OFFICE OF
THE INSPECTOR GENERAL

SOCIAL SECURITY ADMINISTRATION

Impact of State Budget Issues on the
Social Security Administration’s Disability Programs

November 2009

A-01-10-11006

QUICK RESPONSE
EVALUATION

MEMORANDUM

Date: November 18, 2009 Refer To:

To: The Commissioner

From: Inspector General

Subject: Impact of State Budget Issues on the Social Security Administration’s Disability Programs (A-01-10-11006)

The attached final quick response evaluation presents the results of our review. Our objective was to assess the impact of State budget issues on the Social Security Administration’s disability programs.

If you wish to discuss the final report, please call me or have your staff contact Steven L. Schaeffer, Assistant Inspector General for Audit, at (410) 965-9700.

/s/
Patrick P. O’Carroll, Jr.

Attachment

November 2009

Mission

By conducting independent and objective audits, evaluations and investigations, we inspire public confidence in the integrity and security of SSA’s programs and operations and protect them against fraud, waste and abuse. We provide timely, useful and reliable information and advice to Administration officials, Congress and the public.

Authority

The Inspector General Act created independent audit and investigative units, called the Office of Inspector General (OIG). The mission of the OIG, as spelled out in the Act, is to:

 Conduct and supervise independent and objective audits and investigations relating to agency programs and operations.
 Promote economy, effectiveness, and efficiency within the agency.
 Prevent and detect fraud, waste, and abuse in agency programs and operations.
 Review and make recommendations regarding existing and proposed legislation and regulations relating to agency programs and operations.
 Keep the agency head and the Congress fully and currently informed of problems in agency programs and operations.

To ensure objectivity, the IG Act empowers the IG with:

 Independence to determine what reviews to perform.
 Access to all information necessary for the reviews.
 Authority to publish findings and recommendations based on the reviews.

Vision

We strive for continual improvement in SSA’s programs, operations and management by proactively seeking new ways to prevent and deter fraud, waste and abuse. We commit to integrity and excellence by supporting an environment that provides a valuable public service while encouraging employee development and retention and fostering diversity and innovation.

Background
OBJECTIVE

Our objective was to assess the impact of State budget issues on the Social Security Administration’s (SSA) disability programs.

BACKGROUND

SSA provides Disability Insurance (DI) and Supplemental Security Income (SSI) payments to eligible individuals under Titles II and XVI of the Social Security Act. To receive benefits under either program, an individual must file an application with SSA. Once an application is filed, an SSA field office determines whether the individual meets the non-disability criteria for benefits. If so, the field office generally forwards the claim to the disability determination services (DDS) in the State or other office with jurisdiction for a disability determination. DDSs are in each of the 50 States plus the District of Columbia and Puerto Rico.

SSA reimburses the DDS for 100 percent of allowable expenditures up to its approved funding authorization. The expenditures include both costs directly related to claims processing (such as disability adjudicators’ salaries) and indirect costs. (See Appendix B for additional information about DDS funding.)

Federal regulations state, “Subject to appropriate Federal funding, the State will, to the best of its ability, facilitate the processing of disability claims by avoiding personnel freezes, restrictions against overtime work, or curtailment of facilities or activities.”

However, to address budget deficits, some States have instituted, or are considering, furloughs for State employees—including staff at the DDSs, which are fully funded by SSA. Additionally, some States have implemented other measures, such as changes in hiring procedures, that may affect disability claims processing in the DDSs.

Some States have taken other measures to balance budgets that may impact individuals already receiving DI and/or SSI. For example, some States reduced the amount of the SSI State Supplemental Payments to recipients and restricted the availability of free or low-cost health care.

To perform this review, we gathered and reviewed data related to workloads in Fiscal Years (FY) 2009 and 2010; contacted SSA officials and staff to obtain information on the Agency’s disability programs and the effects of State budget cuts; calculated the monetary impact of States that were furloughing all DDS employees and savings in States that were not furloughing DDS employees as a result of SSA’s efforts; and researched the impact of State budgetary issues on DI beneficiaries and SSI recipients. (See Appendix C for additional information about our scope and methodology.)

The results presented in this report are a snapshot of what was happening with State budgets between August and November 2009 and the impact on SSA’s disability programs and current beneficiaries. If the current nationwide economic crisis continues, more States may impose furloughs and/or hiring freezes and continue to make cuts in services until their State economies improve.

Results of Review
State budget issues have affected SSA’s disability programs. At the same time that SSA has experienced a surge in new disability claims, State furloughs have affected the Agency’s ability to process claims—even though it has taken measures to address these issues. Additionally, State budget cuts have affected disability beneficiaries and recipients.

In the States furloughing all DDS employees, the DDSs will encounter a shortfall of capacity up to 14 percent because of furlough days. As a result of furloughs, we expect approximately 69,000 disability cases to be delayed in processing over the next 12 months. This wait will result in about $126.2 million in benefit payments being delayed to newly disabled claimants and from flowing into the economies of these States.

INCREASED INITIAL DISABILITY CLAIMS APPLICATIONS

In late FY 2008, SSA began experiencing a significant increase in initial disability claim applications due to the deteriorating economy. The rate of increased applications continued to grow through FY 2009—totaling about 15 percent above the previous year. Although the Agency has been able to process almost 8 percent more initial claims than last year, this growth in new claims has outpaced the DDS’ ability to keep up with the new workload. By the end of FY 2009, the number of initial cases pending in the DDSs had grown to almost 770,000—about 38 percent higher than at the end of FY 2008.

The American Recovery and Reinvestment Act of 2009 (ARRA) provided SSA with $500 million to help address the increasing disability and retirement workloads caused by the combination of the economic downturn and the leading edge of the baby boomer retirement wave.

ARRA funding enabled the Agency to put new front-line hires in place to address the growing critical workloads. By the end of FY 2009, the States—working with SSA—used ARRA funding to hire 300 new employees in the DDSs.

In addition to using ARRA funding for new hires, SSA included in its FY 2010 budget proposal strategies for dealing with the increasing initial disability claims workloads, such as:

• Increasing capacity in the State DDSs and Federal Disability Processing Units. The Agency hired additional staff in most DDSs and Federal units. Additionally, SSA established Extended Service Teams in the Arkansas, Mississippi, Oklahoma, and Virginia DDSs. These specialized units, although housed in these four States, have been dedicated to assisting other States in processing disability claims.
• Expanding the use of automated screening tools to identify and help triage likely allowances.

The Agency has also developed a number of initiatives to expedite its disability claims process, including the following.

• Plan to Eliminate the Hearing Backlog and Prevent Its Recurrence
• Quick Disability Determinations
• Compassionate Allowances
• Terminal Illness Cases
• Military Service Casualty Cases
• Presumptive Disability and Blindness Cases
• Health Information Technology

See Appendix D for more information on these initiatives.

FURLOUGHS

In FY 2009, SSA spent about $2 billion funding DDS operations for more than 14,000 DDS employees who processed almost 3.9 million disability claims nationwide. (See Table E-4 in Appendix E for a breakout by DDS.) Further, the Agency plans to spend more than $2 billion in FY 2010 on DDS operations and expects the DDSs to process almost 4 million claims. However, State furloughs have had an effect on SSA’s ability to process disability claims.

As shown in Table 1, nine States implemented or were considering furloughs for all DDS employees, and three States implemented furloughs for some DDS employees. (See Appendix F for details on the furlough status for all 52 DDSs.)

Table 1: DDS Furloughs Implemented or Being Considered as of November 2009
DDS Number of Furlough Days per FY Notes
California 36 Applies to all employees through June 2010.
Connecticut 3 Applies to all employees for FY 2010.
Hawaii 18 to 24 Applies to all employees in FYs 2010 and 2011.
Maine 10 Applies to FYs 2010 and 2011. Some staff exempted.
Massachusetts 3 to 9 Applies to managers for FY 2010, with number of days depending on salary. Other staff exempt from furlough.
Nevada 12 Applies to FYs 2010 and 2011. Adjudicative staff—examiners, medical consultants, unit supervisors, and call center staff—exempt from the furlough.
New Jersey 10 Applies to all employees through June 2010.
Ohio 10 Applies to all employees for FYs 2010 and 2011.
Oregon 6 to 7 Applies to all employees in FYs 2010 and 2011. Includes DDS shutdown days and furlough days based on salary.
Rhode Island 12 Applies to all employees through June 2010.
Virginia 1 Applies to all employees on May 28, 2010.
Wisconsin 8 Applies to all employees for FYs 2010 and 2011.

Dollar Impact on the Economy

In FY 2008:
• SSA issued over $142 billion in DI and SSI payments to more than 14 million individuals. Most of these beneficiaries were found disabled by the DDSs.
• DDSs handled over 3.6 million claims. The DDSs allowed 36 percent of claims at the initial level and 13.8 percent of claims at the reconsideration level of appeal.
• DDSs processed initial DI and SSI claims in 81 days, on average.

In FY 2009:
• DDSs received almost 15 percent more initial claims than in FY 2008.
• DDSs processed almost 3.9 million claims—including almost 2.8 million initial disability claims. The DDSs allowed 36.9 percent of claims at the initial level and 13.8 percent of claims at the reconsideration level of appeal.
• DDSs processed initial DI claims in 80 days, on average, and SSI claims in 83 days, on average.

(See Tables E-3 and E-4 in Appendix E for statistics and costs by DDS for FYs 2008 and 2009.)

Furloughs will impact the number of disability determinations some DDSs will make in FY 2010, including the number of claims allowed. In the nine States furloughing or considering furloughing all DDS employees in FY 2010, the DDSs will encounter a shortfall of capacity up to 14 percent due to furlough days. As a result, we expect approximately 69,000 disability cases to be delayed in processing over the next 12 months. This wait will result in about $126.2 million in benefits that will not be paid to disabled beneficiaries during this period that would have been paid had the furloughs not occurred. Additionally, these States will lose over $39 million in administrative funding from SSA because these employees will be furloughed.

Furloughs will also impact the Agency’s initiatives to expedite its disability claims process and the number of continuing disability reviews conducted.

OTHER STATE BUDGET ISSUES AFFECTING DISABILITY CLAIMS PROCESSING

In addition to furloughs, other issues, such as attrition rates and State budgets, will impact the DDS’ ability to process workloads. As of October 2009, most DDSs were not subject to hiring freezes, because either the States did not have hiring freezes or the DDSs were exempt.

Attrition Rate

The national attrition rate for DDS disability examiners was 12.5 percent in FY 2008 and 12.2 percent in FY 2009. (See Table E-6 in Appendix E for attrition rates by DDS.) The attrition rate has remained steady at the national level and has declined in over 30 DDSs. However, some DDSs have experienced a significant rise in the attrition rate—partly due to State budget and pay issues. In Connecticut, for example, the examiner attrition rate rose from 4.9 percent in FY 2008 to 23.6 percent in FY 2009. Similarly, the examiner attrition rate in Kansas rose from 12 to 26.2 percent, and the rate in New Mexico rose from 3.5 to 22.3 percent. These issues may become more of an obstacle to SSA’s processing disability workloads if furloughs and other State budget issues continue.

Other State Budget Issues

In several States, salaries were frozen or pay reductions were imposed. Furthermore, in some States, DDS hiring approval was more difficult to obtain or hiring was on hold because of potential layoffs in other agencies.

For example, in Delaware, the State reduced employees’ pay by 2.5 percent in FY 2010, while increasing employees’ health insurance premium payments by 2 percent. (See Appendix G for additional details regarding State budget issues.)

SSA’s Efforts to Lessen the Impact of Furloughs

The Social Security Act and Federal regulations give the Agency limited control over how the States set up and administer their DDSs, even though they are fully federally funded. SSA is involved in the States’ ongoing program management only as necessary and in accordance with regulations.
However, SSA has been proactive in addressing the impact of furloughs. Since December 2008, the Commissioner has contacted all the State governors and some State legislators about the SSA/DDS, Federal/State relationship and the impact of furloughs. Additionally, in July 2009, the Vice President wrote the Chair of the National Governors Association urging States to exempt DDS employees from furloughs and hiring freezes.

Furthermore, in October 2009, SSA filed a Statement of Interest with a California Superior Court that furloughs of DDS employees were inconsistent with the State’s obligations and responsibilities under the Social Security Act. Specifically, regulations obligate California to provide adequate facilities and qualified personnel to carry out the disability determination function and, “. . . to the best of its ability, facilitate the processing of disability claims by avoiding personnel freezes, restrictions against overtime work, or curtailment of facilities or activities.”

Because of the Agency’s efforts, Colorado and Maryland have fully exempted the DDSs from furloughs and Illinois, Maine, Massachusetts, and Nevada have partially exempted the DDSs from furloughs. Because of the Agency’s efforts, we estimate approximately 13,000 disability cases will be processed that would have been delayed. These individuals will receive about $24.4 million in benefits that would otherwise be delayed. Additionally, these States will receive almost $6.7 million in administrative funding that SSA would not have paid if these DDS employees were furloughed (see Table C-3 in Appendix C).

Additionally, several States either fully exempted or exempted on a case-by-case basis, the DDSs from hiring restrictions, including Arizona, California, Colorado, Connecticut, Delaware, Idaho, Iowa, Maine, Nevada, New Hampshire, New Jersey, New York, Ohio, Oregon, Pennsylvania, Puerto Rico, South Dakota, Tennessee, Virginia, Washington, West Virginia, and Wyoming.

Finally, SSA has worked with the States to coordinate transfer of some cases between States and to the Federal Disability Processing Branches and Units. These Units recently hired 192 new staff (mostly adjudicators), and the Agency planned to rely on them to help process cases.

Even though SSA has had some success in lessening the impact of State furloughs, these actions—along with a significant increase in new disability claims—have affected the Agency’s ability to keep up with the initial claims workloads.

STATE BUDGET ISSUES AFFECTING CURRENT DISABILITY BENEFICIARIES AND RECIPIENTS

Because of budget shortfalls, some States have made budget cuts that have affected disability beneficiaries and SSI recipients. For example, some States reduced SSI State Supplemental Payments (SSP) and restricted eligibility for other programs, including health care coverage. (See Appendix H for a list of State Websites providing additional budget information.)

Reduced SSPs

The SSI program was designed as a nationwide, Federal cash assistance program administered by SSA to provide a minimum level of income to financially needy individuals who are aged, blind, or disabled. Recognizing that there were variations in living costs across the nation, many States built on the Federal program by supplementing the SSI payment. However, because of budget issues, some States have reduced, or are considering reducing, their SSP.

For example, in 2009, California reduced its SSP between 11 and 25 percent, depending on the recipient’s living arrangements. The State plans to reduce its SSP rates again in November 2009. As a result of decreases in the SSPs, an estimated 20,000 individuals lost their eligibility for Medicaid (known as Medi-Cal in California) in May 2009. An additional 12,000 lost their Medi-Cal eligibility in July 2009.

Other State Budget Cuts Affecting the Disabled or Elderly

According to the Center on Budget and Policy Priorities, at least 27 States have implemented cuts in public health programs—such as Medicaid or the Children’s Health Insurance Program—that will restrict low-income children’s or families’ eligibility for health insurance or reduce their access to health care services. Additionally, at least 24 States and the District of Columbia are cutting medical, rehabilitative, home care, or other services needed by low-income individuals who are elderly or have disabilities, or they are significantly increasing the costs of these services. The National Conference of State Legislatures also compiled a list of measures, both proposed and enacted, that States took or were considering about health care to close their budget gaps (see Appendix I).

Although SSA does not administer health care benefits, its field offices often receive questions about these issues from current beneficiaries. For example, Tennessee field offices received numerous calls and congressional inquires when the State changed its Medicaid program. Additionally, California field offices and teleservice centers have been adversely affected by numerous calls regarding SSP reductions and changes in Medi-Cal.

SSA’s Regional Commissioners and their staffs assisted us in gathering information about State budget cuts and the effect on disabled beneficiaries and recipients in their States (see Appendix J).

Matters for Consideration
State budget issues have affected SSA’s disability programs. At the same time that SSA has experienced a surge in new disability claims, State furloughs have affected the Agency’s ability to process disability claims—even though it took measures to address these issues. As a result of furloughs, we expect approximately 69,000 disability cases to be delayed in processing over the next 12 months. This wait will result in about $126.2 million in benefits that will not be paid to disabled beneficiaries during this period that would have been paid if the furloughs did not occur. Additionally, State budget cuts have affected disability beneficiaries and recipients.

The Social Security Act and Federal regulations give the Agency limited control over how the States set up and administer the DDSs, even though they are fully federally funded. However, SSA has been proactive in addressing the effect of furloughs, and some States have responded to the Agency’s efforts to exempt the DDSs from furloughs and hiring freezes.

Appendices
APPENDIX A – Acronyms
APPENDIX B – Disability Determination Services Funding
APPENDIX C – Scope and Methodology
APPENDIX D – The Social Security Administration’s Initiatives to Expedite the Disability Claims Process

APPENDIX E – Disability Statistics by Jurisdiction
APPENDIX F – Furlough and Hiring Freeze Status by Disability Determination
Services
APPENDIX G – Other State Budget Issues Affecting Disability Determination Services and Disability Claims Processing

APPENDIX H – Budget Website Information by State
APPENDIX I – Cuts to Programs for Public Health and the Elderly and Disabled
APPENDIX J – Other State Budget Issues Affecting Disability Beneficiaries and Recipients
APPENDIX K – OIG Contacts and Staff Acknowledgments

Appendix A
Acronyms
ARRA American Recovery and Reinvestment Act of 2009
C.F.R. Code of Federal Regulations
CHIP Children’s Health Insurance Program
DDS Disability Determination Services
DI Disability Insurance
FY Fiscal Year
MEGAHIT Medical Evidence Gathering and Analysis through Health Information Technology
OMB Office of Management and Budget
POMS Program Operations Manual System
Pub. L. No. Public Law Number
SSA Social Security Administration
SSI Supplemental Security Income
SSP State Supplement Payment
U. S. C. United States Code

Appendix B
Disability Determination Services Funding

The Social Security Administration (SSA) implements policies for the development of disability claims under the Disability Insurance (DI) and Supplemental Security Income (SSI) programs. The DI program provides benefits to wage earners and their families in the event of disability. The SSI program provides benefits to financially needy individuals who are aged, blind, or disabled. Additionally, States have the option of supplementing their residents' SSI payments and may choose to have the additional payments administered by SSA.

Disability determinations under both the DI and SSI programs are performed by disability determination services (DDS) in each State or other responsible jurisdiction in accordance with the Social Security Act and Federal regulations. In carrying out its obligation, each DDS is responsible for determining claimants’ disabilities and ensuring adequate evidence is available to support its determinations. To assist in making proper disability determinations, each DDS is authorized to purchase medical examinations, X rays and laboratory tests on a consultative basis to supplement evidence obtained from the claimants’ physicians or other treating sources.

SSA reimburses the DDS for 100 percent of allowable expenditures up to its approved funding authorization. The DDS withdraws Federal funds through the Department of the Treasury’s Automated Standard Application for Payment system to pay for program expenditures. Funds drawn down must comply with Federal regulations and intergovernmental agreements entered into by the Department of the Treasury and States under the Cash Management Improvement Act of 1990. An advance or reimbursement for costs under the program must comply with Office of Management and Budget (OMB) Circular A-87. At the end of each quarter of the Fiscal Year, each DDS submits a Form SSA-4513, State Agency Report of Obligations for SSA Disability Programs, to account for program disbursements and unliquidated obligations.

Appendix C
Scope and Methodology

To accomplish our objective, we:

 Reviewed applicable sections of the Social Security Act and the Social Security Administration’s (SSA) regulations, policies, and procedures.

 Researched prior reports issued by the Office of the Inspector General.

 Researched published reports and articles on how State budget cuts have affected programs that provide health care and other benefits to the disabled and elderly.

 Reviewed National Disability Determination Services (DDS) Performance Summary reports for Fiscal Years (FY) 2007 through 2009.

 Gathered and reviewed data related to the anticipated DDS workloads in FY 2010.

 Contacted SSA officials and staff to obtain information on SSA’s disability programs, the effect of State furloughs on claims processing, and the effect of State budget cuts on current disabled beneficiaries and recipients.

 Calculated the dollar impact of States that were furloughing all DDS employees and savings in States that were not furloughing DDS employees as a result of SSA’s efforts.

We performed our review between August and November 2009 in Boston, Massachusetts. We conducted our review in accordance with the President’s Council on Integrity and Efficiency’s Quality Standards for Inspections.

Methodology of Furlough Impact

SSA prepared estimates of the cost of a furlough per day in each DDS. Table C-1 shows SSA’s estimates.

Table C-1: Estimated Effects of a Furlough Day for FY 2009 by DDS
DDS Budgeted Number of Cases per Year Value of 1-Day Furlough
Number of Cases Administrative Funding Monthly Benefits Delayed
Alabama 82,534 330 $189,100 $77,100
Alaska 5,030 20 $17,300 $7,700
Arizona 70,687 283 $121,500 $73,500
Arkansas 65,695 263 $99,900 $72,900
California 368,982 1,476 $849,400 $420,800
Colorado 32,589 130 $76,700 $40,800
Connecticut 31,850 127 $76,500 $31,200
Delaware 9,458 38 $26,100 $12,100
District of Columbia 10,032 40 $33,300 $12,000
Florida 261,894 1,048 $435,900 $266,200
Georgia 130,357 521 $231,200 $106,100
Hawaii 10,324 41 $26,500 $15,400
Idaho 21,509 86 $32,400 $24,600
Illinois 143,435 574 $289,700 $154,900
Indiana 90,814 363 $165,900 $96,700
Iowa 32,371 129 $87,000 $33,400
Kansas 33,572 134 $63,800 $38,000
Kentucky 96,403 386 $167,800 $94,800
Louisiana 70,709 283 $151,900 $76,600
Maine 17,100 68 $33,200 $18,000
Maryland 60,501 242 $118,500 $69,400
Massachusetts 73,994 296 $167,900 $102,100
Michigan 123,153 493 $309,400 $140,400
Minnesota 51,084 204 $95,400 $60,300
Mississippi 75,844 303 $106,600 $59,400
Missouri 78,579 314 $138,300 $79,600
Montana 10,583 42 $22,200 $13,600
Nebraska 18,441 74 $37,400 $20,500
Nevada 25,584 102 $53,100 $32,000
New Hampshire 10,720 43 $23,400 $16,500
New Jersey 84,109 336 $212,000 $121,400
New Mexico 27,128 109 $51,500 $30,400
New York 202,046 808 $600,100 $278,100
North Carolina 131,861 527 $215,500 $117,300
North Dakota 5,632 23 $10,100 $7,100
Ohio 182,815 731 $345,100 $149,900
Oklahoma 57,784 231 $106,800 $67,500
Oregon 44,720 179 $101,100 $52,900
Pennsylvania 148,024 592 $380,100 $160,300
Puerto Rico 31,988 128 $67,200 $55,500
Rhode Island 13,888 56 $31,800 $15,000
South Carolina 71,518 286 $137,000 $69,900
South Dakota 7,868 31 $12,700 $8,900
Tennessee 110,085 440 $214,100 $88,600
Texas 298,075 1,192 $533,400 $384,100
Utah 18,149 73 $44,100 $24,900
Vermont 6,752 27 $16,900 $9,700
Virginia 75,015 300 $154,000 $88,500
Washington 70,192 281 $142,000 $84,100
West Virginia 42,944 172 $82,700 $34,200
Wisconsin 62,322 249 $124,000 $83,900
Wyoming 4,213 17 $10,700 $6,600
TOTAL 3,810,956 15,241 $7,840,200 $4,205,400

In States furloughing or considering furloughing all DDS employees in FY 2010, the DDSs will encounter a shortfall of capacity up to 14 percent due to furlough days. As a result, we expect approximately 69,000 disability cases to be delayed in processing over the next 12 months. This wait will result in about $126.2 million in benefits that will not be paid to disabled beneficiaries during this period that would have been paid if the furloughs did not occur. Table C-2 shows the States and the calculation of costs of the planned furloughs based on SSA’s estimates in Table C-1.

Table C-2: Costs of Planned Furlough by DDS
DDS Value of 1-Day Furlough Furlough Days per Year Costs of Planned Furloughs per Year
Number of Cases Administrative Funding Monthly Benefits Delayed Number of Cases Administrative Funding Delayed Benefits
California 1,476 $849,400 $420,800 36 53,136 $30,578,400 $98,467,200
Connecticut 127 $76,500 $31,200 3 381 $229,500 $608,400
Hawaii 41 $26,500 $15,400 18 738 $477,000 $1,801,800
New Jersey 336 $212,000 $121,400 10 3,360 $2,120,000 $7,891,000
Ohio 731 $345,100 $149,900 10 7,310 $3,451,000 $9,743,500
Oregon 179 $101,100 $52,900 6 1,074 $606,600 $2,063,100
Rhode Island 56 $31,800 $15,000 12 672 $381,600 $1,170,000
Virginia 300 $154,000 $88,500 1 300 $154,000 $88,500
Wisconsin 249 $124,000 $83,900 8 1,992 $992,000 $4,362,800
TOTAL 68,963 $38,990,100 $126,196,300

Because SSA worked with these States to exempt DDS employees from furloughs, we estimate approximately 13,000 disability cases will be processed that would have been delayed. These individuals will receive about $24.4 million in benefits that would otherwise be delayed. Additionally, these States will receive almost $6.7 million in administrative funding that SSA would not have paid if these DDS employees were furloughed. Table C-3 shows by DDS the savings in States that exempted DDS employees from furloughs. The number of cases and benefits processed per day were based on SSA’s estimates in Table C-1.

Table C-3: Savings from Furlough Exemptions by DDS
DDS Value of 1-Day Furlough Furlough Days Avoided Per Year Savings from Furlough Exemptions
per Year
Number of Cases Administrative Funding Monthly Benefits Processed Number of Cases Administrative Funding Benefits Not Delayed
Colorado 130 $76,700 $40,800 4 520 $306,800 $1,060,800
Illinois 574 $289,700 $154,900 12 6,888 $3,476,400 $12,082,200
Maine 68 $33,200 $18,000 10 680 $332,000 $1,170,000
Maryland 242 $118,500 $69,400 8 1,936 $948,000 $3,608,800
Massachusetts 296 $167,900 $102,100 6 1,776 $1,007,400 $3,981,900
Nevada 102 $53,100 $32,000 12 1,224 $637,200 $2,496,000
TOTAL 13,024 $6,707,800 $24,399,700

Appendix D
The Social Security Administration’s Initiatives to Expedite the Disability Claims Process

The Social Security Administration (SSA) has a number of initiatives to expedite the disability claims process, including a plan to eliminate the hearings backlog and prevent its recurrence, Quick Disability Determinations, compassionate allowances, military service casualty cases, presumptive disability and blindness cases, terminal illness cases, and health information technology.

Plan to Eliminate the Hearings Backlog and Prevent Its Recurrence

In May 2007, the Commissioner testified before Congress that SSA had developed a plan to eliminate the backlog of hearing requests by 2013 and prevent its recurrence. The plan focuses on (1) compassionate allowances, (2) improving performance, (3) increasing adjudicatory capacity, and (4) increasing efficiency with automation and business processes. To improve performance, SSA is reducing its aged cases and providing certain attorney advisors the authority to make fully favorable decisions on cases—thus reserving administrative law judges to conduct hearings on more complex cases.

Quick Disability Determinations

In February 2008, SSA implemented the Quick Disability Determination process, which uses a predictive model to electronically identify claims involving a high potential that the applicant is disabled, medical evidence can be quickly and easily obtained, and the claim can be processed within 20 Calendar Days of receipt in the disability determination services (DDS).

Compassionate Allowances

In October 2008, SSA implemented the Compassionate Allowance process, which quickly identifies claims electronically involving diseases and other medical conditions that invariably qualify under SSA’s Listings based on minimal, but sufficient, objective medical information. Like the Quick Disability Determination process, this initiative uses a predictive model, but it is simpler—selecting claims for processing based solely on the applicant’s allegation of having a disease or other medical condition listed in the Agency’s list of Compassionate Allowance conditions.

Terminal Illness Cases

SSA implemented procedures to ensure disability claims with an indication of terminal illness—either alleged by the claimant or a third party or indicated in medical records—are handled expeditiously because of their sensitivity. These cases may be identified by the teleservice center, field office, or DDS.

Military Service Casualty Cases

The Military Service Casualty initiative is an SSA commitment to provide expedited disability claim services to wounded service members and their families. SSA established procedures to expedite disability claims for any military service personnel injured October 1, 2001 or later, provided the injury occurred while on active duty. SSA and DDS staffs are instructed to process these cases under the terminal illness procedures.

Presumptive Disability and Blindness Cases

In the 1970s, SSA implemented the presumptive disability and presumptive blindness provisions. Under these provisions, an individual applying for Supplemental Security Income disability payments may receive up to 6 months of payments before the final determination if he or she is likely disabled and meets all other eligibility criteria.

Health Information Technology

In August 2008, SSA began piloting the Medical Evidence Gathering and Analysis through Health Information Technology (MEGAHIT) prototype with Beth Israel Deaconess Medical Center in Boston, Massachusetts. This computer process automatically requests and receives electronic health records in a standardized form to support SSA’s disability claim decision-making process. MEGAHIT then analyzes the data and alerts the disability examiner if the claim might be an allowance according to SSA’s Listing of Impairments. According to SSA, this process occurs within a matter of minutes, resulting in shorter-than-average claim processing times.

In February 2009, SSA began working with MedVirginia in a trial implementation of a system-to-system health information exchange through the Nationwide Health Information Network. This is a secure Network connecting consumers, medical providers, and others involved in supporting health care. SSA requests and receives electronic health records through the Nationwide Health Information Network. MEGAHIT then processes the electronic health record data. According to SSA, as of May 2009, disability cases processed using medical information through these systems has resulted in a higher rate of case allowance in less time compared to all disability cases. The Agency is continuing to evaluate this process.

Appendix E
Disability Statistics by Jurisdiction

Table E-1 shows the number of all Disability Insurance (DI) beneficiaries and their dependents as of December 2007 and the estimated total annual benefits paid to those individuals.

Table E-1: December 2007 DI Statistics by Jurisdiction
Jurisdiction Disabled
Beneficiaries Dependents Annual
Benefits Paid
(in millions)
Alabama 211,668 50,792 $2,542
Alaska 11,737 2,711 $147
Arizona 143,125 32,475 $1,872
Arkansas 130,110 31,368 $1,534
California 675,491 140,871 $8,430
Colorado 88,431 17,940 $1,107
Connecticut 81,921 17,870 $1,030
Delaware 25,412 5,515 $334
District of Columbia 12,328 1,706 $129
Florida 466,830 98,148 $5,848
Georgia 242,033 53,975 $2,923
Hawaii 22,881 4,810 $285
Idaho 36,685 8,773 $447
Illinois 281,168 61,593 $3,441
Indiana 178,959 41,307 $2,178
Iowa 73,818 15,079 $846
Kansas 65,692 14,080 $780
Kentucky 198,836 48,592 $2,392
Louisiana 145,689 38,292 $1,700
Maine 56,646 13,632 $652
Maryland 111,716 21,724 $1,402
Massachusetts 188,613 45,137 $2,307
Michigan 303,099 69,424 $3,852
Minnesota 113,489 23,931 $1,375
Mississippi 129,993 33,551 $1,503
Missouri 197,456 44,502 $2,374
Montana 25,601 5,107 $302
Nebraska 40,203 8,912 $462
Nevada 53,086 10,613 $718
New Hampshire 40,178 11,226 $530
New Jersey 188,202 41,653 $2,523
New Mexico 56,661 12,777 $674
New York 503,928 116,553 $6,389
North Carolina 305,284 63,319 $3,707
North Dakota 14,332 2,678 $156
Ohio 306,402 63,552 $3,555
Oklahoma 117,499 25,340 $1,396
Oregon 92,712 16,449 $1,143
Pennsylvania 375,865 85,898 $4,590
Rhode Island 34,831 7,515 $417
South Carolina 159,995 33,738 $1,956
South Dakota 18,186 3,557 $200
Tennessee 226,309 49,070 $2,668
Texas 500,548 120,629 $6,034
Utah 39,327 10,350 $483
Vermont 20,183 4,613 $232
Virginia 203,412 46,039 $2,537
Washington 152,960 29,269 $1,915
West Virginia 101,006 23,912 $1,271
Wisconsin 141,085 30,001 $1,686
Wyoming 11,507 2,299 $142
American Samoa 1,269 763 $13
Guam 1,493 617 $16
Northern Mariana Islands 249 79 $2
Puerto Rico 171,528 48,729 $1,752
U.S. Virgin Islands 2,057 579 $24
Foreign countries 18,658 3,857 $162
Total 8,118,382 1,817,491 $99,086

Table E-2 shows the number of disabled Supplemental Security Income (SSI) recipients and the amount they received in December 2008.

Table E-2: December 2008 SSI Disability Statistics
by Area
Jurisdiction
Disabled Recipients
Payments Issued in December 2007 (in thousands)
Alabama 152,376 $76,510
Alaska 9,639 $4,771
Arizona 89,444 $45,693
Arkansas 91,048 $45,461
California 899,395 $589,470
Colorado 51,148 $25,591
Connecticut 48,788 $25,040
Delaware 13,556 $6,685
District of Columbia 20,794 $11,450
Florida 342,340 $174,583
Georgia 187,489 $97,277
Hawaii 17,469 $9,745
Idaho 22,871 $11,214
Illinois 235,074 $123,696
Indiana 102,531 $54,085
Iowa 42,028 $20,097
Kansas 38,752 $20,400
Kentucky 174,372 $87,003
Louisiana 150,256 $75,721
Maine 31,749 $15,466
Maryland 85,812 $46,357
Massachusetts 136,448 $75,618
Michigan 216,203 $118,178
Minnesota 70,294 $36,152
Mississippi 110,090 $54,371
Missouri 115,898 $58,690
Montana 14,978 $7,273
Nebraska 21,710 $10,550
Nevada 27,622 $14,849
New Hampshire 15,002 $7,347
New Jersey 125,580 $65,933
New Mexico 49,280 $24,484
New York 523,026 $299,886
North Carolina 186,099 $91,822
North Dakota 7,167 $3,344
Ohio 250,281 $135,110
Oklahoma 81,031 $41,177
Oregon 58,293 $29,903
Pennsylvania 313,020 $167,377
Rhode Island 27,750 $15,059
South Carolina 96,745 $48,322
South Dakota 11,540 $5,405
Tennessee 150,669 $76,759
Texas 459,220 $225,988
Utah 23,045 $11,697
Vermont 13,314 $6,595
Virginia 122,379 $58,821
Washington 109,622 $59,602
West Virginia 76,226 $38,806
Wisconsin 91,411 $46,051
Wyoming 5,550 $2,602
Northern Mariana Islands 723 $412
Unknown 98 $51
Total 6,317,245 $3,404,553

Table E-3 shows workload statistics at disability determination services (DDS) in Fiscal Year (FY) 2008, including the number of claims received and processed, costs, number of employees, and average processing times for DI and SSI claims.

Table E-3: FY 2008 DDS Workload Statistics
DDS Initial
Receipts Initial Claims Processed Total Claims Processed DDS Costs Employees Processing Time (days)
DI SSI
Alabama 65,181 62,546 75,641 $41,596,075 342 64 63
Alaska 4,234 4,129 4,831 $3,858,083 20 78 78
Arizona 35,160 35,247 62,330 $29,136,899 223 94 93
Arkansas 41,965 43,285 64,658 $22,902,043 235 63 62
California 256,273 261,511 357,556 $198,593,617 1,310 86 88
Colorado 27,688 27,799 32,609 $18,580,491 133 77 77
Connecticut 23,771 23,536 28,633 $17,616,286 105 72 81
Delaware 6,925 6,242 9,183 $5,988,105 44 97 97
District of Columbia 5,919 5,509 8,531 $5,987,299 34 78 77
Florida 163,876 162,414 230,003 $100,169,044 832 80 83
Georgia 86,973 85,149 128,131 $52,448,208 441 88 88
Hawaii 7,001 6,782 9,007 $5,692,256 40 84 92
Idaho 12,002 11,372 16,615 $6,896,280 52 62 62
Illinois 96,734 100,541 144,975 $68,138,817 482 74 76
Indiana 59,267 58,842 87,124 $38,199,876 271 80 84
Iowa 20,269 20,352 29,552 $18,670,523 122 80 83
Kansas 20,756 20,679 31,613 $14,674,611 116 73 71
Kentucky 58,999 58,899 94,093 $39,280,761 385 83 84
Louisiana 54,071 54,510 65,180 $31,999,862 286 67 67
Maine 12,335 12,062 15,172 $7,528,838 61 64 68
Maryland 44,526 42,832 58,763 $27,957,577 225 78 82
Massachusetts 51,718 51,021 63,449 $40,453,622 254 71 76
Michigan 103,058 104,178 123,252 $72,179,008 514 83 85
Minnesota 33,463 34,556 50,220 $22,329,232 156 75 77
Mississippi 49,144 48,289 76,320 $25,907,947 260 72 69
Missouri 60,723 61,737 73,447 $29,070,791 274 61 60
Montana 6,638 6,674 9,945 $4,918,848 43 78 81
Nebraska 11,414 11,549 17,334 $9,222,641 78 65 64
Nevada 17,400 18,046 24,140 $11,625,528 98 94 98
New Hampshire 9,218 9,319 10,269 $5,274,467 45 91 101
New Jersey 53,811 54,346 79,019 $50,830,026 288 113 113
New Mexico 18,081 18,134 26,783 $12,059,628 86 78 78
New York 145,252 150,299 187,645 $143,994,254 821 78 81
North Carolina 90,013 82,808 125,476 $48,387,556 437 93 94
North Dakota 3,388 3,493 5,563 $2,502,789 25 67 72
Ohio 121,106 123,373 176,252 $75,610,439 570 90 92
Oklahoma 35,872 37,176 54,185 $23,187,209 207 85 85
Oregon 25,680 26,183 39,328 $23,077,980 163 83 87
Pennsylvania 122,054 121,703 142,130 $88,139,201 569 94 94
Puerto Rico 17,111 16,960 27,735 $14,612,254 149 130 ***
Rhode Island 9,477 9,942 12,387 $7,014,615 40 122 131
South Carolina 47,953 46,048 68,481 $31,425,550 273 85 86
South Dakota 5,033 5,204 7,477 $3,126,011 28 88 97
Tennessee 66,094 64,972 104,972 $47,283,932 419 92 94
Texas 194,905 198,414 284,578 $122,628,215 974 61 60
Utah 11,193 11,162 16,429 $9,611,617 68 87 90
Vermont 4,879 4,931 5,982 $3,554,829 31 90 92
Virginia 55,904 54,541 76,973 $36,908,443 320 77 78
Washington 45,405 45,574 66,300 $33,329,700 235 74 75
West Virginia 26,434 26,029 40,835 $18,106,038 168 77 77
Wisconsin 43,612 40,903 59,799 $28,344,924 213 78 84
Wyoming 2,905 2,981 3,889 $2,650,167 16 84 88
Total 2,592,863 2,594,783 3,614,794 $1,803,283,012 13,604 81 81
*** SSI is limited to residents of the 50 States, the District of Columbia, or the Northern Mariana Islands.

Table E-4 shows workload statistics at disability determination services (DDS) in Fiscal Year (FY) 2009, including the number of claims received and processed, costs, number of employees, and average processing times for DI and SSI claims.

Table E-4: FY 2009 DDS Workload Statistics
DDS Initial Claim Receipts Initial Claims Processed Total Claims Processed DDS Costs Employees Processing Time (days)
DI SSI
Alabama 74,197 72,384 91,103 $47,728,207 359 66 65
Alaska 4,585 4,374 5,286 $4,252,785 20 95 94
Arizona 46,546 43,508 71,921 $30,943,723 234 82 83
Arkansas 47,353 44,624 68,175 $26,731,329 260 59 62
California 286,652 273,068 368,971 $204,512,909 1,322 77 81
Colorado 33,242 27,662 33,185 $20,093,503 135 92 93
Connecticut 26,347 24,695 36,007 $19,816,676 108 87 98
Delaware 6,179 6,138 9,453 $6,172,083 41 106 105
District of Columbia 8,736 8,323 12,126 $8,789,635 42 71 76
Florida 197,960 190,282 276,494 $113,036,858 907 73 78
Georgia 104,251 89,377 123,164 $56,801,976 480 96 99
Hawaii 8,421 8,090 10,430 $6,657,130 43 82 89
Idaho 15,617 15,021 21,698 $8,149,427 61 65 64
Illinois 105,672 96,050 140,396 $72,866,505 473 73 76
Indiana 68,603 63,552 92,707 $41,540,573 278 77 81
Iowa 23,431 22,956 34,076 $21,018,168 129 74 80
Kansas 24,018 21,923 33,373 $15,634,129 115 77 76
Kentucky 66,140 62,290 97,035 $43,950,143 406 86 86
Louisiana 64,036 60,790 72,848 $37,754,681 298 64 64
Maine 14,448 13,705 19,774 $8,238,519 63 81 83
Maryland 50,751 43,938 63,116 $30,288,852 231 85 90
Massachusetts 58,385 52,496 74,062 $43,767,920 273 86 93
Michigan 115,664 107,181 126,332 $77,738,934 536 97 101
Minnesota 37,917 35,579 52,069 $24,312,107 163 71 75
Mississippi 52,463 50,331 82,814 $27,051,302 270 75 71
Missouri 71,564 65,796 80,302 $34,211,666 294 61 62
Montana 8,186 7,606 11,011 $5,629,003 47 79 81
Nebraska 13,030 12,097 17,974 $9,983,203 80 68 67
Nevada 21,816 18,874 26,712 $13,168,413 105 86 96
New Hampshire 10,951 9,919 11,384 $5,539,012 46 87 94
New Jersey 57,213 55,297 77,724 $52,956,224 285 98 103
New Mexico 21,457 19,367 26,829 $13,367,889 83 79 81
New York 162,391 156,742 206,019 $150,877,764 822 70 75
North Carolina 99,531 100,416 147,413 54,905,568 471 103 105
North Dakota 3,756 3,361 5,058 $2,584,438 24 71 83
Ohio 135,587 120,609 183,918 $83,696,332 613 89 91
Oklahoma 42,946 39,163 58,590 $26,912,670 226 74 79
Oregon 32,746 29,438 45,635 $25,986,744 176 76 78
Pennsylvania 134,190 123,351 148,065 $94,697,966 598 93 95
Puerto Rico 20,632 20,109 27,399 $20,156,057 147 121 ***
Rhode Island 11,417 10,008 14,506 $8,522,733 43 120 134
South Carolina 56,146 51,272 71,055 $34,790,045 298 92 93
South Dakota 5,739 5,318 7,377 $3,542,739 30 84 97
Tennessee 83,016 72,421 114,249 $55,418,891 457 91 94
Texas 227,117 209,817 302,393 $132,003,347 998 59 61
Utah 13,802 11,765 17,481 $11,036,794 71 92 97
Vermont 5,685 5,256 7,428 $4,259,396 33 89 87
Virginia 63,518 55,783 78,301 $38,498,241 338 84 89
Washington 51,130 48,951 74,631 $37,095,271 255 67 71
West Virginia 28,135 26,401 44,833 $20,113,163 176 79 81
Wisconsin 48,651 45,951 67,627 $30,667,950 220 108 116
Wyoming 3,463 3,186 4,079 $2,684,903 16 72 74
Total 2,975,429 2,766,611 3,894,608 $1,971,154,496 14,199 80 83
*** SSI is limited to residents of the 50 States, the District of Columbia, or the Northern Mariana Islands.

Table E-5 shows workload statistics at the Federal Disability Processing Branches and Flexible Disability Units in FY 2009 through September 25, 2009.

Table E-5: FY 2009 Disability Processing Branches and Flexible Disability Units Workload Statistics (Through September 25, 2009)
Unit Initial Receipts Initial Dispositions Total Dispositions Pending Claims
Mid-America Program Service Center Flexible Disability Unit 359 36 1,000 370
International Program Service Center 1,369 1,178 1,451 1,356
Federal DDS 9,790 7,518 7,539 3,017
Great Lakes 181 163 3,207 785
Western Program Service Center 2,295 1,995 4,531 1,967
Guam 868 775 948 359
Virgin Islands 330 325 361 100
Office of Central Operations 7,545 8,718 8,718 2,091
South Eastern Payment Service Center 6,354 6,120 6,122 1,221
Mid-Atlantic Payment Service Center 3,205 3,073 3,332 842
Northeastern Payment Service Center 3,712 3,425 3,425 1,064
TOTAL 36,008 33,326 40,634 13,172

Table E-6 shows the attrition rates at DDSs in FY 2008 and FY 2009.

Table E-6: DDS Attrition Rates FYs 2008-2009
DDS FY 2008 FY 2009
Examiner All Staff Examiner All Staff
Alabama 7.6 6.5 13.5 8.9
Alaska 46.5 27.5 36.0 40.0
Arizona 21.4 14.1 15.9 11.4
Arkansas 11.9 4.9 13.5 10.0
California 8.4 9.4 6.4 7.7
Colorado 14.1 9.7 11.5 10.6
Connecticut 4.9 3.9 23.6 19.1
Delaware 24.7 21.5 23.5 33.8
District of Columbia 4.2 12.1 2.9 6.8
Florida 19.7 15.3 17.4 9.5
Georgia 19.9 13.7 11.8 6.6
Hawaii 9.1 4.5 14.6 7.3
Idaho 11.8 9.9 16.5 8.6
Illinois 13.7 12.4 10.1 8.2
Indiana 15.3 9.2 13.7 8.3
Iowa 0.8 3.5 0.0 1.4
Kansas 12.0 8.0 26.2 21.4
Kentucky 14.9 14.3 15.3 8.1
Louisiana 34.0 19.9 27.7 12.8
Maine 40.4 18.9 1.4 4.9
Maryland 16.7 15.9 14.1 8.7
Massachusetts 3.6 3.4 4.8 8.3
Michigan 7.0 7.1 7.7 5.2
Minnesota 11.7 9.5 3.1 5.4
Mississippi 13.9 10.9 9.0 5.7
Missouri 11.4 5.8 17.5 8.2
Montana 2.7 9.3 11.7 13.7
Nebraska 15.2 9.8 4.1 2.2
Nevada 16.7 10.5 13.1 16.4
New Hampshire 0 1.3 0.0 0.0
New Jersey 12.6 11.9 7.0 6.4
New Mexico 3.5 6.0 22.3 10.7
New York 8.5 8.3 7.9 6.8
North Carolina 13.3 14.5 23.3 16.3
North Dakota 0.0 2.3 27.2 33.8
Ohio 9.8 10.2 12.7 12.6
Oklahoma 12.2 8.0 7.0 4.7
Oregon 31.4 17.6 22.7 11.9
Pennsylvania 9.4 6.9 19.3 12.7
Puerto Rico 5.9 4.0 6.9 7.2
Rhode Island 2.7 19.7 2.4 8.9
South Carolina 12.5 10.1 7.2 6.8
South Dakota 27.9 25.7 8.4 9.4
Tennessee 15.4 10.8 12.4 9.2
Texas 10.3 8.5 11.2 8.0
Utah 1.5 9.5 13.3 12.5
Vermont 10.5 13.8 16.7 9.3
Virginia 17.4 11.2 16.1 13.5
Washington 8.8 14.9 7.4 8.2
West Virginia 9.7 11.3 8.0 7.0
Wisconsin 8.9 10.2 9.2 10.5
Wyoming 22.7 23.3 0.0 3.3
National 12.5 10.5 12.2 9.2

Appendix F
Furlough and Hiring Freeze Status by Disability Determination Services

Table F-1 shows each disability determination services’ (DDS) furlough and hiring freeze status as of October 2009.

Table F-1: Status of Furlough and Hiring Freeze by DDS
DDS Furlough Status Hiring Freeze Status Remarks
Alabama No furlough. No hiring freeze.
Alaska No furlough. No hiring freeze.
Arizona No furlough. Hiring freeze but DDS exempt.
Arkansas No furlough. No hiring freeze.
California Furlough in place. Hiring freeze but DDS exempt. California State employees, including DDS employees, are subject to 3 furlough days per month through June 30, 2010. They are exempt from fixed furlough days. They will continue to accrue 3 flex furlough days per month, and the DDS will be open on the fixed furlough days. All State employees covered by the original and amended furlough plans must use their accrued furlough days before using vacation, annual leave, personal holiday, holiday credit, personal leave plan credit, or compensatory time off.
The State has changed overtime rules to eliminate the opportunity to earn overtime pay in weeks in which a furlough, sick, or annual leave day is taken. These 3 furlough days translate to an approximate 13.8 percent reduction in monthly pay.
A fourth furlough day per month is possible.
Colorado Furlough in place but DDS exempt. Hiring freeze but DDS exempt. Information technology staff, employed by the State yet support the DDS, are not exempt from the furlough.
Connecticut Furlough in place. Hiring freeze but DDS exempt. The Administrator took 1 voluntary furlough day. The Governor reached an agreement with the union on several concessions to avoid layoffs. The DDS will be shut down 7 days; 1 in FY 2009 and 3 each in FYs 2010 and 2011. In addition to the mandatory furlough days, State employees are being encouraged to voluntarily reduce their tours of duty, but no one has done so.
Delaware No furlough. Hiring freeze but DDS exempt.
District of Columbia No furlough. No hiring freeze.
Florida No furlough. No hiring freeze.
Georgia No furlough. No hiring freeze.
Hawaii Furlough expected to take effect soon—DDS not expected to be exempt. Hiring freeze for DDS. In October 2009, the Governor and the Hawaii Government Employees Association agreed on a plan to furlough all State employees 18 days in FY 2010 and 24 days in FY 2011.
Idaho No furlough. Hiring freeze but DDS exempt.
Illinois Furlough in place but DDS partially exempt. No hiring freeze. The DDS’ bargaining employees are not subject to furloughs. The DDS’ non-bargaining employees are the only exemption to the Department of Human Services’ furloughs.
The Governor's office reviews all approvals for initial postings of positions in addition to a second review for final approval to hire. In the past, this has resulted in significant delays in hiring at the DDS.
Indiana No furlough. No hiring freeze. The State has not implemented a hiring freeze; however, each vacancy is considered individually. The State added an additional layer of review to fill vacancies, resulting in a protracted hiring process.
Iowa No furlough. Hiring freeze but DDS exempt.
Kansas No furlough. No hiring freeze. The DDS has been allowed to hire, but it has not been allowed to promote into a couple of key positions.
Kentucky No furlough. No hiring freeze.
Louisiana No furlough. Hiring freeze but DDS exempt.
Maine Furlough in place but DDS partially exempt. Hiring freeze but DDS exempt. The State imposed 10 furlough days in both FYs 2010 and 2011 (total of 20). In the DDS, 40 staff are exempted from the furlough; however, 24 staff are not exempt.
The DDS is exempt from a State-wide hiring freeze, but each vacancy must be individually exempted which delays replacement and backfill hiring.
Maryland Furlough in place but DDS exempt. No hiring freeze. The State is treating DDS employees as essential personnel (similar to police and firefighters), so the DDS will not close on the 5 service reduction days when all other State offices will close in FY 2010.
Massachusetts Furlough in place but DDS partially exempt. No hiring freeze. The State imposed 3 to 9 furlough days for DDS managers, effective November 27, 2009 through June 30, 2010. The furlough obligation is tiered based on salary as follows:
$50,000 to $69,999 subject to 3 furlough days,
$70,000 to $89,999 subject to 6 furlough days, and
$90,000 and up subject to 9 furlough days.
Michigan No furlough. No hiring freeze. A Continuing Resolution has been signed through October 2009. There is no indication whether furloughs or freezes will be included in the FY 2010 budget.
The State has imposed agency hiring limits; however, the DDS has been successful in being exempt from hiring limits based on their 100 percent Federal funding.
Minnesota No furlough. No hiring freeze. With additional documentation provided to demonstrate the critical need to fill positions, all DDS personnel requests in Minnesota have been approved.
Mississippi No furlough. No hiring freeze.
Missouri No furlough. No hiring freeze. The State is experiencing greater budget shortfalls than projected and is considering more layoffs in State agencies. The DDS has been exempted in the past, and there is no indication there is a change in philosophy.
Montana No furlough. No hiring freeze.
Nebraska No furlough. No hiring freeze.
Nevada Furlough in place but DDS partially exempt. Hiring freeze but DDS exempt. The Nevada Board of Examiners (which includes the Governor) met, and based on health, safety, and direct client service, exempted 94 adjudicative staff (Examiners, Medical Consultants, Unit Supervisors, and Call Center staff) from the furlough. Of the non-adjudicative staff, 9 are not exempt, including the Bureau Chief, Operations Manager, Professional Relations Officer, and other administrative clerical staff. Furloughed staff are required to take one floating furlough day per month.
Adjudicative staff will continue to work overtime. Furloughed staff are prohibited from working overtime within the pay period they are furloughed, but are being encouraged to take advantage of overtime in the non-furlough weeks to minimize the financial loss and maintain productivity.
Due to a change (cuts) in retirement benefits effective July 1, 2009, the State is providing disincentives for possible retirees to stay on beyond June 30, 2009. The DDS will have to consider hiring from the layoff list for positions such as their Information Technology supervisor. However, if there is no interest or the candidate does not work out, they may post for an outside hire.
New Hampshire No furlough. Hiring freeze but DDS exempt. The DDS will need to give consideration to State employees laid off from other departments when filling positions.
New Jersey Furlough in place. Hiring freeze for DDS. Although the State had initially agreed to exempt DDS employees from State-wide furloughs, a new Memorandum of Agreement between the State and labor union removes that exemption. Under the agreement, the DDS is subject to 10 furlough days between July 2009 and June 2010. The furlough days consist of 8 self-directed unpaid leave days, the day after Thanksgiving in 2009, and President’s Day in 2010. Furthermore, the State has designated the day after Thanksgiving in 2010 as a paid holiday. The agreement also calls for a deferment of the
July 2009 3.5 percent pay raise until
January 2011, leaving in place the scheduled July 2010 raise. In recognition of the agreement to defer the pay raise and to institute furloughs, the State agreed not to layoff any workers through December 2010. It also agreed to establish a Paid Leave Bank that will credit every employee with
7 days of paid leave to be accrued through June 30, 2010 that may be carried over indefinitely.
New Mexico No furlough. No hiring freeze.
New York No furlough. Hiring freeze but DDS exempt. The DDS has potential layoffs, work schedule reductions, and retirement bonuses. Requests for exemption from both the hiring freeze and layoffs are pending in the Office of the Governor. However, the DDS was granted permission to hire 200 employees. Expansion of the State’s work schedule reduction program, introduction of retirement bonuses, and a new cost-saving tier to the State retirement pension system were announced on June 5, 2009 but have not been implemented. These negotiated agreements between the Governor and the labor unions require legislative approval which is being delayed by recent upheaval in the New York State Senate. The State Legislature will pick up these issues when it reconvenes.
North Carolina No furlough. No hiring freeze. All State employees had forced reduction in pay equal to ½ of 1 percent for FY 2009 with the total of the pay reduction to be taken out of employee payroll checks in May and June 2009. Also, employees will be required to take 10 hours of paid leave between June and December 2009. The 10 hours of paid leave will allow the employees to recoup the ½ of 1 percent lost in May and
June 2009.
The DDS hiring process is more cumbersome due to the need to obtain "freeze releases" to fill positions not deemed "critical." The DDS has, however, received approval to designate DDS specialists/examiners, as well as Medical and Psychological Consultants, as "critical." Therefore, the DDS has been able to recruit and hire for these positions. Also, the DDS has been able to obtain an exception to fill positions not on the "critical" list.
North Dakota No furlough. No hiring freeze.
Ohio Furlough in place. Hiring freeze but DDS exempt. A budget has been signed for FYs 2010-2011. The State announced furloughs or Cost-Savings Days effective July 2009. There will be Cost-Savings Days in each of the next 2 FYs, for a total of 20 days. All employees are subject to the
Cost-Savings Days. The State is moving forward with the cost savings provisions. Each pay period includes a pay reduction of 3.076 percent, which equates to the 10 self-directed cost savings days per FY. Additionally, there is a provision that no overtime can be worked in a week a Cost-Savings Days is taken by the employee.
The DDS is under a hiring freeze but received approvals to hire. Pay will be reduced by 3.076 hours each pay period throughout the year beginning July 2009.
Oklahoma No furlough. No hiring freeze.
Oregon Furlough in place. Hiring freeze but DDS exempt. For FYs 2010 and 2011, the number of furlough days depends on salary range. A pay freeze took effect on September 1, 2009. The entire DDS is subject to a 10-day State office shutdown schedule and an additional 2 to 4 more furlough days dependent upon salary. The scheduled shutdown days begin in October 2009 and end May 2011.
Pennsylvania No furlough. Hiring freeze but DDS exempt. The DDS is subject to a case-by-case authorization requirement for hiring.
Puerto Rico No furlough. Hiring freeze but DDS exempt.
Rhode Island Furlough in place. Hiring freeze for DDS. The Governor signed an Executive Order that includes 12 furlough days, beginning September 4, 2009. Each of the remaining days will be around holidays. Meetings between the Governor and union are ongoing, which may result in possibly averting furlough days.
South Carolina No furlough. No hiring freeze.
South Dakota No furlough. Hiring freeze for DDS. The DDS hiring is considered on a case-by-case situation.
Tennessee No furlough. Hiring freeze but DDS exempt.
Texas No furlough. No hiring freeze.
Utah No furlough. No hiring freeze.
Vermont No furlough. No hiring freeze. The Administration had been negotiating with the unions. The negotiations had been aimed at settling the $7.4 million budget shortfall without layoffs through a combination of furloughs, on-payment for holidays, reduced health insurance benefits, and other employee give-backs.
The Administration will now proceed to obtain the savings through elimination of vacant positions and State-wide layoffs of 200 to 300 employees.
The DDS has been exempted from layoffs and the State is allowing them to establish, recruit for, and fill vacant positions.
Virginia Furlough in place. Hiring freeze but DDS exempt. There will be a 1-day furlough on May 28, 2010. However, a new governor will be in office effective January 2010, therefore, this may change.
While not subject to a general hiring freeze, the DDS will have to postpone clerical hiring if and when layoffs occur. The DDS will have to give qualified clerical employees in such agencies with layoffs priority consideration for positions in the DDS.
Washington No furlough. Hiring freeze but DDS exempt. The DDS is waiting to hear whether it will get a similar exception to the hold on salary increases, equipment purchases and contracts. Pay restrictions are in place.
West Virginia No furlough. Hiring freeze but DDS exempt.
Wisconsin Furlough in place. No hiring freeze. The Governor has issued an Executive Order requiring that all State employees take 8 furlough days in each of the next 2 FYs, including the DDS. Details of the implementation of the furlough are still being worked out. The first furlough day is expected to be in October 2009.
There is no State-wide hiring freeze in Wisconsin; however, hiring authority is often delayed by the State as the process for gaining approval to post vacancies has become more complex.
Wyoming No furlough. No hiring freeze. Agencies can request hiring on a case-by-case basis which must be approved by the Governor’s office. The DDS Administrator and Parent Agency have requested authority to hire three positions.

Appendix G
Other State Budget Issues Affecting Disability Determination Services and Disability Claims Processing

The Social Security Administration’s (SSA) Regional Commissioners and their staffs assisted us in gathering information about State budget issues affecting disability determination services (DDS) and disability claims processing. Table G-1 list issues identified by certain States.

Table G-1: State Budget Issues Affecting DDSs and Disability Claims Processing
State Issues Identified by SSA Regions
California The SSA field offices were impacted by the number of calls from current beneficiaries asking questions about budget issues. For the same reason, the teleservice centers were also adversely impacted.
Connecticut The State furlough is having a negative impact on DDS performance. The State has imposed 4 furlough days in Calendar Year 2009 and 3 more in 2010. All furlough days are tied to State holidays when normal leave usage runs high. While this does have an impact, it is minimized as everything but essential services in the State shuts down on the furlough days.
Delaware The State imposed a 2.5-percent pay reduction on employees, including those of the DDS, for Fiscal Year (FY) 2010, which began July 1, 2009. In addition, employees’ health insurance premium payments have increased by 2 percent.
Three experienced DDS employees hastened their retirements because they feared possible effects of the recently imposed pay reduction on their pensions.
The DDS is not able to hire clerical employees as a result of the State’s budget situation.
Florida The DDS no longer has the authority to grant performance based salary increases; however, increases for additional duties or promotion have not been impacted yet.
The 2009 Legislative session removed the DDS from exemption of additional budget oversight, which may, in the future, prevent or delay salary increases for promotions/added duties and may possibly restrict future hiring (that is, in FY 2011).
Georgia The cost-of-living increase originally scheduled for January 2009 was rescinded (before it was implemented).
Illinois Hiring freeze but DDS exempt. Additionally, since July 1, 2009, DDS management staff scheduled for annual evaluation and raises have not received any increase. All management increases are currently frozen.
Kansas The attrition rate remains very high, especially for examiner and management positions (losing some of their more experienced staff to SSA, Veterans Affairs, and other better paying jobs), partly due to the fact that there has been no change in their salary schedule (no step increases and minimal cost of living increases).
Maine One-third of the DDS staff is subject to a State furlough. There are 10 shutdown days in each of FYs 2010 and 2011. This, along with hiring and pay freezes, limits or reduces the DDS’ ability to provide prompt determinations.
Maryland The State applied the following provisions to its employees, including those of the DDS, between January 14 and June 30, 2009:
(a) All employees were required to forego the equivalent of 2 days’ pay.
(b) Employees earning $40,000 to $59,999 had to take 16 furlough hours in addition to the aforementioned reduction of 2 days’ pay.
(c) Employees earning $60,000 or more had to take 24 furlough hours in addition to the aforementioned reduction of 2 days’ pay.
The State applied, effective August 26, 2009, both pay reductions and furlough days on State employees for FY 2010, which began on July 1, 2009.
(a) As of August 28, 2009, DDS employees are exempt from having to take furlough days.
(b) DDS employees are subject to the following pay reductions.
• Employees earning $39,999 or less will experience a temporary pay reduction equivalent to 3 days’ pay.
• Employees earning $40,000 or more will experience a temporary pay reduction equivalent to 5 days’ pay.
The pay reductions will be apportioned over 20 pay periods beginning with the pay period on September 23, 2009 and ending June 29, 2010.
Michigan While State DDS disability examiners and medical consultants were exempted from furloughs, all other DDS staff had to take 6 specified furlough days in FY 2009. Furlough days have complicated the State’s productivity efforts. The State has put into place a Workload Emergency to allow managers to do bargaining unit work under its Collective Bargaining Agreement with represented staff. Mandatory overtime has been put into place. Such measures mitigate the impact of the furlough days, but these measures would likely have been put into place to address the increasing initial claims workload, even had there been no furloughs. While the State is on pace to complete its budgeted workload, receipts far outpace the budgeted workload.
Mississippi There could be an increase in attrition and/or retirements because of restrictions imposed by the State Legislature. Language was placed in the Agency's Appropriation Bill for FY 2010 by the State Legislature that prohibits pay increases for reclassifications and restricts pay increases for promotions. According to the DDS, reclassification of the examiner position is essential for staff retention and recruitment.
Retention and recruitment are the issues of greatest concern with regard to human resources. The following language was placed in each Agency's Appropriation Bill and includes those components receiving Federal funding: “Unless otherwise authorized in this act, no State agency shall take any action to promote or otherwise award salary increases through reallocation, reclassification, realignment, educational benchmark, career ladder, equity salary adjustment, or any other means to increase salaries of employees or positions..."
Nebraska As of October 2009, the State Legislature requires any State agency verify the legal residency status of anyone applying for public benefits. If the attestation form is not obtained, the DDS cannot process the claim. Obtaining a signed attestation from every applicant will inevitably add to case processing time, and in some cases, will delay the effectuation of an otherwise completed determination. SSA’s Office of General Counsel sent a letter to the DDS indicating this law does not pertain to the DDS since the DDS makes medical determinations on behalf of SSA for federal benefit programs, not State benefits. SSA verifies residency status in the process of determining eligibility for federal benefits.
New Jersey The State DDS staff will be subject to 10 furlough days to be taken between July 2009 and June 2010. Eight of those days will be self-directed. The remaining 2 days will occur on the days following Thanksgiving and President’s Day. A 3.5 percent pay raise scheduled for July 2009 has been delayed until January 2011.
In any week in which a staff member has taken a furlough day(s), overtime will be permitted to be worked only up to the number of furlough hours taken. Furthermore, those hours will be compensated as straight-time rather than time and one-half pay.
The New Jersey State Legislature enacted an Early Retirement Incentive package in Calendar Year 2008, resulting in the loss of 16 experienced staff members including the Director of Operations. Additionally, the discontent caused by the furloughs may be contributing to some employees’ decisions to retire this FY.
The State established a Paid Leave Bank that has credited every employee with 7 days of paid leave. Those days may be used in lieu of vacation days and may be carried over indefinitely. While there is no cost to the employee, SSA will be paying for the additional time off through the DDS operating budget.
Travel expenses incurred by trainees have been delayed since July 2009. Some State checks bounced after overnight travelers presented them for payment to hotels. Funds have subsequently been made available for payment.
New York There has not been a decrease in pay to DDS staff; however, certain management officials did not receive scheduled pay increases.
North Carolina All State employees received a 0.5 percent reduction in pay based on their annual salary for the months of May and June 2009, which was split between the 2 months. In exchange for this reduction in pay, employees were given 10 hours of paid “furlough” leave to be taken anytime (based on supervisor approval) between June and December 31, 2009. This action impacted approximately 520 DDS staff employed as of June 2009, and will result in around 5,200 hours of leave being taken between June and December 2009. The estimated productivity loss resulting from the additional leave to be taken has been determined to equate to approximately 2.5 full time positions.
The DDS hiring process is more cumbersome because of the need to obtain "freeze releases" to fill positions not deemed "critical." The DDS has, however, received approval to designate DDS specialists/examiners, as well as Medical and Psychological Consultants, as "critical" and has therefore been able to recruit and hire for these positions. Also, the DDS has been able to obtain an exception to fill positions not on the "critical" list.
Ohio All employees are subject to 10 furlough days in FYs 2010 and 2011, so they receive less pay than they would have had there been no furlough. While the DDS remains productive, time lost to furlough days is definitely making it more difficult for the DDS to process its budgeted workload.
Oregon In FY 2009, DDS managers were subject to furloughs.
In FY 2010, it is anticipated the union will ratify a contract that calls for the closure of State offices, including the DDS, for 7 work days. In total for this period, those making $3,100 per month and above (all journey level adjudicators and managers) will be subject to 14 furlough days, which includes the 7 days the DDS will be closed. Those below that pay range will have a total of 10 furlough days, again with 7 accounted for by the DDS closure. Increased hiring and overtime could offset the impact of these furloughs.
Pennsylvania DDS employees received one partial paycheck and missed one entire paycheck at the beginning of the FY, which began on July 1, 2009. They have received the pay they missed and are now being paid regularly.
Three DDS employees hired from other State agencies returned to those agencies because of the budget uncertainty at the beginning of FY 2010, which did not apply to those other State agencies.
The DDS, while not subject to a general hiring freeze, had to postpone clerical hiring because of potential layoffs in other State agencies. The DDS will have to give qualified clerical employees in such agencies priority consideration for positions in the DDS.
Puerto Rico There have not been any decreases in pay. However, in January 2009, the Commonwealth implemented a freeze on hiring, promotions (including career ladder), and pay increases. Additionally, payment for unused sick leave was suspended in February 2009, resulting in increased sick leave usage.
In March 2009, programs were announced for a Voluntary Permanent Reduction in Work Schedule, and a Program for Voluntary Resignation with Incentives. Two DDS employees took advantage of the resignation package; however, no one in the DDS took advantage of the work schedule reduction program. In June 2009, two experienced staff members took advantage of early retirement incentives that were offered by the Commonwealth.
In December 2008, SSA took over payments for the DDS’ medical consultants, consultative examination providers, and certain medical evidence of record providers. This action was taken in response to the Department of the Treasury’s failure to issue payments to these individuals and entities on a timely basis. The delayed payments affected the DDS’ ability to process cases in a timely manner as it impacted the production of the medical consultants; made it more difficult to schedule consultative examinations; and hindered their attempts to collect medical evidence of record in a timely manner. This process remains in effect pending a detailed action plan from the DDS’s parent agency. To date, over $4 million has been sent to the Office of Finance for payment.
Rhode Island The State announced a 12-day furlough program that is expected to include the DDS. Negotiations are in process that may avert this action. Any furlough will have a serious impact on the DDS, as there is already a shortage of staff due to years of hiring restrictions. The DDS case processing time and pending levels are already suffering despite ongoing, significant Federal assistance.
Tennessee The DDS has not been able to secure raises for its staff (including cost of living raises). Also, it has been unable to secure upgrades/reclassifications for its clerical staff that have been pending for several years and were necessitated by implementation of SSA’s electronic disability folder.
The State has cut its workforce in many “support” areas and requests for support are sometimes delayed, such as with the ordering of supplies, personnel transactions, repairs to audio-visual equipment, etc.
Vermont Budget-related changes in the State's hiring approval process, provisions for rehiring reduction in force employees, and the requirements of the early retirement incentive legislation have contributed to the slowing of the DDS hiring process. This is one factor contributing to the growth of DDS case backlogs and case processing delays.
Washington DDS employees will not receive a previously negotiated cost of living increase.
Wisconsin There will be a deduction in pay for non-exempt staff beginning September 2009 to account for the upcoming 8 furlough days. Exempt staff will have the deduction when they take a furlough day. Mandatory overtime was implemented effective August 24, 2009 to handle the backlog and pending claims.

Appendix H
Budget Website Information by State

Table H-1 lists Website resources for State budgets as of September 14, 2009.

Table H-1: Budget Website Information by State as of September 14, 2009
State Website
Alabama http://budget.alabama.gov/

Alaska http://www.gov.state.ak.us/omb/

Arizona http://www.ospb.state.az.us/

Arkansas http://www.arkansas.gov/dfa/budget/budget_index.html

California http://www.ebudget.ca.gov/

Colorado http://www.colorado.gov/cs/Satellite?c=Page&cid=1193823054606&pagename=GovRitter%2FGOVRLayout

Connecticut http://www.ct.gov/governorrell/cwp/view.asp?A=1317&Q=425180

Delaware http://budget.delaware.gov/fy2010/budget2010.shtml

District of Columbia http://cfo.dc.gov/cfo/cwp/view,a,1321,q,589949,cfoNav,%7C33210%7C.asp

Florida http://www.myflorida.com/

Georgia http://www.opb.state.ga.us/

Hawaii http://hawaii.gov/budget/

Idaho http://legislature.idaho.gov/budget/index.htm

Illinois http://www.state.il.us/budget/

Indiana http://www.in.gov/sba/index.htm

Iowa http://www.iowa.gov/

Kansas http://www.kansas.gov/KanView/

Kentucky http://osbd.ky.gov/default.htm

Louisiana http://doa.louisiana.gov/OPB/state-budget.htm

Maine http://www.maine.gov/governor/baldacci/policy/budget/index.html

Maryland http://dbm.maryland.gov/agencies/operbudget/Pages/2010OperatingBudgetDocuments.aspx

Massachusetts http://www.mass.gov/?pageID=afsubtopic&L=4&L0=Home&L1=Budget%2c+Taxes+%26+Procurement&L2=State+Budget&L3=FY2010+Budget+Information&sid=Eoaf

Michigan http://www.michigan.gov/budget/

Minnesota http://www.doer.state.mn.us/fin/budget

Mississippi http://www.dfa.state.ms.us/

Missouri http://oa.mo.gov/bp/execbudgets.htm

Montana http://budget.mt.gov/execbudgets/default.mcpx

Nebraska http://www.budget.state.ne.us/

Nevada http://open.nv.gov/OpenGov/ViewBudgetSummary.aep

New Hampshire http://admin.state.nh.us/budget/

New Jersey http://www.njleg.state.nj.us/legislativepub/finance.asp

New Mexico http://budget.nmdfa.state.nm.us/content.asp?CustComKey=201583&CategoryKey=201584&pn=Page&DomName=budget.nmdfa.state.nm.us

New York http://www.budget.state.ny.us/

North Carolina http://www.osbm.state.nc.us/ncosbm/budget/index.shtm

North Dakota http://www.nd.gov/fiscal/budget/state/

Ohio http://obm.ohio.gov/SectionPages/Budget/FY1011/ExecutiveBudget.aspx

Oklahoma http://www.ok.gov/OSF/Budget/index.html

Oregon http://www.oregon.gov/DAS/BAM/GRB0911intro.shtml

Pennsylvania http://www.budget.state.pa.us/portal/server.pt/community/office_of_the_budget____home/4408

Puerto Rico http://www.gobierno.pr/gprportal/inicio

Rhode Island http://www.budget.ri.gov/CurrentYear/GovernorsBudget.php

South Carolina http://www.budget.sc.gov/OSB-about.phtm

South Dakota http://www.state.sd.us/bfm/overview.htm

Tennessee http://tennessee.gov/finance/bud/bud0910/10publications.html

Texas http://governor.state.tx.us/bpp/

Utah http://www.governor.utah.gov/budget/default.html

Vermont http://finance.vermont.gov/state_budget/rec

Virginia http://dpb.virginia.gov/budget/budget.cfm

Washington http://fiscal.wa.gov/Budgets.aspx

West Virginia http://www.wvbudget.gov/

Wisconsin http://www.doa.state.wi.us/debf/execbudget.asp?locid=3

Wyoming http://ai.state.wy.us/budget/index.asp

Appendix I
Cuts to Programs for Public Health and the Elderly and Disabled

According to the Center on Budget and Policy Priorities, at least 27 States have implemented cuts in public health programs—such as Medicaid or the Children’s Health Insurance Program (CHIP)—that will restrict low-income children’s or families’ eligibility for health insurance or reduce their access to health care services. Additionally, at least 24 States and the District of Columbia are cutting medical, rehabilitative, home care, or other services needed by low-income individuals who are elderly or have disabilities, or they are significantly increasing the costs of these services. The National Conference of State Legislatures also compiled a list of measures, both proposed and enacted, that States took or were considering about health care to close their budget gaps. Table I-1 shows these States and the program cuts they implemented.

Table I-1: State Cuts to Programs for Public Health and the Elderly and Disabled
State Medicaid and Other Public Health Programs Programs for the Elderly and Disabled
Alabama Ended homemaker services for approximately 1,100 older adults. These services often allow the elderly to stay in their own homes and avoid nursing home care.
Arizona Reduced its Medicaid rolls by requiring that some adult beneficiaries reapply for benefits more frequently. (Research has shown added paperwork requirements cause many eligible people to lose coverage.)
Cut funding for community health centers and vaccines and suspended funding for the children’s rehabilitative services program, affecting 4,700 children with chronic or disabling conditions. Eliminated temporary health insurance for people with disabilities who have serious medical problems. The State also eliminated general assistance, a program designed to provide time-limited cash assistance to adults with physical or
mental disabilities. In addition, in February 2009, the State eliminated independent living supports for 450 elderly residents
and respite care funding for
130 caregivers. It also established a waiting list for vocational rehabilitation services, affecting 2,100 disabled individuals.

The Department of Health Services will cut the number of free HIV/AIDS medications given to poor and uninsured patients. Essential medications will still be covered.
California Cut $1.3 billion from the State’s Medi-Cal program budget.

Medi-Cal will no longer pay for certain optional benefits, such as dental services.

Froze enrollment in the CHIP program – Healthy Families. The program has over 33,000 children on its waiting list. Overall, the Healthy Families program budget was reduced by $178.6 million—a 44 percent reduction from the prior year. Capped or reduced funding for programs that serve people who have disabilities or are elderly.

Colorado Cut payments to doctors who treat Medicaid patients. Cut $15 million from health clinics that mostly serve the uninsured.
Connecticut Cut $4.5 million from State programs by changing the definition of what is medically necessary in 2011.
District of Columbia Capped or reduced funding for programs that serve people who have disabilities or are elderly.
Florida Enacted cuts in Medicaid or CHIP. The State also cut Medicaid reimbursements to hospitals and community-based services for the elderly, such as meals and homemaker services.
Georgia Enacted cuts in Medicaid or CHIP. Reduced such programs for the elderly as Alzheimer services, elder service centers, prescription drug assistance, and elder support
Idaho Enacted cuts in Medicaid or CHIP.
Illinois Cut $600 million from Medicaid.
Kansas Capped or reduced funding for programs that serve people who have disabilities or are elderly.
Louisiana Reduced payments to Medicaid providers by $86 million. Capped or reduced funding for programs that serve people who have disabilities or are elderly.
Maine Enacted cuts in Medicaid or CHIP. Capped or reduced funding for programs that serve people who have disabilities or are elderly.
Maryland Enacted cuts in Medicaid or CHIP. Capped or reduced funding for programs that serve people who have disabilities or are elderly.
Massachusetts Enacted cuts in Medicaid or CHIP. The Governor ordered cuts in programs for elderly, including home care, geriatric mental health services, and prescription drug assistance.
Michigan Dropped coverage of dental and/or vision services for adult Medicaid beneficiaries. Capped or reduced funding for programs that serve people who have disabilities or are elderly.
Minnesota Eliminated funding for its General Assistance Medical Care program, which provides health care to 29,500 low-income persons between ages 21 and 64 who have no dependent children and do not qualify for Federal health care programs. Capped enrollment at current levels for a program that provides expanded health services and care coordination for people with disabilities.
Missouri Enacted cuts in Medicaid or CHIP. Capped or reduced funding for programs that serve people who have disabilities or are elderly.
Nevada Proposed reducing Medicaid eligibility for the elderly and disabled.
Dropped coverage of dental and/or vision services for adult Medicaid beneficiaries.
New Hampshire Enacted cuts in Medicaid or CHIP.
New Jersey Enacted cuts in Medicaid or CHIP.
New Mexico Cut cash assistance payments for low-income disabled residents by a third. The State provides these payments to an average of 2,100 disabled individuals each month who cannot work and are not eligible for Temporary Assistance to Needy Families.
New York Enacted cuts in Medicaid or CHIP.
Enacted limits to Medicaid drug therapy and required doctors to use less expensive drug treatments.
North Carolina Cut $76 million from Medicaid. Community support services cut by $65 million and group home funding cut by $15.9 million.
Ohio Cut 3 percent from State payments to Medicaid providers. Cut local mental health agency funding by $190 million.
Cut home-based health care for the elderly by $68 million.
Oregon Hospitals will be taxed 4 percent and insurers at 1.5 percent to pay for adding 80,000 uninsured children and 35,000 uninsured adults to the Oregon Health Plan.
Pennsylvania Capped or reduced funding for programs that serve people who have disabilities or are elderly.
Rhode Island Reduced the maximum income level at which parents can receive public health insurance to 175 percent of the Federal poverty line from 185 percent, eliminating coverage for approximately 1,000 parents. Over 7,800 other low-income families are paying higher monthly premiums for public health insurance. Low-income elderly must pay higher rates for subsidized adult day care. This is estimated to affect more than 1,200 elderly with incomes below $20,000.
South Carolina Enacted cuts in Medicaid or CHIP. Capped or reduced funding for programs that serve people who have disabilities or are elderly.
South Dakota Cut Medicaid and related programs by 3.1 percent.
Tennessee Enacted cuts in Medicaid or CHIP. Reduced community-based services for people with intellectual disabilities and cut nursing services for some adults with serious disabilities.
Utah Cut Medicaid funding for physical, occupational, and speech and hearing therapy services for adults – as well as Medicaid provider rates for hospitals, skilled nursing, and dentists. Also dropped coverage of dental and/or vision services for adult Medicaid beneficiaries. Capped or reduced funding for programs that serve individuals who have disabilities or are elderly.
Vermont Reduced some home-based services,
such as housekeeping and shopping, for people who are elderly or disabled. Such services help people stay in their own homes and possibly delay or avoid more expensive nursing home care.
Virginia Decreased reimbursements for special hospitals serving individuals with needs relating to mental health, mental
retardation, or substance abuse. The
State also reduced pass-through grants for various aging programs and funding for local mental health providers.
Washington Increased premiums by an average of 70 percent for a health plan serving low-income residents. Premiums for the poorest plan members—those earning up to 125 percent of the poverty line—will double. The premium increase is expected to cause between 7,000 and 17,000 enrollees to leave the program. Cut $225 million by reducing services
under the basic health plan for the poor
and stopped enrollments in the plan. As a result, 40,000 residents lost coverage.
Capped or reduced funding for programs that serve the disabled or elderly.
Enacted cuts to nursing home daily rates.
Wisconsin Enacted cuts in Medicaid or CHIP.
Wyoming Enacted cuts in Medicaid or CHIP.

Appendix J
Other State Budget Issues Affecting Disability Beneficiaries and Recipients

The Social Security Administration’s (SSA) Regional Commissioners and their staffs assisted us in gathering information about State budget issues affecting disability beneficiaries and recipients. Table J-1 lists issues identified by certain States as of September 2009.

Table J-1: Other State Budget Issues Affecting Disability Beneficiaries and Recipients
State Issues
California The State’s Medi-Cal program will no longer pay for the following benefits and services for most adults: dental, speech therapy, podiatric, audiology, chiropractic, acupuncture, optometric, optician, and psychological services.
The State proposed limiting In Home Support Services to only the most severely ill and lowering the State’s share of In Home Support Service worker pay to $8.00 per hour.
Colorado The State terminated its Aid to the Needy and Disabled program—an interim assistance program that required recipients to apply for Supplemental Security Income (SSI) payments. The assistance provided by this program would terminate upon the receipt of an SSI payment.
Illinois State budget issues may impact Ticket to Work and/or Vocational Rehabilitation services. The Department of Human Services, Division of Rehabilitation Services, made arrangements for the Coalition of Citizens with Disabilities in Illinois to serve as the Work Incentives Planning and Assistance Organization for portions of the State. Since this arrangement was made, funding within the State has been reduced due to the State's budgetary crisis. As a result of these funding cuts, all employees of the Coalition were laid off, at least temporarily, as of July 16, 2009. The Division of Rehabilitation Services is dealing with the impact and contracting issues with SSA as they relate to the Work Incentive Planning and Assistance activities. Additional layoffs to State employees, potentially including Vocational Rehabilitation, may occur.
Louisiana The State will impose a limit on the number of Medicaid prescriptions it will cover. This may affect access to prescription drugs for mentally ill or disabled individuals who rely on several medications to manage their conditions.
Michigan The State eliminated optional Medicaid benefits as of July 1, 2009. This included chiropractic services, podiatrist services, hearing aids, eyeglasses, and associated vision and adult dental services.
Montana The State reported an increase in its Medicaid eligibility workload due to increased referrals—resulting in longer waiting times for applicants.
New Mexico The State cut cash assistance payments for low-income disabled residents by one third in July 2009. The State provided these payments to an average of 2,100 disabled individuals each month who could not work and were not eligible for Temporary Assistance to Needy Families.
Ohio There will be an impact on State Legal Rights Services, which is a Work Incentives Planning and Assistance Organization and a Protection and Advocacy Agency for Social Security beneficiaries. Like DDS employees, all State Vocational Rehabilitation employees will have to take 10 furlough days during Fiscal Year 2010. A Work Incentives Planning and Assistance Organization in Ohio has started to lay off Community Work Incentive Coordinator staff.
Rhode Island The State raised Medicaid co-payments.
Additionally, the State decreased the State supplement effective January 2009 by the amount of the Federal cost of living increase so there was no net gain for recipients.
Cuts at the State’s Department of Children and Family Services have compromised SSA’s ability to effectively manage its programs. Redeterminations and Limited Issue cases are difficult to complete when the Department is the representative payee. The Department is not proactive in filing for Social Security benefits for those in their care who may be entitled. The Department also contributes to creating benefit misuse situations by failing to notify SSA timely when children receiving Social Security benefits or SSI payments come into their care. Benefits continue to be sent to the prior payees who may misuse them rather than return them to SSA.
Tennessee Eligibility requirements for the State Medicaid Spend-Down Program were revised due to budget cuts. Beneficiaries not meeting the new eligibility criteria lost access to health care coverage. Field Offices and Public Affairs Specialists received numerous calls and Congressional inquires concerning the cuts in the Medicaid Standard Spend Down entitlement. Beneficiaries inquired about other programs to supplement their medical expenses.
As a result of a court decision, TennCare is no longer responsible for paying Medicare Part B premiums for approximately 142,000 beneficiaries. An estimated 5,000 of these beneficiaries reside outside Tennessee. Presently, these beneficiaries/recipients are not eligible for SSI payments but have continued State Medicaid eligibility and are automatically entitled to the Medicare Part D Low Income Subsidy because of a court injunction. Tennessee Field Offices received several calls and visits for explanations regarding Medicare premiums and health care coverage issues.
Utah The State’s General Assistance program reduced the entitlement period from 18 to 12 months. This could result in a lapse of benefits for any Social Security case pending longer than 12 months.
Vermont The State contemplated cutting the State supplement by 50 percent of the Federal SSI increase. However, because there will be no Federal SSI increase in 2010, the State will not reduce the State supplement.
Wisconsin Vocational Rehabilitation employees will be subject to 4 furlough days in each of federal Fiscal Years 2010 and 2011. These furlough days will be sporadic and linked to federal holidays (Columbus Day, the day after Thanksgiving, Presidents' Day, and the Friday before Memorial Day), so the direct impact on service will not be as severe as it could have been had these days been concurrent.

Appendix K
OIG Contacts and Staff Acknowledgments
OIG Contacts

Judith Oliveira, Director, Boston Audit Division

Phillip Hanvy, Audit Manager

Acknowledgments

In addition to those named above:

Katie Toli, Auditor

For additional copies of this report, please visit our web site at www.socialsecurity.gov/oig or contact the Office of the Inspector General’s Public Affairs Staff Assistant at (410) 965-4518. Refer to Common Identification Number A 01 10-11006.

DISTRIBUTION SCHEDULE

Commissioner of Social Security
Office of Management and Budget, Income Maintenance Branch
Chairman and Ranking Member, Committee on Ways and Means
Chief of Staff, Committee on Ways and Means
Chairman and Ranking Minority Member, Subcommittee on Social Security
Majority and Minority Staff Director, Subcommittee on Social Security
Chairman and Ranking Minority Member, Committee on the Budget, House of Representatives
Chairman and Ranking Minority Member, Committee on Oversight and Government Reform
Chairman and Ranking Minority Member, Committee on Appropriations, House of Representatives
Chairman and Ranking Minority, Subcommittee on Labor, Health and Human Services, Education and Related Agencies, Committee on Appropriations,
House of Representatives
Chairman and Ranking Minority Member, Committee on Appropriations, U.S. Senate
Chairman and Ranking Minority Member, Subcommittee on Labor, Health and Human Services, Education and Related Agencies, Committee on Appropriations, U.S. Senate
Chairman and Ranking Minority Member, Committee on Finance
Chairman and Ranking Minority Member, Subcommittee on Social Security Pensions and Family Policy
Chairman and Ranking Minority Member, Senate Special Committee on Aging
Social Security Advisory Board

Overview of the Office of the Inspector General
The Office of the Inspector General (OIG) is comprised of an Office of Audit (OA), Office of Investigations (OI), Office of the Counsel to the Inspector General (OCIG), Office of External Relations (OER), and Office of Technology and Resource Management (OTRM). To ensure compliance with policies and procedures, internal controls, and professional standards, the OIG also has a comprehensive Professional Responsibility and Quality Assurance program.
Office of Audit
OA conducts financial and performance audits of the Social Security Administration’s (SSA) programs and operations and makes recommendations to ensure program objectives are achieved effectively and efficiently. Financial audits assess whether SSA’s financial statements fairly present SSA’s financial position, results of operations, and cash flow. Performance audits review the economy, efficiency, and effectiveness of SSA’s programs and operations. OA also conducts short-term management reviews and program evaluations on issues of concern to SSA, Congress, and the general public.
Office of Investigations
OI conducts investigations related to fraud, waste, abuse, and mismanagement in SSA programs and operations. This includes wrongdoing by applicants, beneficiaries, contractors, third parties, or SSA employees performing their official duties. This office serves as liaison to the Department of Justice on all matters relating to the investigation of SSA programs and personnel. OI also conducts joint investigations with other Federal, State, and local law enforcement agencies.
Office of the Counsel to the Inspector General
OCIG provides independent legal advice and counsel to the IG on various matters, including statutes, regulations, legislation, and policy directives. OCIG also advises the IG on investigative procedures and techniques, as well as on legal implications and conclusions to be drawn from audit and investigative material. Also, OCIG administers the Civil Monetary Penalty program.
Office of External Relations
OER manages OIG’s external and public affairs programs, and serves as the principal advisor on news releases and in providing information to the various news reporting services. OER develops OIG’s media and public information policies, directs OIG’s external and public affairs programs, and serves as the primary contact for those seeking information about OIG. OER prepares OIG publications, speeches, and presentations to internal and external organizations, and responds to Congressional correspondence.
Office of Technology and Resource Management
OTRM supports OIG by providing information management and systems security. OTRM also coordinates OIG’s budget, procurement, telecommunications, facilities, and human resources. In addition, OTRM is the focal point for OIG’s strategic planning function, and the development and monitoring of performance measures. In addition, OTRM receives and assigns for action allegations of criminal and administrative violations of Social Security laws, identifies fugitives receiving benefit payments from SSA, and provides technological assistance to investigations.