Some in Congress look at incentives in disability benefit

By Patricia Wen
Globe Staff / January 18, 2011

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Key members of Congress are demanding an investigation into whether a fast-growing, $10 billion federal disability program designed to serve poor disabled children is flawed in multiple ways, including the possibility that it creates incentives for families to put those children on psychiatric drugs.

A top member of the US House Ways and Means Committee, along with Representative Richard Neal and Senator Scott Brown of Massachusetts, issued a letter asking the Government Accountability Office to investigate the striking rise in the number of children receiving Supplemental Security Income benefits, or SSI, for behavioral and mental issues such as attention deficit disorders and depression, and whether low-income families are tempted to put their youngsters on psychiatric drugs “to improve their chances’’ of qualifying. It also asked investigators to examine whether the Social Security Administration, which runs the program, can effectively screen new recipients and adequately determine when children’s conditions have improved to the point that they are no longer eligible for benefits.

A three-part Boston Globe series last month, called “The Other Welfare,’’ showed how the program, created in 1972 for children with severe physical disabilities, now serves largely those diagnosed with behavioral, learning, and mental disorders. Of the 1.2 million low-income children who receive SSI benefits, 53 percent, or 640,000, qualify because of mental disabilities, up from 8 percent in 1990. By significant margins, delayed speech and attention deficit hyperactivity disorder, or ADHD, were the top reasons children received benefits, including Medicaid coverage and $700 a month in cash.

Since the series was published, Neal and Brown have called for government hearings. The letter to the Government Accountability Office, sent Friday, was also signed by Representative Geoff Davis, a Kentucky Republican and the new chairman of the human resources subcommittee of the powerful House Ways and Means Committee, which oversees Social Security programs. Davis and Brown could not be reached for comment yesterday.

Neal, a Springfield Democrat, said he has been talking about children’s SSI with lawmakers in both parties, including Dave Camp, a Republican from Michigan who now chairs the House Ways and Means Committee. Neal said he also met with Michael Astrue, commissioner of the Social Security Administration, and said Astrue expressed concern about the issues raised in the Globe series.

Based on Astrue’s suggestions, Neal said his office has also asked the Institute of Medicine — an independent, nonprofit health research organization of the National Academy of Sciences — to help with technical guidance in the ongoing government investigations.

“We thought pursuing the issue in a methodical and judicious way was the right course to take,’’ Neal said.

The Globe series also showed how the SSI program created disincentives for teenagers to take up part-time work, largely because their pay may jeopardize benefits.

The cash benefits, which can be used for day-to-day expenses, often make up roughly half of a family’s income.

Neal said it is likely that Congress will hold hearings on the children’s SSI program, without waiting for the completion of the government accountability reports.

He predicted that momentum to address problems in the program will not be stalled by bipartisan strife that has affected other issues pending before Congress.

“The mental health issues of children are far removed from day-to-day political differences,’’ he said.

Patricia Wen can be reached at