GAO Reviews SSI Kids Program

December 18, 2011

Author: Catherine M. Callery (Kate)| Louise M. Tarantino

The Government Accountability Office (GAO) has begun a preliminary review of the SSI Children’s  program.  In testimony before the Congressional  Subcommittee on Human Resources and Committee on Ways and Means, the GAO stated that its work in this area is ongoing and offered no recommendations at this point.  It plans to issue a final report in April 2012.  Highlights of the testimony can be read at GAO-12-196T, available at http://www.gao.gov/highlights/d12196thigh.pdf.

According to the GAO, the numbers of children applying for and receiving SSI benefits due to mental impairments has increased over the past ten years, and now constitute a majority of child beneficiaries.  Although half of the children applying for benefits each year are denied, children with mental impairment represent a growing share of those approved.  The GAO considered factors for this increase, including but not limited to increases in the number of children living in poverty and increases of diagnoses of children with certain mental impairments.

The GAO analyzed program data and interviewed SSA officials, personnel in field offices and state   disability determination services (DDS).  It noted that SSA considers a combination of medical and nonmedical information in determining eligibility, including use of prescription medications, school  records and teacher assessment.  Although the officials acknowledged the critical nature of the teacher assessments, the GAO observed that examiners face challenges in obtaining this information, as teacher are often reluctant to complete the assessments.

The GAO also noted that SSA is not conducting   timely continuing disability reviews (CDRs) of children on SSI.  SSA acknowledged the importance of these reviews, estimating that the CDR process yields a savings - to - cost ratio of $12.50 to $1.  It pointed, however, to resource constraints for recent decreases in the number of childhood CDRs performed.