National and State Trends in autistic Adult Supplemental Security Income Awardees: 2005-2019.

This paper used Social Security Administration program data from 2005 to 2019 to examine national- and state-level changes in the number of new adult supplemental security income (SSI) awardees on the autism spectrum relative to awardees with intellectual disability and other mental health disorders. We identified three main findings: the number of autistic awards increased between 2005 and 2019 when awards for all other mental health disorders declined; roughly nine out of every 10 autistic adult awardees were between ages 18-25 years; there was variation in the growth of autistic awards across states. These findings support the need to consider geographic and age differences in SSI program participation among autistic adults and determine the underlying causes.

Promoting Readiness of Minors in Supplemental Security Income (PROMISE): Early Impacts from a Multi-Site Random Assignment Evaluation.

BACKGROUND: PROMISE was a federal initiative to support youth receiving Supplemental Security Income (SSI) during the transition to adulthood. OBJECTIVES: This article presents estimates of the impacts of the six PROMISE projects on youth and family outcomes as of 18 months after enrolling in PROMISE. RESEARCH DESIGN: The study uses a randomized controlled trial design. SUBJECTS: The six PROMISE projects each enrolled a minimum of 2000 treatment and control youth (and their parents) residing in their service areas who were aged 14 to 16 and receiving SSI. MEASURES: We estimated impacts on outcomes related to youth and family service use, school enrollment, training, employment, earnings, and federal disability program participation using survey and administrative data. RESULTS: The projects succeeded in connecting more youth to transition services and more families to support services during the 18 months after enrollment, and most increased the likelihood that youth applied for state vocational rehabilitation services. On average, there was no impact on youth's school enrollment, but there were favorable impacts on youth's receipt of job-related training, employment, earnings, and total income. The projects did not affect parents' employment, earnings, or income, on average. For most outcomes PROMISE affected, the impacts varied substantially across the projects. CONCLUSIONS: The positive short-term impacts of PROMISE on youth's use of transition services, youth employment, and families' use of services are consistent with the program logic model and suggest there might be potential for longer-term favorable impacts on youth and family outcomes.

Trends in Supplemental Security Income Payments to Adults With Autism.

OBJECTIVE: This study used Social Security Administration program data to identify population-level trends in Supplemental Security Income (SSI) program participation and payments to adult recipients with autism spectrum disorder (ASD) relative to recipients with intellectual disability and other mental disorders. METHODS: The authors examined SSI program data from 2005 to 2015. Variables included caseload size, number of new adult awardees per year, total annual SSI payments per disability group, and average annual SSI payment per recipient. RESULTS: Adults with ASD represented a growing share of the total first-time SSI awards given to adults with mental disorders, with percentages increasing from 1.3% in 2005 to 5.0% in 2015. In 2015, 158,105 adults with ASD received SSI benefits, a 326.8% increase since 2005. Federal SSI payments to adults with ASD increased by 383.2% during the same period (totaling roughly $1.0 billion in 2015). The annual average payment for adults with ASD was $6,527.40 in 2015. CONCLUSIONS: The purpose of the SSI program is to reduce the extent of poverty by providing monthly payments to eligible individuals with disabilities. The authors found that a large and growing number of adults with autism receive SSI benefits. This finding underscores the importance of future research related to the economic security of adults on the autism spectrum.

Subsequent program participation of former social security disability insurance beneficiaries and supplemental security income recipients whose eligibility ceased because of medical improvement.

The Social Security Administration (SSA) periodically reviews the disabilities of Supplemental Security Income (SSI) recipients and Social Security Disability Insurance (DI) beneficiaries to determine if their impairments still meet the requirements for program eligibility. For individuals whose eligibility was ceased after a full medical review from 2003 to 2008, we track subsequent program participation for up to 8 years. We use survival analyses to estimate the time untilfirst return to SSI and DI and explore the differences in returns by various personal and programmatic characteristics such as age, disability type, time on program, and SSA expectations regarding medical improvement. Overall, we estimate that about 30 percent ofSSI-only recipients whose eligibility ceases because of medical improvement return to the SSI program within 8 years. For DI-only worker beneficiaries whose eligibility ceases, we estimate that 20 percent will return to the DI program within 8 years.

Linking youth transition support services: results from two demonstration projects.

Many youths with disabilities, especially those receiving or potentially eligible for Social Security benefits, need assistance as they transition into adulthood. Upon completing secondary school, they face an abrupt end to provider-initiated public entitlement services. They often lack the knowledge and support to access and link fragmented adult support services. This article presents an overview of two projects in the Social Security Administration's Youth Transition Demonstration: California's Bridges to Youth Self-Sufficiency and Mississippi's Model Youth Transition Innovation. We report key outcomes and highlight the experience of one youth in each project who successfully completed the program.

Health-related unmet needs of supplemental security income youth after the age-18 redetermination.

OBJECTIVE: Young adults who exit Supplemental Security Income (SSI) after their age-18 eligibility redetermination may have greater health-related unmet needs than those who remain on SSI. The objective of this paper is to determine the magnitude and causes of this gap. DATA SOURCES: Uses the 2001-2002 National Survey of SSI Children and Families, a nationally representative survey of SSI youth. STUDY DESIGN: Self-reported unmet medical, dental, and prescription drug needs of 869 individuals ages 19-23 who have had their SSI eligibility redetermined are compared. In addition to raw differences in unmet needs, logistic regressions are used to determine the sources of these differences. PRINCIPAL FINDINGS: Young adults who exit SSI are almost twice as likely to have health-related unmet needs subsequent to their exit as those who remain on SSI after the age-18 redetermination. Access to care, particularly insurance coverage (either Medicaid or non-Medicaid), accounts for much of the difference between these two groups; measures of health status do not explain much of the difference. CONCLUSION: Policies addressing access to health care are likely to be more successful in addressing unmet needs than policies focused on disability-specific issues in health for youth who lose access to SSI after their age-18 redetermination.

Effect of postsecondary education on the economic status of persons who are deaf or hard of hearing.

This article examines the effect that postsecondary education has on earnings and the duration of time spent in the Social Security disability programs for young persons who are deaf or hard of hearing. Our hypothesis is that investments in postsecondary training increase the likelihood of employment for persons who are deaf or hard of hearing and thus reduce dependency on disability-related income support programs. A longitudinal data set based upon records from the National Technical Institute for the Deaf and Social Security administrative records is used for this analysis. We find that those who graduate, even those who graduate with vocational degrees, experience significant earnings benefits and reductions in the duration of time spent on federal disability programs when compared with those who do not graduate with a degree. This finding suggests that reductions in the duration of time spent on Social Security programs are not limited to those with the highest level of scholastic aptitude and that investments in post-secondary education can benefit a broad group of deaf and hard-of-hearing persons. In addition, the data show that individuals who attend college, but withdraw before graduation, fair no better economically than individuals who never attended college.

Occupations of SSI recipients who work.

This article uses the 2007 American Community Survey to estimate the occupational distribution of Supplemental Security Income (SSI) disability recipients aged 18-61 who work, and it compares their occupational distribution with that of working nonrecipients with and without disabilities. Based on models of occupational choice for working SSI recipients and nonrecipients, predicted occupational distributions are also estimated to understand what occupations are available to SSI recipients. Unlike the nonrecipient populations that are largely composed of sales- and office-based occupations (25 percent), the most common occupations of SSI recipients who work are in services (34 percent) and production, transportation, and material moving (30 percent), although sales- and office-based occupations are also common for SSI recipients (22 percent). The occupational distribution of working SSI recipients is also more concentrated than that of nonrecipient populations. Dissimilarity indices are used to compare the predicted and actual occupational distributions of the SSI recipient population and nonrecipient populations. More than one-half of the difference between the occupations of working SSI recipients and nonrecipients can be explained by demographic characteristics, human capital, and disability type. Additionally, nonemployed SSI recipients have similar predicted occupational distributions as currently employed SSI recipients. Given the estimated occupational distributions and the average earnings of individuals in the most common occupations of SSI recipients, the results suggest that more targeted vocational training may provide expanded opportunities for employment.

The age-18 redetermination and postredetermination participation in SSI.

Youth who initially become eligible for Supplemental Security Income under the definition of disability for children must have their eligibility redetermined upon attaining age 18, using the definition of disability for adults. Based on 8 years of administrative data from the Social Security Administration, this article provides statistics on the average age-18 redetermination outcomes over time by various individual characteristics. We find little change in the initial cessation rate for all groups over time, although there are large differences in initial cessation rates between disability type and other characteristics. The majority of redeterminations result in initial continuances. The article also examines data on individuals who successfully appeal an initial cessation determination and/or who successfully reapply for payments after losing eligibility. Many youth initially found not to meet the definition of disability for adults successfully appeal that decision, and a nontrivial number who lost eligibility successfully reapply at a later date.

How postsecondary education improves adult outcomes for Supplemental Security Income children with severe hearing impairments.

The rapid growth in the number of children participating in the Supplemental Security Income (SSI) program before the age of 18 has led policymakers to consider new methods of assisting children with disabilities in their transition from school to work. Postsecondary education represents one path that SSI children may take to acquire the skills necessary to enter employment and reduce dependency on the SSI disability program as adults. Yet little is known about SSI children's experience with postsecondary education, let alone their ability to increase their labor market earnings and reduce their time on SSI as adults in the long term. This lack of information on long-term outcomes is due in part to a lack of longitudinal data. This article uses a unique longitudinal data set to conduct a case study of SSI children who applied for postsecondary education at the National Technical Institute for the Deaf (NTID) within the Rochester Institute of Technology. The data set was created by merging NTID administrative data on the characteristics and experiences of its applicants to Social Security Administration (SSA) longitudinal data on earnings and program participation. We used this data file to estimate the likelihood that an SSI child will graduate from NTID relative to other hearing-impaired NTID applicants, and we estimated the influence of graduation from NTID on participation in the SSI adult program and later success in the labor market. The results of our analysis show that the percentage of NTID applicants who were SSI children increased over time, from a low of 10 percent in 1982 to more than 41 percent in 2000. However, the differences in the probability of graduation from NTID between deaf SSI children and deaf applicants who were not SSI children did not change accordingly. The probability of graduation for SSI children who applied to NTID was 13.5 percentage points lower than for those who were not SSI children. The estimated disparity indicates that targeting college retention programs toward SSI children may be an effective way to improve overall graduation rates. Our results also show that SSI children who graduated from NTID spent less time in the SSI adult program and had higher earnings than SSI children who did not gradu- ate. Compared with SSI children who were accepted to NTID but chose not to attend, SSI children who graduated from NTID left the SSI program 19 months earlier, were less likely to reenter the program, and at age 30 had increased their earnings by an estimated 49 percent. Our findings demonstrate that SSI children need not be relegated to a lifetime of SSI participation as adults, despite the poor overall labor market experience of this population since the creation of the SSI program in 1974.