[Congressional Record Volume 141, Number 14 (Tuesday, January 24, 1995)]
[Extensions of Remarks]
[Page E171]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


                               SSI REFORM

                                 ______


                        HON. BLANCHE L. LINCOLN

                              of arkansas

                    in the house of representatives

                       Tuesday, January 24, 1995
  Mr. LINCOLN. Mr. Speaker, I rise today to begin a series of 
discussions over the direction of a program that began with the noblest 
of intentions, but is rapidly turning into a mockery of the 
Government's ability to help its citizens. I am speaking of the 
Supplemental Security Income program for children.
  The SSI program was created as a part of the Social Security 
Amendments of 1972 in order to assist aged, blind, and disabled 
individuals with supplemental cash assistance. At the time that the law 
was being written, there was debate over whether or not to include 
children. The House believed that children should qualify and wrote 
that, ``. . . disabled children . . . are deserving of special 
assistance in order to help them become self-supporting members of our 
society.'' The other body disagreed, arguing that the needs of disabled 
children were no greater than the needs of non-disabled childern--with 
the exception of health care costs, which were covered under the 
Medicaid program. Ultimately the House prevailed and disabled children 
were included.
  Mr. Speaker, that was over 23 years ago. After the program was 
established, 71,000 blind and disabled children received SSI. Today 
over 700,000 children receive SSI and the question over whether or not 
they should be eligible is still unresolved.
  When the program was implemented both adults and children were 
eligible after the Social Security Administration compared their 
disability against a ``Medical Listing of Impairments.'' Adults who did 
not qualify under the medical listings were entitled to another test 
called the residual functional capacity test which measured their 
ability to engage in ``substantial gainful activity''--or work. Because 
most children did not work, they were not given the option of a second 
test and were simply denied benefits if they did not meet the medical 
listings.
  For 16 years the process worked in this manner until February of 1990 
when the Supreme Court ruled in favor of a plaintiff, a child who had 
been denied benefits because he did not meet the medical listings. That 
decision in Sullivan versus Zebley proved to be a watershed moment in 
the history of SSI for children.
  As a result of the Zebley decision, the Social Security 
Administration was ordered to develop a process that would allow a 
child to have a separate test administered in the case that they did 
not meet the medical listings. Experts were called in and meetings were 
held for months on end. And when the meetings
 were over, the SSA had created a process known as the Individualized 
Functional Assessment or IFA.

  Because children could not be judged on an ability to work, the IFA 
was intended to cover specific age-appropriate activities and 
developmental milestones. Five different so-called developmental 
domains were established to determine disability which included motor 
functioning, communicative skills, cognition, socialization, and 
behavior.
  Mr. Speaker, let me say at this point that I agree with the Zebley 
decision--because I believe that in the context of the original 
statute, 
[[Page E171]] the Supreme Court acted appropriately. My concerns 
therefore center around the wisdom of that original statute.
  I came to this issue because numerous constituents of mine, including 
doctors, teachers and parents came to me with allegations of 
``coaching''--which is the term applied when parent encourages a child 
to misbehave or perform poorly in class in order to receive SSI 
benefits. As a result of these concerns I asked the GAO to investigate 
these allegations as well as the overall soundness of the program.
  It is exactly the soundness of the program that has prompted me to 
become interested in this issue. Individuals that qualify for SSI 
receive a minimum cash payment of $434--higher in some States. In the 
case of children there are no requirements that the money be spent to 
improve the quality of life for the child. It's a strict cash payment--
no strings attached, and to an extent, no questions asked.
  But I have questions. I question the good that this program can 
deliver through cash payments. I wonder whether medical and therapeutic 
services might be a more appropriate and beneficial means of addressing 
the needs of a disabled child. And I doubt the ability of the IFA--
which is at least largely subjective--to best determine who is truly 
needy.
  Mr. Speaker over the next 2 nights I will continue this dialogue and 
explain in detail the problems that I have discovered over the past few 
months that I have been involved in this program. I look forward to the 
coming debate and yield back the balance of my time.
Vol. 141


WASHINGTON, TUESDAY, JANUARY 24, 1995

No. 14


House of Representatives