[Congressional Record Volume 140, Number 13 (Thursday, February 10, 1994)]
[Senate]
[Page S]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: February 10, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
    DISABILITY DRUG ABUSE PREVENTION AND REHABILITATION ACT OF 1994

  Mr. COHEN. Mr. President, today I am announcing a legislative package 
on behalf of myself and Senators Dole, Kassebaum, Thurmond, D'Amato, 
and Lugar to reform the Social Security disability process and to stop 
taxpayers' dollars from fueling the addictions of illegal drug users 
and other substance abusers.
  Absurd as it must seem to hardworking Americans, who see more and 
more of their paychecks going to taxes, and to severely disabled 
persons who truly need assistance, we are now paying over a billion 
dollars a year in disability payments to drug addicts and alcoholics--
many of whom are using taxpayer dollars to buy more drugs and alcohol.
  This legislative package is the result of an investigation of the SSI 
and SSDI programs that was conducted by the Minority Staff of the 
Senate Special Committee on Aging and the General Accounting Office.
  Our investigation found that the current policy of allowing addicts 
and alcoholics to use disability payments to turn around and buy more 
drugs and drink seriously undermines our efforts to combat crime, 
promote preventive health care and reform our welfare system. Far from 
encouraging rehabilitation, the current laxity of the Social Security 
Administration in enforcing the statutory treatment requirement hurts 
the addicts themselves by perpetuating drug and alcohol abuse.
  Our investigation revealed that the word on the street is that SSI 
gives easy cash for drugs and alcohol. For example,

       The director of a homeless shelter in Denver has called SSI 
     ``suicide on the installment plan'' because the program 
     provides ready cash to addicts and alcoholics with no strings 
     attached for follow-up or treatment. He maintains that the 
     first day of every month is considered ``Christmas Day'' by 
     many of the alcoholics and addicts who use the money for 
     illegal drugs and alcohol, fail to enter treatment programs, 
     and then either stay on the street or return to homeless 
     shelters for food and shelter once their disability benefit 
     has been spent on drugs.
       A mental health worker specializing in chemical dependency 
     told the committee that his caseload of illegal drug users 
     was about ``99.5 per cent'' SSI recipients. He said that he 
     has witnessed several deaths of SSI recipients from drug 
     overdoses, ``yet their checks just keep coming.''

  In our investigation, we heard several allegations that the current 
disability process has spawned a cottage industry of clinics, attorney 
representatives, and doctors who help abusers get on the disability 
rolls.
  We also found that lump sum disability benefits of thousands of 
dollars are being paid to substance abusers who are using these funds 
to buy drugs and alcohol. Even more astounding is that benefits are 
awarded to claimants even in cases where the SSA or the administrative 
law judge hearing the case is directly told that the claimant is 
engaged in criminal activity, such as drug dealing, to support his or 
her addiction.
  Let's try to explain that one to the American taxpayer.
  Mr. President, in establishing substance abuse as a disability which 
qualifies for benefits under the SSI programs, Congress placed two 
conditions on the payment of benefits to substance abusers: first, the 
substance abuser must receive treatment; and second, a third party, 
such as a friend or relative, must collect the benefits on behalf of 
the substance abuser.
  Unfortunately, both of these protections have failed. For example, up 
until last month, the SSA had set up programs to monitor and enforce 
the treatment requirement in only 18 states. In fact, 26 States have 
never had an agency approved by SSA to monitor treatment.
  Fewer than one-third of the approximately 250,000 drug addicts and 
alcoholics are required to get treatment or have someone else collect 
their benefits for them.
  Of the $1.4 billion in benefits flowing to drug addicts and 
alcoholics on the SSI and disability programs, less than $320 million 
of these payments are even covered by these protections. So, over $1.1 
billion in payments are exposed to widespread abuse--with no controls 
in place. Maine, for example, has never had an agency approved by SSA 
to monitor treatment.
  There are widespread problems in the collection of payments by third 
parties on behalf of the drug and alcohol abusers--in fact, we found 
cases where the bartender, the local drug dealer, or another addict was 
appointed as the guardian of the payments.
  The legislative package we are announcing today addresses many of 
these problems by strengthening the enforcement of the current law, 
extending those protections to the SSDI program, and by reforming the 
disability programs so that it is not life-time maintenance for 
substance abusers.
  Mr. President, I urge my colleagues to join me in sponsoring this 
legislation and request unanimous consent that the following 
explanation of the legislation be included in the Congressional Record.
  There being no objection, the explanation was ordered to be printed 
in the Record, as follows:

 Senator Cohen's Proposed Legislation to Reform the SSI and DI Programs

       Extend current statutory Supplemental Security Income (SSI) 
     disability treatment and representative payee requirements to 
     recipients of Social Security Disability (SSDI) benefits:
       Currently, the SSI disability program imposes two special 
     statutory requirements on drug addicts and alcoholics who 
     qualify for the program on the basis of their substance 
     addiction. First, in order to prevent benefits from being 
     used to fuel addition, all cash payments must be paid to a 
     ``representative payee'' rather than directly to the 
     beneficiary. Second, these beneficiaries must participate in 
     a substance abuse treatment program approved by the Social 
     Security Administration as a condition of eligibility, and 
     must also demonstrate that they are in compliance with the 
     terms and conditions of treatment in order to retain their 
     eligibility.
       Even though the SSDI program provided $380 million in 
     benefits to drug addicts and alcoholics in 1993, the SSDI 
     places no requirements of treatment or representative payee 
     as conditions of receiving the benefits. The proposed 
     legislation extends these treatment and representative payee 
     requirements to SSDI beneficiaries who qualify for the 
     program on the basis of their substance abuse.
       Extend current conditions of treatment and third-party 
     payment of benefits to all SSI/SSDI recipients who are 
     substance abusers regardless of whether the substance abuse 
     is the primary or secondary basis for disability:
       The Social Security Administration does not classify 
     individuals who have substance addiction as a secondary 
     impairment as subject to the treatment and representative 
     payee requirements. In other words, substance abusers who 
     have other impairments which are independent of their 
     addiction, and whose addiction is not material to the finding 
     of their disability, are not considered formal substance 
     abusers and are not required to seek treatment or have a 
     representative payees. The effect of this distinction is that 
     SSI payments are being made to a large class of substance 
     abusers who are not subject to any controls to ensure that 
     they attend treatment or do not use their benefits to buy 
     drugs or alcohol.
       This agency policy is contrary to the language of the 
     Social Security Act which provides that the treatment and 
     payee requirements should apply to all disability recipients 
     who are addicts and alcoholics.
       The legislation would expressly extend these requirements 
     to beneficiaries in both programs who have a secondary 
     impairment of addiction or alcoholism.
       Reform the representative payee program:
       A ``representative payee'' is a third party who assists in 
     managing the funds of a substance abuser to ensure that 
     benefits are not used for drugs or alcohol. Currently, a 
     representative payee can be a friend, relative, social 
     service agency, or anyone else selected by the Social 
     Security Administration (SSA).
       Recent reports by the Minority Staff of the Senate Special 
     Committee on Aging and the Inspector General of Health and 
     Human Services found that the current representative payee 
     system is not working to protect against abuse of payments to 
     substance abusers. Responsible representative payees are 
     difficult to find, particularly for drug and alcohol abusers. 
     Family members are often unable to resist pressure or even 
     threats of abuse if benefits are not turned over. Some 
     representative payees are drug or alcohol abusers themselves, 
     and there are numerous cases where liquor store operators and 
     bartenders have even been approved by the SSA to serve as 
     representative payees.
       The legislation would limit the designation of 
     representative payees to government agencies, state licensed 
     or certified facilities, or state-bonded and licensed 
     community-based nonprofit agencies.
       Prohibit the payment of lump-sum benefits to drug addicts 
     and alcoholics:
       Since it frequently takes a year or longer to be awarded 
     benefits for SSI and DI, and, because benefits are 
     retroactive to the date of initial application, lump sums as 
     high as $15,000 to $20,000 can be awarded to substance 
     abusers. Despite existing representative payee requirements, 
     the Aging Committee Minority Staff investigation uncovered 
     disturbing evidence that many lump sums are often used 
     immediately to buy more drugs or alcohol with life-
     threatening or even fatal consequences for the claimant.
       Therefore, the legislation would prohibit the payment of 
     lump sum disability benefits to substance abusers and would 
     require that these funds be held in trust to be managed for 
     them while they are in rehabilitation.
       Require SSA to establish Referral Monitoring Agencies in 
     every state:
       To enforce the treatment requirements for drug addicts and 
     alcoholics, the Social Security Administration has entered 
     into agreements with state agencies or private firms to refer 
     these beneficiaries to treatment facilities and to monitor 
     them on a regular basis in order to ensure compliance with 
     the law. These agencies are known as ``Referral Monitoring 
     Agencies.''
       The Aging Committee Minority staff investigation revealed 
     that the SSA has failed to give adequate priority to the 
     statutory requirement that drug addicts and alcoholics 
     receive treatment. Despite the tripling of the numbers of 
     these individuals receiving benefits from 1990 to 1993, the 
     SSA had established RMA's for only 18 states as of August 
     1993. Despite a recent contract award covering 29 additional 
     states and the District of Columbia, seven states still do 
     not have an RMA.
       Therefore, the legislation requires SSA to establish RMAs 
     in every state within one year of enactment, and to report 
     these periodically to Congress on the effectiveness of the 
     RMAs.
       Clarify that proceeds from illegal activities such as drug 
     dealing constitute substantial gainful activity and are 
     therefore a basis for denying benefits:
       The 7th Circuit Court of Appeals recently upheld the denial 
     of SSI benefits on the grounds that illegal activity can 
     constitute substantial gainful activity for purposes of 
     denying SSI payments. However, other courts have found that 
     active drug dealing is not enough to deny benefits. The 9th 
     Circuit Court of Appeals ruled this month, for example, that 
     a heroin addict who sold drugs to support his habit could not 
     be denied benefits due to this illegal activity. This 
     interpretation of the current law allows claimants in some 
     areas of the country to legally receive benefits while 
     dealing drugs or actively engaging in other criminal 
     activities.
       Therefore, the legislation clarifies that any criminal 
     activity undertaken to support substance abuse would be prima 
     facie evidence of substantial gainful activity, and thus 
     preclude awarding of either SSDI or SSI disability benefits.
       In order to ensure adequate treatment for SSI and DI 
     recipients, priority will be given for treatment for such 
     recipients in programs of the Substance Abuse Mental Health 
     Services Administration:
       In light of a requirement that SSI and DI substance abusers 
     receive treatment, this would assure adequate treatment 
     sites.
       Revision of disability definition and procedures regarding 
     substance abusers.
       In order to improve monitoring and enforcement of treatment 
     requirements, the legislation will revise the definition of 
     disability and its application to substance abusers. The goal 
     of these revisions will be to limit disability benefits for 
     substance abusers to the time such individuals are actually 
     disabled.
       Study the feasibility of replacing cash benefits with a 
     voucher system for substance abusers:
       The Aging Committee Minority Staff Report found that the 
     current system of awarding cash benefits to substance abusers 
     perpetuates addiction and undermines treatment efforts. The 
     legislation will require a study of the feasibility of 
     providing voucher in lieu of cash payments to substance 
     abusers.

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