Friday, January 21, 2011

Reforming "Funny Money"

While listening to NPR, I heard about a series of Boston Globe articles on SSI for children, how the number of cases has exploded, and raising questions about both whether the current criteria for SSI eligibility are appropriate and the extent to which the system is abused by people looking for "no strings attached cash aid" to supplement their family's welfare benefits or modest earnings.

The interview took a "You may not be aware of this, but..." approach to the explosion of child recipients of SSI, but it's not exactly a closely held secret that many people who were removed from welfare rolls as a result of 1990's-era welfare reforms ended up on SSI. A lot of that transition was legitimate. But as with any system, some were quick to attempt to exploit the system.

I believe I first heard the term "funny money" in the early years of welfare reform from a classmate who had moved to a Bible Belt state, and who related that the term was being used by people who wanted their kids, whatever the reality, to be classified as disabled. That idea is more than a bit creepy - find a way to have your child classified as mentally ill (that's a lot easier to do, after all, than getting a classification of physical illness) so you can significantly boost your family's income. And it was not unusual for families who played this game to have multiple children, perhaps all of their children, collecting "funny money".

The Globe covers some of the consequences - parents who get upset when their children's mental health improves because it could mean losing the money, teenagers who are fully capable of working part-time jobs who are instead pressured to remain idle lest their employment result in a reduction or the end of their SSI checks. It's hard not to be judgmental. One article opens,
Geneva Fielding, a single mother since age 16, has struggled to raise her three energetic boys in the housing projects of Roxbury. Nothing has come easily, least of all money.

Even so, she resisted some years back when neighbors told her about a federal program called SSI that could pay her thousands of dollars a year. The benefit was a lot like welfare, better in many ways, but it came with a catch: To qualify, a child had to be disabled. And if the disability was mental or behavioral — something like ADHD — the child pretty much had to be taking psychotropic drugs.

Fielding never liked the sound of that. She had long believed too many children take such medications, and she avoided them, even as clinicians were putting names to her boys’ troubles: oppositional defiant disorder, depression, ADHD. But then, as bills mounted, friends nudged her about SSI: "Go try."

Eventually she did, putting in applications for her two older sons. Neither was on medications; both were rejected. Then last year, school officials persuaded her to let her 10-year-old try a drug for his impulsiveness. Within weeks, his SSI application was approved.

"To get the check," Fielding, 34, has concluded with regret, "you’ve got to medicate the child."
That's a pretty sympathetic spin, but I'm not buying it. It didn't occur to Fielding that perhaps the reason her oldest two children didn't receive SSI was because they didn't have qualifying disabilities? That pushing them onto medications they don't need in order to try to get them on SSI would represent bad parenting?

I would propose a simple reform: instead of issuing a "one size fits all" check, the Social Security Administration should assess how much money a typical family might be expected to spend, above and beyond its normal budget, for the condition at issue, while otherwise maintaining Medicaid eligibility rules such that medical costs aren't an issue. Then, rather than issuing $700 checks, they could issue payments that range from quite small (e.g., for the toddlers who are now being pushed into the system over "delayed speech" who will often already be eligible for a free and full set of services through the public schools) while being able to offer more significant benefits to families that are dealing with disabilities that have more substantial costs attached or require a parent to become a full-time caregiver. For some disabilities (e.g, delayed speech) there should be an automatic sunset date for benefits at which time, absent a new diagnosis, benefits will end. Such modifications will not only better direct financial help where it is most needed, it will significantly reduce the financial incentive to push normal kids into the disability system.
When little Alfonso tried a full sentence it came out in a swirl of sounds, often followed by a major league tantrum when he realized he was not understood. And so his mother, Roxanne Roman, was not surprised when the 18-month-old was diagnosed by a specialist with speech delay.

It came as a shock, however, when she learned from relatives that Alfonso’s problem might qualify him for thousands of dollars in yearly disability payments through the federal Supplemental Security Income program. For Roman, pregnant with her second child at age 17 and living at her mother’s, the extra income was attractive. She wanted to rent her own place.

Within three months, the boy’s application was approved. Alfonso receives $700 in monthly cash benefits, plus free government-paid medical coverage. Roman said her relatives told her she can pretty much count on the disability checks for Alfonso, now 5, to keep arriving in the mailbox for the rest of his childhood.

"They don’t ask many questions about the child once you’re approved," Roman said.
Some questions are well overdue.

I understand the argument that a lot of the families who game the system are living well below the poverty line. It was suggested on the radio program that the average family that gets a SSI check for a child doubles its income based upon that check - that is, if there even is a wage earner in the family we're talking part-time, minimum wage work. But I can't see the abuse of the disability system to be justified by the inadequacy of other aspects of the social safety net. Leaving the taxpayer aside, it's unfair to families who are trying to live within the rules, it sets a terrible example for other families, and it isn't healthy for the children. And, of course, it opens up the entire welfare system to attack as overly generous and beset with fraud and abuse. (Unless you truly believe that proponents of welfare reform care, please don't tell me that such an attack would be misleading and unfair. Do I need to remind you about Cadillac-driving welfare queens?)

1 comment:

  1. Thanks for writing this. All this talk about how to cut the deficit, and no one seems to care much about the fraud and abuse surrounding the SSI program.

    ReplyDelete