A profile of children with disabilities receiving SSI: highlights from the National Survey of SSI Children and Families

This article provides a nationally representative profile of noninstitutionalized children 0 to 17 years of age who were receiving support from the Supplemental Security Income (SSI) program because of a disability. To assess the role of the SSI program in providing assistance to low-income children with disabilities and their families, it is important to obtain detailed information on demographic characteristics, income and assets, health and disabilities, and health care utilization. Yet administrative records of the Social Security Administration do not contain many of the relevant data items, and the records provide only an incomplete picture of the family relationships affecting the lives of children with disabilities. The National Survey of SSI Children and Families fills this gap. This summary article is based on survey interviews conducted between July 2001 and June 2002 and provides some highlights characterizing children with disabilities who were receiving SSI and their families. Most children receiving SSI (hereafter referred to as "SSI children") lived in a family headed by a single mother, and less than one in three lived with both parents. A very high proportion, about half, were living in a household with at least one other individual reported to have had a disability. About 70 percent of children received some kind of special education. SSI support was the most important source of family income, with earnings a close second. On average, SSI payments accounted for nearly half of the income for the children's families, and earnings accounted for almost 40 percent. When all sources of family income were considered, slightly more than half (54 percent) of SSI children lived in families above the poverty threshold, a notable fact given that the federal SSI program guarantees only a subpoverty level of income. However, beyond these averages there was substantial variation, with some children living in families with income well below the poverty threshold and others having income well over 200 percent of the poverty threshold. About one-third of SSI children lived in families owning a home, two-thirds lived with parents or guardians with at least one car, and about 40 percent lived with parents or guardians with zero liquid assets. Less than 4 percent lived with adults who owned stocks, mutual funds, notes, certificates of deposit, or savings bonds. The Social Security Administration's administrative records contain only a limited amount of information about disability diagnoses. The National Survey of SSI Children and Families supplements those records with data from an array of questions on functional limitations, self-reported health, and the perceived severity of disabilities. The data suggest that a great degree of variation in severity exists within the childhood caseload, as reflected in reports of the presence or absence of six functional limitations, perceived overall health status, and perceived impact of disability on the child's ability to do things. Overall, 36 percent of the children were reported to have had disabilities that affected their abilities to do things "a great deal," and for 21 percent their difficulties had very little or no impact. Physical disabilities were most common among children aged 0 to 5, and mental disabilities dominated the picture for the other two age groups: 6 to 12 and 13 to 17. Virtually all SSI children are covered by some form of health insurance, with Medicaid being by far the most common source of health insurance coverage. Just as in the case of the severity of disabilities, substantial variation was reported in health care utilization among SSI children. Almost 30 percent of children had two or fewer doctor visits during the 12 months preceding the interview, and close to 50 percent had five or more doctor visits. About four-fifths of the children had no reported hospitalizations or surgeries during the previous year. More than 40 percent of the children visited an emergency room during the previous year, most of them more than once. Importantly, no out-of-pocket costs associated with medical care were reported for more than two-thirds of the children, and only about 3 percent had annual expenses exceeding $1,000 for physical and mental health care. This finding suggests that SSI payments are not used to cover medical expenses for the overwhelming majority of children. The use of supportive therapies varied widely among SSI children: more than half reported having used physical, occupational, or speech therapy; only 8 percent used respite care for the parents or other family members. An analysis of the perception of the survey respondents shows that more than one-third of children had unmet needs for mental health counseling services, and about three-quarters of families had unmet needs for respite care. In several service categories, the proportion perceived to have had unmet service needs was around 10 percent or less. In the dominant service category of physical, occupational, and speech therapy, only 11 percent perceived to have had unmet service needs.     

Parental schooling choice: A case study of minnesota

Public support of nonpublic elementary and secondary education has become one of the most controversial issues in American educational policy, with tuition tax credits and deductions subjects of ongoing debate at both the state and federal level. This article presents the results of one of the first empirical investigations of how a tax subsidy for tuition costs actually influences parents' school choices using data from Minnesota, the first state to have a tuition subsidy pass judicial review at all levels. It should be uyseful to policy makers, researchers, adn practitioners who are concerned with how parents make schooling decisions on behalf of their children, and how tax subsidies for educational expenses might affect those choices.     

Crowd‐Out or Affordability? The Lifeline Expansion's Effect on Wireless Service Spending

Public subsidization of private goods often leads to crowd‐out, reducing private spending. This effect is intended for a policy such as the 2008 Lifeline phone subsidy expansion, which aimed to increase affordable access to services. I examine the effects of this policy on households’ self‐reported wireless phone service spending in the Consumer Expenditure Survey. Using state‐level variation in policy implementation and triple‐differences event study methods, I estimate that the expansion reduced households’ wireless service spending by more than 100 percent of subsidy payments. I document that the expansion led to a separate, competitive market for providers catering to low‐income households. Consequently, higher‐quality subsidized services crowded out lower‐quality unsubsidized options, saving households more than an equivalent cash transfer. This highlights how market segmentation and competition can magnify a targeted subsidy's impact.     

The Impact of Child‐Care Subsidies on Child Development: Evidence from Geographic Variation in the Distance to Social Service Agencies

In this paper, we examine the impact of U.S. child‐care subsidies on the cognitive and behavioral development of children in low‐income female‐headed families. We identify the effect of subsidy receipt by exploiting geographic variation in the distance that families must travel from home to reach the nearest social service agency that administers the subsidy application process. Using data from the Kindergarten cohort of the Early Childhood Longitudinal Study, our instrumental variables estimates suggest that children receiving subsidized child care in the year before kindergarten score lower on tests of cognitive ability and reveal more behavior problems throughout kindergarten. An auxiliary analysis of longer‐run outcomes shows that these negative effects largely disappear by the time children finish first grade.     

Blind and disabled persons awarded federally administered SSI payments, 1975.

State agencies made medical determinations on 975,000 applications filed by the blind and disabled in 1975. Forty percent were found eligible for federally administered payments, and 60 percent were found ineligible. Nine out of 10 of the awardees were adults. Forty percent of these adults either had no occupation or no occupation was reported. Among both adults and children, the leading cause of disability was mental illness. Nearly 1 out of 3 adults was awarded benefits on the basis of mental disorders. The proportion of children determined disabled by mental illness was about twice that of adults. More than one-half of all children awarded benefits were mentally retarded. Among adults, the second most frequent disabling impairment was cardio-vascular disease; among children, it was diseases of the nervous system and sense organs.     

INTERGOVERNMENTAL IMPACTS ON POLICY VARIATIONS WITHIN STATES: EFFECTS OF LOCAL DISCRETION ON GENERAL ASSISTANCE PROGRAMS

Variation in state policy outputs is often a function of the level of inter governmental involvement in policy decisions by the federal government. This study examines comparable impacts of intergovernmental involvement by states on variations of welfare policy outputs within the states. The analysis of the effects of state-level involvement on General Assistance payments indicates that state delegation of policy discretion in this program leads to significantly higher levels of variation of policy effects within states.     

Use of coping resources among African American and Latino parents of children with special needs: implication for interventions

African American and Mexican American children are disproportionately overrepresented among children with learning disabilities. Once identified as learning disabled or having special needs, children of color encounter more deleterious effects in comparison with their White counterparts. The purpose of this study was to take a strength-based approach to examine the coping resources of African American (n = 149) and Mexican American (n = 100) parents of children with special needs. The results from this study demonstrated that there were more similarities than there were differences between the two ethnic groups. This study's findings lend support to an increasing focus on family-centered strength-based approaches to enhancing policy and providing services to families. The implications of the findings may be used to improve the development and implementation of interventions to improve the healthy development of children with special needs.     

A comparative study of representations about disability in primary school children's drawings: a sociosemiotic approach

Over the past few years, perceptions about disability – at least at the theoretical level – have been shifted toward a more progressive approach, which stresses the social aspects of the construction of disability (social model) rather than personal limitations, as supported by the traditional disability approach (medical–individual model). Drawing upon the sociosemiotic approach as developed by Kress and van Leeuwen, the present study examines from a comparative perspective the representations about disability and people with disabilities, as emerging from the drawings produced by 4th grade Greek primary school children. The sample consists of two groups of children. Group A does not share the same school environment with schoolchildren with special education needs, while group B shares the same school surroundings with students attending a special education needs School. The comparative analysis of their drawings indicates that children of both groups reproduce the dominant meanings they receive from their direct social environment.     

In‐state tuition for the undocumented: Education effects on Mexican young adults

This paper examines the effect of tuition subsidy in the form of in‐state tuition to undocumented students on the education of noncitizen Mexican young adults. The policy is found to be associated with a 2.5 percentage point increase in college enrollment (base mean = 8%), a 3.7 percentage point increase in the proportion of students with at least some college education (base mean = 10%), and a 1.3 percentage point increase in the proportion with at least an associate degree (base mean = 4%). These results are robust to a variety of specifications. When the analysis is restricted to samples more likely to be affected by the policy, point estimates become larger. The study finds no evidence that in‐state tuition policy for the undocumented adversely affects the educational outcomes of natives. © 2008 by the Association for Public Policy Analysis and Management.     

The Effects of Federal Adoption Incentive Awards for Older Children on Adoptions From U.S. Foster Care

This paper analyzes state responses to the 2003 and 2008 changes in the federal Adoption Incentives program to increase adoptions from the U.S. foster care system. The 2003 change introduced a $4,000 payment to states for every adoption of a child aged 9 and older above a state‐specific baseline. In 2008, the payment was doubled to $8,000. Using a discrete hazard model cast in a difference‐in‐differences framework, I do not find robust evidence that the incentives increased the probability of adoption for older children relative to younger children following the policy changes. I also do not find that the incentives affected the timing of adoption, likelihood of termination of parental rights, or the amounts of adoption assistance for older children relative to younger children. The findings illustrate the incentives are unable to help states overcome many of the challenges associated with achieving adoption for older children.     

Does state AFDC generosity affect child SSI participation?

This article examines the extent of interactions or spillovers between the Supplemental Security Income (SSI) and Aid to Families with Dependent Children (AFDC) programs for children. In the early 1990s, the Social Security Administration substantially relaxed child eligibility criteria for SSI benefits. Since the changes, the number of U.S. children receiving cash and medical benefits through SSI tripled to nearly 1 million. The article describes a family's decision to participate in SSI and/or AFDC, and uses state‐level data for three years before, and three years after, the Zebley decision to estimate the effect of state program generosity on child program participation. The expansions in child SSI eligibility increased child SSI participation and contributed to increased total program participation by children in the early 1990s. Child SSI participation increased more in states with lower AFDC payments and higher state SSI supplementation payments. These results suggest that families use SSI and AFDC as substitutes. At least 32 percent of the Zebley increase in SSI is likely attributable to the SSI–AFDC benefit gap for the median AFDC benefit state. © 2000 by the Association for Public Policy and Management.     

The TANF/SSI connection

Interactions and overlap of social assistance programs across clients interest policymakers because such interactions affect both the clients' well-being and the programs' efficiency. This article investigates the connections between Supplemental Security Income (SSI) and Temporary Assistance for Needy Families (TANF) and TANF's predecessor, the Aid to Families with Dependent Children (AFDC) program. Connections between receipt of TANF and SSI are widely discussed in both disability policy and poverty research literatures because many families receiving TANF report disabilities. For both states and the individuals involved, it is generally financially advantageous for adults and children with disabilities to transfer from TANF to SSI. States gain because the federal government pays for the SSI benefit, and states can then use the TANF savings for other purposes. The families gain because the SSI benefits they acquire are greater than the TANF benefits they lose. The payoff to states from transferring welfare recipients to SSI was substantially increased when Congress replaced AFDC with TANF in 1996. States retained less than half of any savings achieved through such transfers under AFDC, but they retain all of the savings under TANF. Also, the work participation requirements under TANF have obligated states to address the work support needs of adults with disabilities who remain in TANF, and states can avoid these costs if adults have disabilities that satisfy SSI eligibility requirements. The incentive for TANF recipients to apply for SSI has increased over time as inflation has caused real TANF benefits to fall relative to payments received by SSI recipients. Trends in the financial incentives for transfer to SSI have not been studied in detail, and reliable general data on the extent of the interaction between TANF and SSI are scarce. In addition, some estimates of the prevalence of TANF receipt among SSI awardees are flawed because they fail to include adults receiving benefits in TANF-related Separate State Programs (SSPs). SSPs are assistance programs that are administered by TANF agencies but are paid for wholly from state funds. When the programs are conducted in a manner consistent with federal regulations, the money states spend on SSPs counts toward federal maintenance-of-effort (MOE) requirements, under which states must sustain a certain level of contribution to the costs of TANF and approved related activities. SSPs are used for a variety of purposes, including support of families who are in the process of applying for SSI. Until very recently, families receiving cash benefits through SSPs were not subject to TANF's work participation requirements. This article contributes to analysis of the interaction between TANF and SSI by evaluating the financial consequences of TANF-to-SSI transfer and developing new estimates of both the prevalence of receipt of SSI benefits among families receiving cash assistance from TANF and the proportion of new SSI awards that go to adults and children residing in families receiving TANF or TANF-related benefits in SSPs. Using data from the Urban Institute's Welfare Rules Database, we find that by 2003 an SSI award for a child in a three-person family dependent on TANF increased family income by 103.5 percent on average across states; an award to the adult in such a family increased income by 115.4 percent. The gain from both child and adult transfers increased by about 6 percent between 1996 (the eve of the welfare reform that produced TANF) and 2003. Using data from the Department of Health and Human Services' TANF/SSP Recipient Family Characteristics Survey, we estimate that 16 percent of families receiving TANF/SSP support in federal fiscal year 2003 included an adult or child SSI recipient. This proportion has increased slightly since fiscal year 2000. The Social Security Administration's current procedures for tabulating characteristics of new SSI awardees do not recognize SSP receipt as TANF We use differences in reported TANF-to-SSI flows between states with and without Separate State Programs to estimate the understatement of the prevalence of TANF-related SSI awards in states with SSPs. The results indicate that the absolute number of awards to AFDC (and subsequently) TANF/SSP recipients has declined by 42 percent for children and 25 percent for adults since the early 1990s. This result is a product of the decline in welfare caseloads. However, the monthly incidence of such awards has gone up-from less than 1 per 1,000 child recipients in calendar years 1991-1993 to 1.3 per 1,000 in 2001-2003 and, for adult recipients, from 1.6 per 1,000 in 1991-1993 to 4 per 1,000 in 2001-2003. From these results we conclude that a significant proportion of each year's SSI awards to disabled nonelderly people go to TANF/SSP recipients, and many families that receive TANF/SSP support include adults, children, or both who receive SSI. Given the Social Security Administration's efforts to improve eligibility assessment for applicants, to ensure timely access to SSI benefits for those who qualify, and to improve prospects for eventual employment of the disabled, there is definitely a basis for working with TANF authorities both nationally and locally on service coordination and on smoothing the process of SSI eligibility assessment. The Deficit Reduction Act of 2005 reauthorized TANF through fiscal year 2010, but with some rules changes that are important in light of the analysis presented in this article. The new law substantially increases effective federal requirements for work participation by adult TANF recipients and mandates that adults in Separate State Programs be included in participation requirements beginning in fiscal year 2007. Thus SSPs will no longer provide a means for exempting from work requirements families that are in the process of applying for SSI, and the increased emphasis on work participation could result in more SSI applications from adult TANF recipients.     

Infrastructural state capacity in the digital age: What drives the performance of COVID-19 tracing apps?

In a context where states increasingly complement their physical presence with digital means, the classic idea of infrastructural state power needs reconsideration. The COVID-19 pandemic represents an unparalleled opportunity to that end, given the uniformity of one type of digital infrastructural intervention—the offer of contact tracing apps- and its highly varying performance across geographies. Against this backdrop, the article seeks to expand traditional discussions on state infrastructural power by testing a series of propositions on the explanatory factors behind tracing apps' emergence and adoption rates. The findings stemming from a pool of 150 countries show no straightforward connection between traditional and digital forms of infrastructural power. They also point at the primacy of governmental trust over financial, institutional, and technological factors—including privacy standards—when explaining high adoption, suggesting that the relational aspect of infrastructural power acquires a proportionally greater weight in the digital era.     

Collateral Damage: The Impact of Mortgage Debt on U.S. Savings

This article contributes to the literature on saving by empirically investigating the determinants of the saving rate in the United States, with a special focus on the role of mortgage debt. Using data from 1987 to 2013, we find that mortgage payments have a substantial negative impact on both personal and private saving rates in the United States. An increase of 10 percentage points in mortgage payments leads to a 9.1-percentage-point drop in the personal saving rate and a 12.4-percentage-point drop in the private saving rate. In addition, including mortgage debt as an explanatory variable leads to significant changes in the impact of other variables, which further reinforces our claim that mortgage debt is important for the analysis of the saving rate. Comparing mortgage payments with nonmortgage consumer debt payments, we find that mortgage payments have a larger impact on the private saving rate whereas nonmortgage consumer debt payments have a larger impact on the personal saving rate. We also find a partial but robust crowding-out effect of public saving rate on the two saving rates. Our results have implications for monetary policy and government policies that encourage mortgage borrowing.     

Mitigating apprehension about section 8 vouchers: The positive role of housing specialists in search and placement

Abstract

The U.S. Department of Housing and Urban Development has found that Section 8 voucher recipients are often unable to secure apartments outside of high‐poverty areas in tight urban rental markets. However, intensive housing placement services greatly improve the success and mobility of voucher holders. Drawing on ethnographic research in the housing placement department of a private, nonprofit community‐based organization, I first describe how fundamental problems in implementing the public subsidy program in a tight private rental market generate apprehension among landlords and voucher recipients that can prevent the successful use of vouchers. Second, I demonstrate how housing placement specialists can dispel and overcome this apprehension through a variety of tactics that require extensive soft skills and a deep commitment to the mission of housing poor families.

These findings provide support for the increased use of housing placement services to improve success and mobility rates for Section 8 vouchers.     

SSI at its 25th year.

Beginning in January 1974, the three previously existing State adult assistance programs were amalgamated into the Supplemental Security Income (SSI) program, to be administered by the Social Security Administration. This change was made to provide a nationwide floor of income for needs-based assistance, and to make such payments more efficiently by working through SSA's existing network of field offices. This article traces the 25-year patterns of growth and changes in the number of persons applying for assistance, the number and proportion of those applicants who were awarded payments, and the overall number of persons who received SSI. Three major age groups are considered separately: those aged 65 or older, disabled adults aged 18-64, and children age 18 and younger. The last group was newly eligible under SSI for payments based on their own blindness or disability and not, as was the case previously, because they were a member of a needy family.     

Elinor Ostrom: uncommon

The placement of various tee boxes on golf courses subsidizes the first shot of each hole for certain players. McCormick and Tollison find that this subsidy is statistically larger (other factors equal) in the southern US states and that it has been decreasing over time. These findings illustrate more general issues of chivalry, gender, age, and opportunity costs. The economics profession will undoubtedly continue to use sports data to better understand the behavior and interactions of people and firms in the economy.     

Public Attitudes toward Climate Science and Climate Policy in Federal Systems: Canada and the United States Compared1

Multilevel governance poses several challenges for the politics of climate change. On the one hand, the unequal distribution of power and interests can serve as a barrier to implementing coherent policy at a federal level. On the other, these features also enable policy leadership among sub‐federal units. In the context of wide variation in climate policy at both national and sub‐federal levels in Canada and in the United States, this paper utilizes an original data set to examine public attitudes and perceptions toward climate science and climate change policy in two federal systems. Drawing on national and provincial/state level data from telephone surveys administered in the United States and in Canada, the paper provides insight into where the public stands on the climate change issue in two of the most carbon‐intensive federal systems in the world. The paper includes the first directly comparable public opinion data on how Canadians and Americans form their opinions regarding climate matters and provides insight into the preferences of these two populations regarding climate policies at both the national and sub‐federal levels. Key findings are examined in the context of growing policy experiments at the sub‐federal level in both countries and limited national level progress in the adoption of climate change legislation.     

Australian Child Support Reforms: A Case Study of the Use of Microsimulation Modelling in the Policy Development Process

Child support is always a difficult area of public policy, balancing the sometimes competing needs of children, resident and non‐resident parents and the state. This article provides a relatively rare insight into some of the processes involved in developing the new Australian Child Support Scheme (CSS), which will commence full operation in July 2008. In particular, this article shows how microsimulation modelling was used by the Ministerial Taskforce on Child Support and the government in the policy reform process. The availability of such sophisticated distributional analysis and modelling allowed the development of a comprehensive picture of how the reforms would affect CSS clients, thereby facilitating the adoption of major policy change. This article also provides a blueprint for policy‐makers of how modelling can facilitate their policy development processes.