U.S. Interagency Council on Homelessness
2003 Annual Report
Social Security Administration

Our Major Programs and Services - In 1937, the Social Security Act established a program to help protect aged Americans against the loss of income due to retirement. Protection for survivors of deceased workers was added in 1939, creating the Old Age and Survivors Insurance (OASI) program. Social Security was again expanded in 1956 to include the Disability Insurance (DI) program. SSA's responsibilities also include administration of the Supplemental Security Income (SSI) program added in 1972, and Special Benefits for Certain World War II Veterans (title VIII) added in 1999. It is the largest government domestic program in terms of expenditures.

• For the fiscal year ending September 30, 2001, 38.9 million Americans were receiving OASI benefits, totaling $367.7 billion.
  
  
• For the fiscal year ending September 30, 2001, 6.8 million Americans were receiving DI benefits, totaling $58.2 billion.
  
  
• For the fiscal year ending September 30, 2001 6.7 million people were receiving SSI benefits, totaling $27.4 billion.

SSA has a long history of providing service to the American public that includes access to the programs we administer by homeless populations. We are committed to supporting the Administration's initiative to end chronic homelessness within 10 years. We will increase access and services to Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) benefits. We see these benefit programs as a basis of support around which a case manager can build a network of support that could include housing, job training and, if necessary, substance abuse rehabilitation.

We work to prevent homelessness by contacting people who are at risk because they are soon to be released from institutions such as hospitals or penal institutions. To do this, we establish agreements with the institutions so that they give us advance notice of an individual's release date and we can secure an application and the necessary supporting documentation. This gives us time to ensure that an individual who is eligible for SSI has funds for food, clothing and shelter before leaving the institution.

Our Organization - We have centralized management of the Social Security and Supplemental Security Income programs and a decentralized nationwide network of 10 Regional Offices overseeing 1340 Field Offices, 36 Teleservice Centers and
1 Data Operations Center. In addition, we have 138 Hearings Offices and
10 Offices of Hearings and Appeals (OHA) Regional Offices overseen by OHA headquarters.

As of May 2001, we have approximately 65,000 employees at SSA. Of these employees, over 80 percent are involved in providing direct public service -
they work in our field offices, teleservice centers, processing centers and hearing offices.

Our Budget Structure: Our budget has two distinct parts--the program budget and the administrative budget. The program budget covers the benefits we pay to individuals, while the administrative budget covers the costs of administering our programs and serving the American people. Eight separate accounts comprise our overall budget. These accounts are categorized by the type of appropriation from which they are funded.

Limitation on Administrative Expenses (LAE), is SSA's basic administrative account and is an annual appropriation financed from the Social Security and Medicare trust funds. The trust funds initially fund the administrative expenses of the SSI program, but are subsequently reimbursed from the SSI account. In addition, fees paid by States for administration by SSA of their State SSI supplementation payments are used to offset the administrative cost of this service. The following displays the LAE account by funding source (using FY 2000 actual data for illustrative purposes):

Overview of Supplemental Security Income and Current Activities to Assist Homeless: SSA administers the Supplemental Security Income (SSI) program. Through this program, we pay monthly benefits to people with limited income and resources who are age 65 or older, blind or disabled. Blind or disabled children, as well as adults, can receive SSI. By filing for SSI in most States, SSI beneficiaries also can get Medicaid (medical assistance) to pay for hospital stays, doctor bills, prescription drugs and other health costs. Also, in most States, if you are applying for or receive SSI, you may be able to get Food Stamp information and an application form. Thus, for homeless individuals, who are either age 65 or older, blind or disabled, SSA plays a critical role in helping provide monthly benefit payments and linkages to medical and nutrition services.

National estimates on homelessness indicate there are anywhere from 500,000 - 700,000 homeless on any given night. A 1996 study found that of approximately 4,000 homeless individuals surveyed, 11 percent received SSI. Although we do not currently have any way to measure how many of the 6.7 million SSI beneficiaries are homeless, based on this study, the number of homeless SSI recipients could range from 55,000 - 77,000.

As an Agency, SSA is uniquely positioned through its network of over 1300 field offices to provide assistance to the homeless. SSA field offices have established a variety of activities and special procedures to reduce the problems faced by homeless individuals in obtaining Social Security or SSI benefits for which they are eligible. Listed below are examples of what we do to serve homeless populations:

Addressing Impediments to Access to Programs and Services by Homeless Individuals: The primary impediment known to field office and disability determination services staff is the difficulty of maintaining contact with the homeless individual. It is also difficult for homeless individuals to keep appointments and to maintain records of medical treatment. To address these impediments, SSA:

• Allows homeless individuals to receive their monthly checks at the local field office;
  
  
• Assists individuals in establishing bank accounts for Direct Deposit of SSA benefits and using Automatic Teller Machines; and
  
  
• Allows individuals to use the field office as a message center, so that disability determination services' appointments or requests for information are not missed.

Liaison and Current Outreach Activities: Field offices and disability determination services throughout the nation have established liaisons with various organizations to assist the homeless populations in applying for and maintaining entitlement to SSI benefits by:

• Establishing ongoing relationships with homeless organizations, agencies, shelters, churches, county welfare and local healthcare providers that serve homeless populations in order to provide immediate assistance and resolve issues related to homeless populations;
  
  
• Scheduling appointments with various agencies to facilitate the claims or postentitlement process;
  
  
• Coordinating development between disability determination services and treatment providers to expedite the disability claims process;
  
  
• Arranging for field offices to contact disability determination services to schedule consultative examinations for homeless individuals with no medical sources so that the individual is provided the date and time of the appointment before leaving the field office;
  
  
• Working with the Veterans Administration to assist homeless veterans filing claims or maintaining eligibility;
  
  
• Visiting, regularly, homeless shelters and hospitals (by field office staff) to take claims or assist individuals with postentitlement actions;
  
  
• Attending meetings of community based service organizations for the homeless (by field office staff) to provide ongoing information about SSA programs and to maintain good lines of communication;
  
  
• Distributing public information materials to appropriate agencies involved with the homeless and maintaining resource information from those agencies in field offices in order to provide referral services as needed; and
  
  
• Identifying new community service programs that assist the homeless and developing liaisons as appropriate.
  

Training Initiatives: Field office and disability determination services staff provide ongoing training to other agencies and community service organizations that serve the homeless. For example:

• Field offices train social workers and advocacy groups on the completion of claims forms and documentation requirements for claims processing;
  
  
• Field office staff participate in workshops to disseminate information on programs and services; and
  
  
• Public Affairs Specialists and field office management establish relationships with legal aid and law enforcement agencies to provide basic eligibility training on SSA programs.

Providing Information about Social Security and SSI Benefits: SSA also provides information about Social Security and SSI benefits to national advocacy organizations for dissemination to affiliates, professionals and consumers. SSA prepares and releases a Monthly Information Package to all field offices that contains print media products for placement with local media, and a monthly camera-ready newsletter, the Social Security Courier, which is sent to advocacy groups, nonprofit organizations, and intergovernmental entities. These products contain information on programs and issues relevant to homeless populations.

Overview of SSA's Homeless Plan: In support of the President's initiative to end chronic homelessness within 10 years, we participate in the Interagency Council on Homelessness. In addition, we prepared an Agency-wide plan to address homeless issues. SSA's homeless plan documents activities to provide access to benefits and services to homeless populations. We will institutionalize the homeless plan and its activities by convening a workgroup that will be responsible for coordinating and monitoring homeless plan activities.

Our approach is to determine what actions and resources are needed to fulfill our commitment to ending homelessness. In order to achieve this, we need to improve our ability to identify homeless applicants and beneficiaries. SSA's homeless plan includes activities to identify locations of high homeless populations to determine what areas to target for outreach activities and reevaluating current policy and implementation strategies.

SSA's homeless plan objectives seek to:

• Further identify and remove barriers homeless individuals face in accessing SSA's programs - We will review prior outreach activities targeting homeless populations and distribute successful methods of working with community based organizations;
  
  
• Ensure access to our programs and services to the homeless by identifying areas for improvement in current policy and operating procedures and submitting recommended changes;
  
  
• Develop and expand SSDI/SSI outreach and application assistance to the homeless by developing content for and implementing a web page for homeless advocates; and
  
  
• Address service delivery issues through collaborative initiatives (e.g., with Department of Justice on their "Going Home" project which focuses on serious and violent offenders, with Department of Health and Human Services on their project to provide training for case managers whose clients are homeless and potentially eligible for SSI and SSDI and the Health Care for the Homeless program which seeks to improve access to health care, mental health and substance abuse treatment by homeless individuals).
  

Previous Outreach Activities - From 1990-1997, we conducted an extensive SSI Outreach Demonstration Program. It was based on three major premises:

• We must do a better job of providing information about and promoting understanding of the SSDI and SSI programs;
  
  
• We must reach out to people who are aware of our programs, but are reluctant to apply for what is perceived as "welfare" by working toward a more positive public perception of the programs; and
  
  
• We must make the process of applying for benefits easier to ensure that people do not fail to establish eligibility because of some real or perceived obstacle in the application process.

Our outreach projects focused on different approaches to reach targeted populations, including the homeless. Some projects:

• Tested public information approach targeting minority or ethnic groups using bilingual staff;
  
  
• Identified potentially eligible elderly individuals and provided services such as transportation to local offices or serving as a representative payee where needed;
  
  
• Took a case management approach by assisting potentially eligible individuals through the application process, obtaining supporting medical documentation or provided transportation to medical examinations, and made referrals for other benefits and services; and
  
  
• Used a coalition-building approach where they networked with other agencies which assisted them in identifying and screening clients, performing case management or other services, primarily through referrals.

Over 140 cooperative agreements were awarded to organizations serving different groups, including those serving homeless populations.

SSI Outreach Demonstration Project grantees targeting homeless populations included:

• University of Maryland Medical System (UMMS) - (01/01/93 to 01/31/94). In this project, SSA and the disability determination service established a protocol for UMMS to use in identifying cases in which the applicant could be determined to be presumptively disabled due to chronic mental illness without obtaining any additional medical evidence. By qualifying these people earlier, they received their benefits faster, which provided a head start in acquiring housing, treatment, and other supportive services.
  
  
• Bread for the City - (10/01/92 to 02/28/94) This project was designed to make individuals aware of the availability of SSI, and to provide assistance and support during the application process to individuals who were often homeless and physically or mentally ill. Volunteers provided screening and referral services, assisted in completing applications, and disseminated information door-to-door. The results of this project emphasized the importance of partnerships between SSA and community agencies.
  
  
• Collaboration with the Department of Veterans Affairs (DVA). This joint initiative was designed to improve access to Social Security disability benefits among homeless veterans with mental illness. In the SSA-VA initiative, both a Social Security claims representative and a state disability determinations analyst were collocated with Health Care for Homeless Veterans clinical teams to facilitate applications for Social Security benefits. The project had 3 objectives:
  1. To increase applications for SSI and SSDI among entitled veterans;
  2. To increase awards for disability benefits; and
  3. To increase the proportion of timely decisions defined as those made within 90 days of the application.

The SSI Outreach Demonstration Program found:

• That homeless people have difficulty negotiating the SSI application process by themselves;
  
  
• Usually, an advocate or caseworker must assist them with the process; and that
  
  
• A collocation approach to service system integration can improve access to disability entitlement among homeless persons with mental illness.

If outreach funds become available in fiscal year 2003, we will discuss outreach approaches and methodologies with members of the United States Interagency Council on Homelessness to get their views on how best to use these funds. We will prepare Federal Register announcements of our intention to fund outreach grant programs targeting homeless populations.