The legislative mandate for this report requires inclusion of information about relevant research on the Supplemental Security Income (SSI) program by the Social Security Administration (SSA) and others. Section 1 of this appendix describes SSA’s major ongoing projects. Section
2 presents a bibliography of studies regarding SSI payment levels, recipients, and reform proposals published in the past 10 years by both public and private entities. See previous editions for information on prior SSI-related research available at
https://www.ssa.gov/oact/ssir/index.html.
Using data from the Current Population Survey matched to our administrative records, Nicholas and Wiseman (2009 and 2010) assess the impact of using administrative records on poverty estimation among elderly SSI recipients using the official and alternative definitions of poverty. Wiseman and Ycas (2008) compares the Canadian social assistance program for the elderly with the SSI program, looking at program structure, cost, and consequences for elderly poverty rates. Kemp (2010) conducts a descriptive analysis of the SSI student earned income exclusion. Parent, Sayman, and Kulzer (2012) provide a comprehensive profile of the characteristics of disability beneficiaries with a connection to workers' compensation or public disability benefits. Parent, Sayman, and Kulzer (2012) found that 8.3 percent of disabled workers who have this connection tend to be economically better off, more frequently middle-aged, male, afflicted with a musculoskeletal and connective tissue disorder, and tend to wait longer to apply for SSDI benefits after onset than the general disabled-worker population.
Several studies highlight interactions between the SSI program and other Federal and State programs. Dushi and Rupp (2013) uses longitudinal data from the Health and Retirement Study to assess the role of SSI and related social safety net programs in providing a buffer against the potentially adverse effects of disability shocks in the near-elderly population on financial well-being. Coe and Rupp (2013) analyzes whether disability benefit recipients (SSDI and SSI) in States with easier access to health insurance will be more likely to work and exit from SSDI or SSI than their peers in States where health insurance is more difficult to access. Strand (2010) uses matched SIPP records to examine potential eligibility for three major means-tested programs (SSI, Medicaid, and Supplemental Nutrition Assistance Program (SNAP)) among near retirees aged 55-64 and eventual SSI participation upon reaching age 65. A series of studies by Rupp and Riley rely on a linkage of individual-level administrative data from SSA and the Centers for Medicare & Medicaid Services. First, Rupp and Riley (2011) analyzes longitudinal patterns of interaction between SSDI and SSI and finds that one quarter of the year 2000 cohort of first-ever, working-age disability awardees received benefits from both programs over a 60-month period. A second paper (Rupp and Riley 2012) finds that SSI facilitates high levels of Medicaid coverage for SSI awardees overall and provides access to Medicaid for many SSDI awardees during the 24-month Medicare waiting period. A third paper (Riley and Rupp, 2014b) tracks expenditures for 2000-2006 for the SSDI, SSI, Medicare, and Medicaid programs and finds that SSI is a relatively low-expenditure program with important implications for the other three programs. A fourth paper (Riley & Rupp 2014a) focuses on estimated cumulative expenditure patterns over the working-age adult portion of the life cycle for the year 2000 awardees for SSDI, SSI, Medicare, and Medicaid. Finally, Rupp and Riley (2016) focuses on the effect of State variations in Medicaid enrollment policies for SSI recipients on Medicaid coverage and expenditures. Meijer, Karoly, and Michaud (2009, 2010) analyzes eligibility for the Medicare Part D Low Income Subsidy, which relies on a simplified SSI methodology. Martin, Honeycutt, and Hemmeter (2020) document the earnings and SSA benefit outcomes after vocational rehabilitation applications of youth.
In the NBS, we collect information that is not available from our administrative records from a representative sample of SSI and OASDI disability beneficiaries. Key items of interest in the NBS include work attitudes and work-related activities, health and functional status, education, access to health insurance, household composition, and sources of income. We implemented the first four rounds between 2004 and 2010, with a particular focus on the Ticket to Work program. More recent rounds in 2015, 2017, and 2019 have added emphasis on beneficiaries who work, especially those who have experienced employment success to the point of benefit suspension. Work examining the data from the 2017 NBS is ongoing, and we are beginning our analysis of the 2019 data released in 2021. In 2017, we published a compendium of disability statistics from the 2015 NBS, “National Beneficiary Survey: Disability Statistics, 2015” (http://www.ssa.gov/policy/docs/statcomps/nbs/index.html). The publication provides descriptive statistics on the health, program and service participation, employment interest and activity, job characteristics, and benefits and employment interaction of SSI recipients and SSDI beneficiaries. We are updating this publication with 2017 data and plan to release a new compendium in 2021.
Other researchers and policy analysts within SSA and at other Federal agencies and academic institutions use the DAF and the NBS for general disability research. Several of the Rupp and Riley papers mentioned above link data from Centers for Medicare & Medicaid Services to the DAF. Other research using DAF or NBS data include: the differences in employment outcomes between young participants (ages 18 to 30) with psychiatric disabilities versus young participants with other disabilities (Schimmel, Liu, and Croake 2012); the impact of workplace injuries on receipt of SSDI benefits (O'Leary et al. 2012); work activities and employment outcomes for our beneficiaries with disabilities in seven articles in a special issue of the Social Security Bulletin (volume 71, number 3, 2011); the long-term effects of evidence-based supported employment services on vocational outcomes (Cook, Burke-Miller, and Roessel 2016); an analysis of Rehabilitation Services Administration records matched to DAF data, to examine state vocational rehabilitation (VR) agency provision of services to youth with disabilities and differences in outcomes based on SSA benefit receipt status (Honeycutt, et al. 2016); the employment and benefit receipt outcomes of vocational rehabilitation applicants (Mann et al. 2017); the income effect of SSDI payments on earnings (Gelber, Moore, and Strand 2016); a profile of working-age SSDI and SSI beneficiaries with psychiatric disabilities (Livermore and Bardos 2017); outcomes for transition-age youth with disabilities who applied and were eligible for Vocational Rehabilitation services (Honeycutt, Martin, and Wittenburg 2017); the characteristics associated with return-to-work success (Ben-Shalom and Mamun, 2015); a review of work incentive use by transition age youth (U.S. Government Accountability Office 2017); an assessment of the cost effectiveness of vocational rehabilitation services for SSA disabled beneficiaries (U.S. Social Security Administration 2017); an examination of how social insurance, family support, and work capacity enhance individuals' economic well-being following significant health and income shocks (Rennane 2016); and the effect of the ACA on SSI disability applications (Schimmel Hyde et al. 2017): an examination of the relationship between receiving support for postsecondary education (college or vocational training) from state VR agencies and long-term outcomes for youth with mental health conditions (Anand and Honeycutt, 2020); a follow-up assessment of the long-term impact of the Mental Health Treatment Study (Baller, et al. 2020).
The YTD projects in Colorado and New York ended in 2010. The Florida, Maryland, and West Virginia projects ended in 2012. We have released the 12-month, post-random-assignment reports for all the sites to the public. We published a 24-month, post-random-assignment report covering all the sites in the February 2014 edition of the Social Security Bulletin (Hemmeter 2014). We posted the comprehensive final report of the six random assignment projects to our website in November 2014. This demonstration produced mixed evidence on whether YTD impacts on paid employment is sustainable. Camacho and Hemmeter (2013) summarize the findings from two earlier YTD projects.
The goal of the Homeless with Schizophrenia Presumptive Disability (HSPD) Pilot Demonstration is to improve the economic well-being of adult SSI applicants who are both homeless and diagnosed with schizophrenia or schizoaffective disorder. We partnered with clinicians and case managers in California from the Health Services Agencies of San Francisco and Santa Cruz counties, the Department of Public Health of the City of San Francisco, and the Department of Mental Health of Los Angeles County, who are actively assisting their clients to navigate the SSI application process and have established relationships with patients diagnosed with schizophrenia and schizoaffective disorder who are also homeless. There were two main features of the project: (1) the SSI application assistance; and (2) the use of presumptive disability (PD). The clinicians and case managers assisted these individuals with gathering supporting medical evidence, coordinating medical appointments, and submitting the SSI application. Along with the SSI application, a Presumptive Disability Recommendation Form, created for this pilot demonstration, was also submitted. Clinicians from the community agencies certified that the applicant met the SSA criteria for a diagnosis of schizophrenia or schizoaffective disorder. To provide economic relief to the applicant while we processed the application, we awarded up to 6 months of SSI payments to the applicant based on PD. Applicants were not required to pay back these payments if we ultimately denied their applications, as long as we did not deny the applications for non-medical reasons; therefore, there must be a high degree of probability that the applicant was disabled when we conferred PD SSI payments. Our field offices generally make PD findings only for specific disability categories, which do not include schizophrenia or schizoaffective disorder.
In our evaluation (Bailey, Engler, and Hemmeter 2016), we examined whether the program improves the administration of the SSI application and determination process. The evaluation is based on a quasi-experimental design, in which we compared outcomes for applicants who receive assistance and PD payments with applicants from a previous period and applicants in surrounding areas. Within this framework, we examined differences in initial allowance rates, appeals, failure-to-cooperate denials, processing times, total payments, exits from SSI, mortality, and the need for consultative exams. Relative to the comparison groups chosen in the surrounding geographic areas, in an earlier period, and in the same locations, we found that the pilot led to higher allowance rates at the initial adjudicative level, fewer requests for consultative examinations, and reduced time to award.
Promoting Readiness of Minors in SSI (PROMISE) is a joint project between SSA and the Departments of Education (ED), Labor, and Health and Human Services. The goals of the project are to improve the provision and coordination of services and supports for children with disabilities who receive SSI and their families in order to achieve improved education and employment outcomes. The targeted outcomes include completing postsecondary education and job training to obtain competitive employment in an integrated setting that may result in long-term reductions in the child recipient’s reliance on SSI. In 2013, ED funded model demonstration projects in five individual States (Arkansas, California, Maryland, New York, and Wisconsin) and one consortium of States (Arizona, Colorado, Montana, North Dakota, South Dakota, and Utah, collectively referred to as Achieving Success by Promoting Readiness for Education and Employment, or ASPIRE) for 5 years. SSA is responsible for evaluating PROMISE.
The individual projects are also producing research on the projects. A special edition of the Journal of Vocational Rehabilitation included a number of project-specific articles produced by the projects. Schlegelmilch et al. (2019) describe the relationship between work incentive benefits counseling and work in Wisconsin. Golden et al. (2019) describe the community of practice model used in New York State. Hartman et al. (2019) look at employment rates in Wisconsin. Ipsen et al. (2019) look at engagement in services at ASPIRE. Crane et al. (2019) describe the engagement strategies used in Maryland. Williams et al. (2019) look at the predictors of work activities in Arkansas. Luecking et al. (2019) report on lessons about intervention fidelity from Maryland. Enayati and Shaw (2019) estimate bounds on the return on investment for PROMISE projects. Tucker et al. (2019) describe the parent and guardian interventions implemented in California. Saleh et al. (2019) describe the characteristics of effective partnerships in New York State. Chambless et al. (2019) report on the implementation of self-determination training in ASPIRE. Gold et al. (2019) discuss general strategies for recruiting participants across the projects. Anderson, Schlegelmilch, and Hartman (2019) illustrate a cost-benefit analysis in Wisconsin. Anderson and Golden (2019) provide an overview of the special edition.
In FY 2020, we worked with ACF to identify and select programs to participate in ACF's Building Evidence on Employment Strategies (BEES) and Next Generation of Enhanced Employment Strategies (NextGen) projects and approved two programs for PWEIP. The Bridges from School to Work program, an employer-driven program, provides job readiness instruction, placement, and post-placement support for young adults with disabilities in eight urban areas (in GA, MD, IL, TX, CA [2 sites], PA, and DC); implementation starts August 2021. The Kentucky Addiction Recovery Care Program is a mature, innovative model for combining recovery services with workforce development in rural Kentucky. It provides treatment, employment services, housing, and other supports to individuals with substance use disorders.
In FY 2021, ACF proposed nine programs to SSA for consideration; we approved eight programs for inclusion. Four programs feature use of the evidence-based Individual Placement and Support (IPS) model of supported employment as the key intervention. The programs (and the states participating) include: IPS for individuals using Federally Qualified Health Center services (IL and NH); for individuals with substance use disorders (OK and OH); for participants receiving TANF and SNAP assistance (WA); and for justice-system involved individuals within 30 days of re-entering communities (IA, TN, OK, SC, and IL). Another approved program, Families Achieving Success Today program (MN), uses an adaptation of an IPS model to help TANF clients with physical or mental health barriers to employment obtain competitive jobs. The other two programs approved in FY 2021 include the Central City Concern (OR) and the Journey program (two OH county Child Support Enforcement Agencies). Central City Concern is a large housing and employment center with an outpatient clinic providing general healthcare and employment, housing, and recovery services for individuals with substance use disorders who enter from a detoxification center. The Journey program's goals are to improve parental engagement with children and adherence of child support court orders, and its tertiary goal is to increase participant employment rates. All programs approved in FY 2021 experienced COVID-19-related delays in implementation and have planned start dates during the summer 2021. We expect to receive evaluation reports from approved programs beginning in FY 2023.
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Coe, Norma B. and Kalman Rupp. Does Access to Health Insurance Influence Work Effort Among Disability Cash Benefit Recipients. Center for Retirement Research Working Paper No. 2013-10, Center for Retirement Research at Boston College, April 2013.
Coe, Norma B. and Matthew S. Rutledge. What is the Long-Term Impact of Zebley on Adult and Child Outcomes? Center for Retirement Research Working Paper No. 2013-3, Center for Retirement Research at Boston College, January 2013.
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Cook, Judith A. and Jane K. Burke-Miller. The Pathway to SSA Disability Program Entry Among Medicaid Enrollees 2007-2011: The Role of Serious Mental Illness, Multiple Impairments, and Recent Health Care Utilization. DRC Working Paper No. 2019-08, Mathematica Center for Studying Disability Policy, March 2019.
________. The Relationship of Multiple Program Benefits and Employment to SSI/DI Enrollment and Reliance Among Working-Age Adults with Serious Mental Illness. DRC Working Paper No. 2017-03, Mathematica Center for Studying Disability Policy, October 2017.
Cook, Judith A., Jane K. Burke-Miller, and Thomas M. Bohman. Demonstration to Maintain Independence and Employment in Texas: Long-Term Follow-Up of Health Services Utilization and Employment Outcomes? DRC Brief No. 2017-05, Mathematica Center for Studying Disability Policy, September 2017.
Cook, Judith A., Jane K. Burke-Miller, and Dennis D. Grey. Impact of Contingent Work on Subsequent Labor Force Participation and Wages of Workers with Psychiatric Disabilities. DRC Working Paper No. 2015-02, Mathematica Center for Studying Disability Policy, May 2015.
Crane, Kelli, Richard Luecking, Todd Honeycutt, and Sarah Palmer. SSI Youth Recipient and Employment Transition Formative Research Project: Community of Practice: Organizational Features and Lessons Learned. Washington, DC: Mathematica Center for Studying Disability Policy, September 2018.
Cutler, David, Ellen Meara, Susan Stewart. Socioeconomic Status, Perceptions of Pain, and the Gradient in Disability Insurance. NBER Retirement and Disability Research Center Project No. NB19-03, National Bureau of Economic Research, September 2019.
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________. The Effect of the Supplemental Security Income Children’s Program on Parental Labor Supply and Long-Term Outcomes of Enrolled Children. NBER Disability Research Center Working Paper No. NB-13-04, National Bureau of Economic Research, September 2013.
________. How Disability Benefits in Early Life Affect Long-Term Outcomes. NBER Retirement and Disability Research Center Paper No. NB-20-05, National Bureau of Economic Research, August 2020.
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Fraker, Thomas. The Youth Transition Demonstration: Lifting Employment Barriers for Youth with Disabilities. Center for Studying Disability Policy Issue Brief Number 13-01. Princeton, NJ: Mathematica Policy Research, Inc., February 2013.
Fraker, Thomas, Peter Baird, Arif Mamun, Michelle Manno, John Martinez, Debbie Reed, and Allison Thompkins. The Social Security Administration’s Youth Transition Demonstration Projects: Interim Report on the Career Transition Program. Report Prepared for the Social Security Administration, December 2012.
Fraker, Thomas M., Kelli T. Crane, Todd C. Honeycutt, Richard G. Luecking, Arif A. Mamun, and Bonnie L. O'Day. “The Youth Transition Demonstration Project in Miami, Florida: Design, Implementation, and Three-Year Impacts.” Journal of Vocational Rehabilitation 48, 1 (2018): 79–91.
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Honeycutt, Todd, Brittney Gionfriddo, Jacqueline Kauff, Joseph Mastrianni, Nicolas Redel, and Adele Rizzuto. Promoting Readiness of Minors in Supplemental Security Income (PROMISE): Arkansas PROMISE Process Analysis Report. Washington, DC: Mathematica Center for Studying Disability Policy, September 2018.
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Honeycutt, Todd and Gina Livermore. Promoting Readiness of Minors in Supplemental Security Income (PROMISE): The Role of PROMISE in the Landscape of Federal Programs Targeting Youth with Disabilities. Washington, DC: Mathematica Center for Studying Disability Policy, December 2018.
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Honeycutt, Todd, David Wittenburg, Kelli Crane, Michael Levere, Richard Luecking, and David Stapleton. SSI Youth Formative Research Project: Considerations for Identifying Promising and Testable Interventions. Washington, DC: Mathematica Center for Studying Disability Policy, November 2018.
Honeycutt, Todd, David Wittenburg, Michael Levere, and Sarah Palmer. Supplemental Security Income Youth Formative Research Project: Target Population Profiles. Washington, DC: Mathematica Center for Studying Disability Policy, September 2018.
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________. The Transition to Employment: Better Data Needed to Identify Best Practices for Youth SSI Recipients. Washington, DC: Mathematica Center for Studying Disability Policy, September 2018.
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Livermore, Gina A., Denise Hoffman, and Maura Bardos. Ticket to Work Participant Characteristics and Outcomes Under the Revised Regulations.
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