Friday, November 30, 2012

SSI, People With Disabilities, and Reaching the Federal Poverty Level. Information Bulletin #366 (11/2012). Supplemental Security Income (SSI) is basically a federal program for people who are disabled (and older Americans). As of 2011, there were about 6.7 million people with disabilities who received SSI (another 1 million recipients were over 65). These people are the poorest of all the disabled people in the country. Most of them do not qualify for either Social Security or Medicare; some receive both SSI and Social Security, but combined only to the SSI level. Throughout the recent election campaign and well before that, there has been virtually no discussion, mention or let alone a moral outrage addressing a basic minimal, basic, livable support for people who struggle to survive on SSI. The current monthly federal SSI grant is $698 a month ($8,376 annually) for a single person and for a couple it’s $1,086 a month ($13,032 annually). SSI eligibility automatically triggers Medicaid eligibility. States have the option to provide a State Supplement to the federal SSI grant. Of the 6.7 million people with disabilities who somehow survive on SSI, only 1.6 million, who live in the community, receive a State Supplement. By and large, most States supplement SSI for persons who reside in personal care homes, Medicaid facilities, nursing homes, and other institutions – but not for people with disabilities who live independently in the community. The amount of institutional SSI State supplement is much higher than the SSI State supplement to live independently in the community. Hmmm. Sounds like another institutional bias, contrary to ADA’s “the most integrated setting” a la Olmstead. Let’s put the monthly federal SSI sums in some perspective. The federal poverty level is $10,890 for a single person and $14,710 for a couple, compared to the SSI federal $8,376 and $13,032 respectively. As inadequate as the federal poverty level is, it should be the bottom benchmark! For people with disabilities who must survive on SSI, they live on 75% of the federal poverty level for a single person and 83% of the FPL for a couple. This gap has been approximately the same for the last ten years. For those persons who reside in the community on SSI, to reach just the federal poverty level, the federal SSI grant (or a State supplement) would have to increase by $209 a month for a single person and $140 for a couple. Other than Alaska, no State provides that amount of a State Supplement for single persons with a disability who reside independently in the community. Only five States provide more than $140 a month for a couple. We all know how extremely difficult it is for a SSI recipient who is disabled to find a place to live that they can afford. The “2010 Priced Out” Report clearly demonstrated how the housing market overwhelmingly trumps the SSI grant. What advocates could do: 1. This is a federal issue. We do not believe any States will voluntarily increase their SSI State Supplements so people could afford to live healthy and safe lives independently in the community. 2. We need to make this a moral issue! It’s an outrage that the poorest disabled and elderly Americans are totally ignored and forgotten. 3. SSI cuts across all disability categories and the elderly. Therefore, increasing SSI is a great unifying and organizing issue. 4. Increasing the federal SSI amount even to the extremely inadequate federal poverty level is an economic stimulus on both a federal and State levels. People on SSI spend their entire grants just to survive, putting their entire grants into the economy. These are federal allocations well spent! 5. Where is the White House on this issue? Call the White House Domestic Policy, (202) 456-5594, and let them know. 6. Where are your U.S. Senators and House of Representatives who claim to represent and care about persons with disabilities and the elderly? Call them. Steve Gold, The Disability Odyssey continues Back issues of other Information Bulletins are available online at with a searchable Archive at this site divided into different subjects. Information Bulletins will also be posted on my blog located at To contact Steve Gold directly, write to or call 215-627-7100. Ext 227.

Monday, November 26, 2012

Disabled and Elderly People in China. Information Bulletin #365 (11/2012) People with disabilities and elderly folks in China face many of the same issues we face in the U.S. What follows are some observations my wife and I have and what we learned during a recent trip to China. Obviously, what follows is limited to our observations and meetings with disability advocates. Background data: Out of the 1.3 billion people, approximately 85 million are people with disabilities and 190 million are people aged 60 or older. There are about 33 million elderly with various disabilities. China also ranks disabilities I – V, e..g., blindness in one eye ranked a # II but blindness in both eyes ranks as a # I. 1.Shanghai and Beijing each have about 3 percent of their elderly population (not clear about people with disabilities) who are in nursing facilities. In the past, elderly lived with their children as part of “filial piety.” Due to adult children’s pressure of work, their living costs, crowded housing, and geographically restricted medical insurance, such piety is quickly fading. There is no national health care and the available/affordable care depends on what Provence, like U.S. States, one lives in and one’s ability to pay for health insurance, Despite a poll that said “only” 5.5 percent of the respondents wanted to send their parents to a nursing home, there are no other options. When asked what if their parents do not want to go into a nursing home, one person responded that “we talk to our parents and they understand they have to go into one.” People with disabilities and the elderly are virtually forced into nursing homes. So much for choice. 2. China has only 300,000 caregivers, and one report indicated that most of them were unqualified. The same report estimated that about 11 million caregivers were needed So much for community-based services instead of institutional care. 3. China has a very medicalized view and definitions of disability. 4. Despite a marked increase in Provincial medical insurance coverage for the elderly in the past decade, one professor said that the “government should work out policies to guarantee adequate care for the elderly, which is an essential part of stable development. Government should increase the input and add the insurance for healthcare and rehabilitation, which will be much needed among the elderly but not covered by the current insurance system.” So much for a safety net. 5. China used the occasion of the 2008 Olympics to build curb cuts and install a number of accessible public bathrooms. During our recent visit, virtually every accessible bathroom in every city we visited was being used for storage and unusable by both disabled and nondisabled people. 6. Only in Beijing did we see a number of people with disabilities. In most other cities, we saw quite a number of disabled people who were begging in front of tourist attractions. One guide thought they were “professional beggars who maim themselves,” despite their obvious genetic impairments. The absence of people with disabilities in public places in other cities was really stark. 7. The value of people with disabilities was reflected in a conversation that people with disabilities should work. When asked what should be done if they could not work, given their impairments and how they would live, the response was that “with 1.3 billion people, their lives were not valuable and some people [i.e., people with disabilities] will not be missed.” 8. China does not have a viable, active disability or elderly advocacy network. The China Disabled Persons’ Federation is a government appointed and controlled entity which appears to reflect the central government’s positions. We were not surprised that the disability issues and problems were similar to many we face here. Disabled people of the world unite, you have nothing to lose…. Steve Gold, The Disability Odyssey continues. Back issues of other Information Bulletins are available online at with a searchable Archive at this site divided into different subjects. Information Bulletins are also be posted on my blog located at To contact Steve Gold directly, write to or call 215-627-7100. Ext 227.