[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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