessee.........................................     178,885      30,701       1,848     146,336  ............
Texas \5\.........................................     412,028     125,442       5,630     280,956  ............
Utah..............................................      21,013       2,206         298      18,509  ............
Vermont...........................................      12,890       1,969         129      10,792  ............
Virginia \2\......................................     133,433      27,396       1,589     104,448        6,776
Washington........................................      94,795      13,435         940      80,420           82
West Virginia \5\.................................      69,720       7,307         676      61,737  ............
Wisconsin.........................................      94,719      11,897       1,036      81,786  ............
Wyoming \2\.......................................       5,876         669          55       5,152        2,923
Other:
  N. Mariana Islands..............................         555         171          10         374  ............
                                                   -------------------------------------------------------------
      Total \6\...................................   6,613,718   1,412,632      82,137   5,118,949     309,383
----------------------------------------------------------------------------------------------------------------
\1\ July 1996 data.
\2\ Data for Federal SSI payments only. State has State-administered supplementation.
\3\ Data for Federal SSI payments and federally administered State supplementation only, State also has State-
  administered supplementation.
\4\ Estimated data.
\5\ Data for Federal SSI payments only, State supplementary payments not made.
\6\ Includes fewer than 200 cases not distributed by State.

 Source: Office of Research, Evaluation and Statistics and Office of Retirement and Survivors insurance and
  Supplemental Security Income Policy, Social Security Administration.

                           SSI Program Costs

    Table 3-22 shows total expenditures for the SSI Program in
each State, including not only the federally administered
Federal and State supplementation payments but also the State-
administered State supplementation payments. Table 3-23 shows
the total (Federal- and State-administered) State
supplementation payments for SSI for fiscal years 1986-96.
    Table 3-24 presents the total amount of Federal and State
benefit payments from calendar years 1970-87 and fiscal years
1988-2002. 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 1996, Federal
benefit payments totaled $25.0 billion and State payments
totaled $3.4 billion, amounting to an overall total of $28.4
billion. In fiscal year 1997, total (Federal and State) SSI
benefits are estimated to total $29.5 billion and projected to
increase to $32.7 billion in fiscal year 2002.

    TABLE 3-22.--SUPPLEMENTAL SECURITY INCOME: TOTAL PAYMENTS, FEDERAL SSI PAYMENTS, AND FEDERAL- AND STATE-
                           ADMINISTERED STATE SUPPLEMENTARY PAYMENTS, FISCAL YEAR 1996
                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                                      State supplementation
                                                                  Federal SSI  ---------------------------------
                     State                           Total            \1\           Federally          State
                                                                                administered \2\   administered
----------------------------------------------------------------------------------------------------------------
Alabama.......................................        $624,792        $623,765  ................          $1,027
Alaska \3\....................................          41,191          28,219  ................          12,972
Arizona.......................................         304,588         304,214  ................             374
Arkansas......................................         334,450         334,445               $5   ..............
California....................................       5,561,339       3,567,026        1,994,313   ..............
Colorado......................................         286,246         227,132  ................          59,114
Connecticut...................................         290,516         192,281  ................          98,235
Delaware......................................          42,777          41,941              836   ..............
District of Columbia..........................          84,391          81,512            2,879   ..............
Florida.......................................       1,410,256       1,391,872            (\4\)           18,384
Georgia.......................................         722,312         722,291               21   ..............
Hawaii........................................          86,890          75,411           11,479   ..............
Idaho.........................................          70,967          66,214  ................           4,753
Illinois......................................       1,223,862       1,191,972  ................          31,890
Indiana.......................................         367,762         364,222  ................           3,540
Iowa..........................................         152,619         149,601            3,018   ..............
Kansas........................................         149,357         149,356                1   ..............
Kentucky......................................         684,809         668,482  ................          16,327
Louisiana.....................................         730,987         730,987            (\5\)   ..............
Maine.........................................          99,499          95,583            3,916   ..............
Maryland......................................         356,340         349,910               36            6,394
Massachusetts.................................         724,965         565,336          159,629   ..............
Michigan......................................         932,521         905,134           27,387   ..............
Minnesota \3\.................................         310,857         247,137  ................          63,720
Mississippi...................................         514,826         514,818                8   ..............
Missouri......................................         476,469         451,315  ................          25,154
Montana.......................................          54,704          53,799              905   ..............
Nebraska......................................          86,828          80,535  ................           6,293
Nevada........................................          84,433          80,350            4,083   ..............
New Hampshire.................................          51,502          41,013  ................          10,489
New Jersey....................................         612,883         535,503           77,380   ..............
New Mexico....................................         173,542         173,255  ................             287
New York......................................       2,867,367       2,340,239          527,128   ..............
North Carolina................................         763,010         677,736  ................          85,274
North Dakota \3\..............................          31,379          29,462  ................           1,917
Ohio..........................................       1,095,633       1,095,632                1   ..............
Oklahoma......................................         313,262         276,274  ................          36,988
Oregon \3\....................................         222,681         194,636  ................          28,045
Pennsylvania..................................       1,201,433       1,071,815          129,618   ..............
Rhode Island..................................         105,415          85,765           19,650   ..............
South Carolina................................         411,782         398,524  ................          13,258
South Dakota..................................          50,784          49,154                8            1,622
Tennessee.....................................         666,612         666,612  ................  ..............
Texas.........................................       1,448,235       1,448,235            (\4\)   ..............
Utah..........................................          84,295          84,238               57   ..............
Vermont.......................................          49,979          40,577            9,402   ..............
Virginia......................................         512,108         492,476  ................          19,632
Washington....................................         419,008         392,213           26,769               26
West Virginia.................................         289,083         289,083  ................  ..............
Wisconsin.....................................         407,264         374,754           32,510   ..............
Wyoming.......................................          22,828          22,138  ................             690
N. Mariana Islands                                       2,481           2,481  ................  ..............
                                               -----------------------------------------------------------------
      Total...................................     $28,615,468      25,038,366        3,030,697        $546,405
----------------------------------------------------------------------------------------------------------------
\1\ Includes $1.7 million not distributed by State.
\2\ Total reduced by $342,000 due to adjustments not yet identified and credited by State.
\3\ Data estimated for State-administered payments.
\4\ Amount not shown; negative adjustment exceeds amount paid.
\5\ Less than $500.

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

                                                              TABLE 3-23.--STATE SSI SUPPLEMENTATION PAYMENTS, FISCAL YEARS 1986-96
                                                                                    [In thousands of dollars]
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                        Year
                      State                       ----------------------------------------------------------------------------------------------------------------------------------------------
                                                       1986         1987         1988         1989         1990         1991         1992         1993         1994         1995         1996
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Alabama..........................................      $13,659      $11,606      $10,436       $7,964       $6,594       $6,394       $3,845       $2,083       $1,673       $1,370       $1,027
Alaska...........................................       12,970       12,970       12,970       12,970       12,972       12,972       12,972       12,972       12,972       12,972       12,972
Arizona..........................................        2,668        3,045        3,309        2,691        2,560        3,129        3,129        3,129          411          409          374
Arkansas.........................................           28           32           20           14           15           12            8            0            6            4            5
California.......................................    1,466,079    1,729,305    1,862,170    2,038,339    2,274,296    2,303,637    2,433,459    2,212,330    2,014,831    1,981,002    1,994,313

Colorado.........................................       38,320       35,416       24,132       41,035       42,649       50,002       53,309       55,057       53,376       56,703       59,114
Connecticut......................................       36,578       46,577       54,584       74,257       67,670       98,838       94,725       96,836       99,424      100,330       98,235
Delaware.........................................          671          703          730          725          708          721          750          747          819          817          836
District of Columbia.............................        4,202        4,265        4,538        4,498        4,365        4,278        4,694        4,899        5,095        4,342        2,879
Florida..........................................        9,718       11,314       11,309       12,609       14,656       18,055       18,899       18,608       18,608       18,380       18,384

Georgia..........................................            8           19           18           10           16            9           12           19           18           15           21
Hawaii...........................................        3,740        3,893        4,263        6,799       10,885       10,314       10,698       11,066       11,299       11,305       11,479
Idaho............................................        4,136        4,205        4,205        4,205        4,212        4,212        4,212        4,212        4,212        9,459        4,753
Illinois.........................................       51,197       56,856       59,573       55,716       57,137       65,756       64,241       65,836       73,398       69,450       31,890
Indiana..........................................        1,744        2,666        3,619        3,099        3,285        3,405        3,563        3,817        3,884        3,786        3,540

Iowa.............................................        1,908        2,098        2,204        2,275        2,408        2,508        2,672        2,859        2,940        2,951        3,018
Kansas...........................................           27           34           25           21           21           17           12            0            2            1            1
Kentucky.........................................        9,795       10,109       10,467       10,473       11,611       14,801       15,492       15,313       16,612       16,843       16,327
Louisiana........................................           42           47           33           23           25           19           12            4        (\1\)        (\1\)        (\1\)
Maine............................................        5,413        7,454        7,540        7,452        7,494        7,371        7,325        7,233        7,415        7,542        3,916

Maryland.........................................        5,252        5,505        6,159        6,159        6,155        6,520        6,542        6,269        6,102        6,235        6,430
Massachusetts....................................      109,452      112,561      120,010      114,691      117,113      124,761      137,516      147,866      153,034      160,080      159,629
Michigan.........................................       66,338       68,779       69,833       72,369       74,682       72,561       61,636       62,683       61,955       37,296       27,387
Minnesota........................................       19,818       22,850       24,667       40,641       43,924       48,933       55,224       53,860       53,860       63,720       63,720
Mississippi......................................           29           35           27           26           22           19           12           11            7            6            8

Missouri.........................................        5,132        4,410        4,009        3,102        2,808        8,476       26,158       25,866       24,286       29,549       25,154
Montana..........................................          834          844          839          842          864          910          909          902          960          940          905
Nebraska.........................................        5,348        5,457        5,454        6,550        5,793        5,334        6,175        6,705        5,990        5,970        6,293
Nevada...........................................        2,531        2,594        2,704        2,771        2,928        3,029        3,184        3,586        3,717        3,885        4,083
New Hampshire....................................        7,326        6,501        5,865        9,662        6,843        7,675        7,948        8,512        9,573       11,039       10,489

New Jersey.......................................       48,124       49,996       50,446       59,291       53,697       57,328       64,765       71,965       74,242       76,655       77,380
New Mexico.......................................          216          280          248          270          263          307          333          329          321          293          287
New York.........................................      277,035      305,678      317,504      366,972      388,150      410,081      440,374      476,029      494,345      510,096      527,128
North Carolina...................................       41,091       47,963       52,745       58,989       63,135       75,066       91,925       95,445      106,493      115,245       85,274
North Dakota.....................................        1,518        1,406        1,480        1,549        1,390        1,291        1,408        1,220        1,676        1,928        1,917

Ohio.............................................           35           37           31           30           34           31           31           28           18           13            1
Oklahoma.........................................       31,380       32,894       34,045       33,414       34,168       35,055       36,012       36,557       34,987       35,811       36,988
Oregon...........................................        9,767       10,342       11,843       15,419       17,946       20,169       20,169       20,169       20,169       28,045       28,045
Pennsylvania.....................................       69,186       75,502       74,670       76,565       79,571       84,668       94,971      109,947      128,339      136,153      129,618
Rhode Island.....................................        9,402        9,848       10,263       10,816       11,729       12,973       14,967       16,097       17,384       18,811       19,650

South Carolina...................................        4,812        4,927        5,004        9,785        8,897       11,994       11,685       12,377       11,880       12,750       13,258
South Dakota.....................................          591          636          587          590          567          620          652          681          709           73        1,630
Tennessee........................................            0            6            1            4            4            1            1            0        (\2\)        (\2\)        (\2\)
Texas............................................            0            0            0            0            0            0            0            0        (\3\)        (\3\)        (\3\)
Utah.............................................          872          855        1,086          981          808          898          959          878          201           60           57

Vermont..........................................        7,236        7,684        7,841        8,346        8,685        9,374       10,299        9,927        9,715       10,396        9,402
Virginia.........................................       12,164       12,846       14,432       15,949       15,296       16,863       16,782       17,317       17,752       19,156       19,632
Washington.......................................       17,443       19,424       18,058       18,994       19,915       21,558       24,043       26,808       28,374       28,516       26,795
West Virginia....................................            0            0            0            0            0            0            0            0        (\3\)        (\3\)        (\3\)
Wisconsin........................................       80,288       86,363       90,642       95,205      100,276      107,543      118,063      132,761      125,789      123,693       32,510
Wyoming..........................................          216          218          226          296          279          326          440          527          597          660          690
                                                  ----------------------------------------------------------------------------------------------------------------------------------------------
      Total......................................    2,496,275    2,835,516    3,006,796    3,308,277    3,589,348    3,750,812    3,987,110    3,862,151    3,719,314    3,735,250   3,577,102
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ Less than $500.
\2\ Amount not shown; negative adjustment exceeds amount paid.
\3\ Texas and West Virginia do not pay State supplementation.

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

  TABLE 3-24.--FEDERAL AND STATE BENEFIT PAYMENTS UNDER SSI AND PRIOR ADULT ASSISTANCE PROGRAMS, CALENDAR YEARS
                                     1970-87 AND FISCAL YEARS 1988-2002 \1\
                                            [In millions of dollars]
----------------------------------------------------------------------------------------------------------------
                                          Total                             State payments              SSI
                                        constant   Federal    Total  ---------------------------- administrative
          Year \2\              Total     1996    payments    State     Federally       State      costs (fiscal
                                         dollars            payments  administered  administered       year)
----------------------------------------------------------------------------------------------------------------
1970........................    $2,939   $11,885    $1,801    $1,138  ............  ............  ..............
1971........................     3,206    12,420     (\3\)     (\3\)  ............  ............  ..............
1972........................     3,392    12,732     1,993     1,398  ............  ............  ..............
1973........................     3,418    12,078     1,987     1,432  ............  ............  ..............
1974........................     5,246    16,696     3,833     1,413      $1,264          $149           $285

1975........................     5,878    17,142     4,314     1,565       1,403           162            399
1976........................     6,066    16,727     4,512     1,554       1,388           166            500
1977........................     6,306    16,327     4,703     1,603       1,431           172             NA
1978........................     6,552    15,767     4,881     1,671       1,491           180            539
1979........................     7,075    15,290     5,279     1,796       1,590           207            610

1980........................     7,941    15,121     5,866     2,074       1,848           226            668
1981........................     8,593    14,832     6,518     2,076       1,839           237            718
1982........................     8,981    14,602     6,907     2,074       1,798           276            779
1983........................     9,404    14,814     7,423     1,981       1,711           270            830
1984........................    10,372    15,663     8,281     2,091       1,792           299            864

1985........................    11,060    16,127     8,777     2,283       1,973           311            953
1986........................    12,081    17,295     9,498     2,583       2,243           340          1,022
1987........................    12,951    17,887    10,029     2,922       2,563           359            976
1988........................    14,375    19,065    11,368     3,007       2,645           362            975
1989........................    14,707    18,609    11,399     3,308       2,881           427          1,051

1990........................    16,095    19,321    12,507     3,589       3,159           431          1,075
1991........................    17,979    20,711    14,228     3,751       3,235           516          1,257
1992........................    21,258    23,773    17,270     3,987       3,431           556          1,538
1993........................    24,173    26,247    20,312     3,862       3,298           564          1,467
1994 \4\....................    28,288    29,949    24,461     3,827       3,219           608          1,781
1995 \4\, \5\...............    28,124    28,954    24,443     3,681       3,060           621          1,978
1996 \4\....................    28,429    28,429    25,038     3,391       2,845           546          1,949
1997 \4\....................    29,452    28,762    26,442     3,010       3,010        NA \6\          2,133
1998 \4\, \6\...............    28,445    27,048    25,435     3,010       3,010        NA \6\          2,248
1999 \4\, \6\...............    29,749    27,464    26,739     3,010       3,010        NA \6\          2,255
2000 \4\, \6\...............    32,907    29,495    29,662     3,245       3,245        NA \6\          2,276
2001 \4\, \6\...............    29,174    25,387    26,399     2,775       2,755        NA \6\          2,274
2002 \4\, \6\...............    32,677    27,580    29,667     3,010       3,010        NA \6\         2,268
----------------------------------------------------------------------------------------------------------------
\1\ Payments and adjustments during the respective year but not necessarily accrued for that year.
\2\ 1970-73 refers to Old-Age Assistance, Aid to the Blind, and Aid to the Permanently and Totally Disabled;
  1974-2002 refers to Supplemental Security Income.
\3\ Data not available.
\4\ Additional administrative costs are reflected for the SSI Program share of the President's disability
  investment in fiscal years 1994-95, the automation investment in fiscal years 1994-2002, and capital budgeting
  in fiscal years 1999-2002.
\5\ Fiscal year 1995 administrative expenses included funds to pay back the OASI 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 1997-2002, data are projections based on the President's budget estimates of February 1997.

 NA--Not available.

Source: Office of Budget, Social Security Administration.

                          LEGISLATIVE HISTORY

             Legislative Changes Made in the 103d Congress

1993

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

1994

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

             Legislative Changes Made in the 104th Congress

1996

    Public Law 104-121, the Contract with America Advancement
Act of 1996, among other 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 new provisions within 90 days of enactment; and (2) complete
new medical determinations by January 1, 1997 for affected
current beneficiaries who request such a determination within
120 days after the date of enactment. Public Law 104-121
applies representative payee requirements to DI or SSI
beneficiaries who have a DAA condition, as determined by the
Commissioner, and who are incapable of managing benefits. SSA
would refer these individuals to the appropriate State agency
for treatment. The representative payee and referral for
treatment provisions would apply to applications filed after
the third month following the month of enactment. In addition,
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 on a priority
basis 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 (DI) continuing disability
reviews (CDRs) and Supplemental Security Income (SSI) 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, and
requires the agency that provides assistance to a noncitizen to
request reimbursement from the sponsor for assistance provided.
Also requires that all newly-signed affidavits be legally
enforceable.
    Reporting of illegal immigrants to the Immigration and
Naturalization Service (INS).--The Commissioner of Social
Security must furnish to the INS the name, address, and other
identifying information of any individual that SSA knows is
unlawfully 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 (SSA) 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.
    Continuing disability reviews (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 the
recipient turns 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 who are
battered or abused, or if their children 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.''

             Legislative Changes Made in the 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 received
SSI on August 22, 1996, would remain eligible for SSI. In
addition, noncitizens lawfully residing in the United States on
August 22, 1996, would be eligible for SSI if they become
disabled in the future. It also provides that members of Native
American Indian tribes who are noncitizens would not be
affected by the SSI restrictions in Public Law 104-193. In
addition, individuals who received SSI prior to January 1,
1979, would 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,'' 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 drug
addiction or alcoholism condition.
    Technical corrections also are made 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 and clarify when the reporting incentives involving
prisoners apply. 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.

                               REFERENCES

Louis W. Sullivan, Secretary of Health and Human Services,
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National Academy of Social Insurance. (1995). Restructuring the
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Social Security Administration. (1995 and various years).
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        used in preparing various tables for this chapter.]
Social Security Administration. (1995, October). Supplemental
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U.S. General Accounting Office. (1995, July). Supplemental
        security income: Growth and changes in recipient
        population call for reexamining program (GAO/HEHS 95-
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U.S. House of Representatives, Committee on Ways and Means.
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