New Freedom Initiative -- Preliminary Report: Income Supports

U.S. Department of Health & Human Services

Initiative ~ Executive Order ~ HHS Role ~ News & Additional Resources

Delivering on the Promise: Preliminary Report

Federal Agency Actions to Eliminate Barriers and Promote Community Integration

Income Supports

Cash and medical benefits can be critical to an individual's ability to live in the most integrated appropriate setting. Cash benefits, often in conjunction with food stamps and housing subsidies, can provide for basic needs such as food, clothing, and shelter. Medical benefits can enable someone to obtain treatment that may be critical to his or her ability to function in a community setting.

Work can also contribute significantly to an individual's ability to thrive in a community setting. As advances in medicine and assistive technology make it possible for people with disabilities to do more and to be more independent, technology is creating new kinds of work and new pathways to it, such as through homebased businesses and telecommuting. Self-sufficiency through work is an increasingly realistic goal for many people with disabilities despite even severe impairments.

The Social Security Administration (SSA) operates two programs that pay cash benefits to a total of more than ten million people with disabilities. The Social Security Disability Insurance (SSDI) program is a social insurance program with benefits based on prior earnings. The Supplemental Security Income (SSI) program is a means-tested income-assistance program. SSDI beneficiaries are eligible for Medicare after a two-year waiting period. Most SSI beneficiaries are immediately eligible for Medicaid.

The SSI program contains many provisions that facilitate the transition from an institution to a community setting and otherwise promote community living. The SSDI and SSI programs provide a comprehensive package of supports that are designed to assist beneficiaries in their efforts to take advantage of work opportunities.

Some of the actions that SSA will take to ensure that these provisions are being used to maximum effect include:

Providing special training to staff who serve the public directly, including those in field offices, program service centers, and telephone service centers, emphasizing the importance of key policies and procedures in promoting the goals of Olmstead.
Training state disability examiners, administrative law judges, and quality reviewers on Olmstead-related issues, stressing disability evaluation policies that are of particular relevance to individuals who do not reside in institutions.
Maintaining good working relationships with local medical institutions and state agencies in order to facilitate the continuation of SSI benefits during periods of temporary institutionalization.
Upgrading operating instructions on waiving parental deeming for children requiring an institutional level of care, a key provision that (in states that elect this option) protects SSI benefits and Medicaid coverage for these children, enabling them to remain at home if they can be adequately cared for there.
Emphasizing to field offices the importance of processing applications for benefits before an individual leaves an institution, and of maintaining with institutions' and state agencies' agreements that make this possible.
Continuing to improve the selection and accountability of the representative payees who receive and manage benefits on behalf of SSDI and SSI beneficiaries.

Last revised: April 9, 2002