Journal of Vocational Rehabilitation - Volume 30, issue 3

Authors: Davies, Paul S. | Rupp, Kalman | Wittenburg, David

Article Type: Research Article

Abstract: Youth who receive cash benefits from the Supplemental Security Income (SSI) program, the largest federal program that provides cash payments to low-income youth with severe disabilities and their families, face several challenges in transitioning into adulthood. From a human capital development perspective, the disabilities and health problems during childhood and early adulthood as well as the family environment form important inputs that will likely influence long-term adult outcomes. This paper provides a review of some …of the challenges these youth face in transitioning into adulthood using a life-cycle framework and presents descriptive statistics on their challenges and outcomes into early adulthood. Our summary illustrates the challenges that SSI youth face as they make the transition to adulthood and shows how the long-term employment and program outcomes of this population have changed over time. The findings provide a broader framework for the remaining five papers in this issue and underscore the need for rigorous testing of promising interventions and a carefully balanced mix of statistical and econometric analyses based on longitudinal data sources with a long time horizon. Show more

Keywords: Supplemental Security Income, SSI, transition, youth, disabilities, Social Security, SSA, human capital development, evaluation, random assignment

DOI: 10.3233/JVR-2009-0459

Citation: Journal of Vocational Rehabilitation, vol. 30, no. 3, pp. 133-151, 2009

Authors: Rupp, Kalman | Ressler, Steve

Article Type: Research Article

Abstract: Parental and family inputs are particularly important for children with disabilities receiving benefits from the Supplemental Security Income (SSI) program. These children often need disability or health-related care, and nonfamily sources provide only limited access. This is the first study to analyze family and nonfamily caregiving for these children with disabilities based on nationally representative quantitative data from the National Survey of SSI Children and Families (NSCF), a survey focusing on SSI recipient …children with disabilities. The data suggests substantial variability in the need for caregiving among children on SSI. We find that there is also substantial variation in family inputs related to parental education, living arrangements, the presence of other children of preschool age and other factors that affect the quality and quantity of caregiving. Our analysis confirms that family caregiving is much more substantial for these children than nonfamily caregiving, and that caregiving from both sources is associated with various indicators of the nature and extent of disabilities. We find some – but weaker – evidence of an association between the child's disabilities and parental employment. Overall, while there is some substitution between parental employment and caregiving there appears to be a substantial net burden on the family arising from the child's needs for caregiving. We also find that there are significant predictors of family caregiving and parental employment that are unrelated to the child's disabilities. Most of these show opposite relationships to caregiving and parental employment – negative for one, positive for the other or vice versa. However, better parental education substantially increases the odds of both caregiving and parental employment. Parental disability sharply reduces the odds of parental employment and somewhat increases the odds of reported family caregiving. Overall, the challenges are especially substantial for single mothers who cannot share the extra burden of raising a child with severe disabilities with a spouse. Show more

Keywords: Children, caregiving, disabilities, health status, health care utilization, family, labor force participation, home production, parental employment, SSI, SSA

DOI: 10.3233/JVR-2009-0460

Citation: Journal of Vocational Rehabilitation, vol. 30, no. 3, pp. 153-175, 2009

Authors: DeCesaro, Anne | Hemmeter, Jeffrey

Article Type: Research Article

Abstract: Children with disabilities may have substantial health care needs due to their physical, mental, or emotional impairments. For many, taking care of these needs is critical to prevent further deterioration in their health and to promote the successful transition to life as an adult. In this paper we examine the unmet health care needs and medical out-of-pocket (MOOP) expenses for a subgroup of children with disabilities – those collecting Supplemental Security Income (SSI) payments. Using the …National Survey of SSI Children and Families (NSCF), we find that: (1) only 9 percent of SSI children report delaying or going without health care in the year before the interview and 24 percent report MOOP expenses; (2) Medicaid insurance reduces both the incidence of unmet needs and MOOP expenses for SSI children; (3) those with an unmet need have higher MOOP expenses and receive lower SSI payments; and (4) the vast majority of MOOP expenses are substantially less than SSI payments for most child recipients. In total, this research shows fairly good coverage of the medical needs and expenses of SSI youth before they transition to adulthood. Show more

Keywords: Children, Supplemental Security Income, medical out-of-pocket expenditures, unmet needs

DOI: 10.3233/JVR-2009-0461

Citation: Journal of Vocational Rehabilitation, vol. 30, no. 3, pp. 177-199, 2009

Authors: Hemmeter, Jeffrey | Kauff, Jacqueline | Wittenburg, David

Article Type: Research Article

Abstract: This paper provides an analysis of the dynamics of the transition of child Supplemental Security Income (SSI) recipients into adulthood using linked 2001–2002 National Survey of SSI Children and Families (NSCF) survey and Social Security Administration (SSA) administrative data. We examine the interaction of impairment status, reported health needs, and other self-reported indicators of human capital on SSI program and employment outcomes after age 18. Our primary objective is to examine the differences in …pre-age-18 individual characteristics across subgroups of recipients by impairment status and determine whether these differences influence post-age-18 SSI participation and employment outcomes. We find that after controlling for measures of disability severity, duration, and human capital, youth with behavioral disorders and mental disorders other than mental retardation are much less likely to receive SSI at age 19. The findings also suggest that non-health factors, particularly education, employment, and social indicators, play an important role in the probability of a child SSI recipient being on adult SSI after age 18. Our findings indicate that, while some youth appear to be making a successful transition from child SSI benefits to adult benefits or other activities (off of SSI), others appear to have limited prospects for long-term self-sufficiency. A major concern is that some youth no longer on SSI after age 18, particularly those with behavioral disorders and mental disorders other than mental retardation, may not have been sufficiently prepared for life without SSI. Show more

Keywords: Supplemental Security Income, SSI, transition, youth, disabilities, social security, SSA, age 18 redetermination, National Survey of SSI Children and Families (NSCF)

DOI: 10.3233/JVR-2009-0462

Citation: Journal of Vocational Rehabilitation, vol. 30, no. 3, pp. 201-221, 2009

Authors: Fraker, Thomas | Rangarajan, Anu

Article Type: Research Article

Abstract: The Social Security Administration (SSA) is funding Youth Transition Demonstration (YTD) projects in multiple sites across the country. These projects seek to improve transitions to adulthood for youth whose disabilities are so severe that they either are currently receiving Supplemental Security Income (SSI) or Social Security disability benefits, or are at high risk of receiving them in the future. Youth participating in the projects are eligible for more generous earnings disregards and other incentives under SSA …waivers of certain disability program rules. In addition, the projects provide them with individualized employment and benefits planning services. The waivers and services are designed to increase the likelihood that the YTD participants will become employed, earn enough to reduce their disability benefits, and eventually leave the disability rolls. Under contract with SSA, Mathematica Policy Research, Inc. is conducting a rigorous random assignment evaluation of six of the demonstration projects. Approximately 880 youth at each site who agree to participate in the evaluation are being randomly assigned to treatment or control groups. The treatment group members are eligible for the SSA waivers and YTD services; the control group members are eligible for neither, but they can receive standard disability program work incentives and whatever alternative services may be available in their communities. Mathematica is gathering data on the treatment and control group members for up to four years following random assignment through surveys and SSA administrative records. By comparing mean values of outcomes such as earnings and disability benefit amounts for the treatment and control groups, the evaluation will assess whether the YTD projects are successful at improving transitions to adulthood. Findings from the evaluation will be presented in site-specific interim reports in 2010–2012 and in a comprehensive final report in 2014. Show more

Keywords: Transition, youth, disabilities, Social Security, SSA, demonstration, intervention, evaluation, random assignment, experimental

DOI: 10.3233/JVR-2009-0463

Citation: Journal of Vocational Rehabilitation, vol. 30, no. 3, pp. 223-240, 2009

Authors: Luecking, Richard G. | Wittenburg, David

Article Type: Research Article

Abstract: Post-school employment rates for youth with significant disabilities remain intractably low. An important policy concern is whether youth who receive disability cash benefits from the Social Security Administration (SSA) are obtaining the necessary supports to make a successful transition to adult life. The SSA initiated the Youth Transition Demonstration (YTD) projects in an attempt to develop services and supports to assist youth in making a successful transition into adulthood. This article provides a detailed description of …the intervention components for the YTD projects and presents three case descriptions to illustrate how youth can potentially benefit from these services. The selected cases in this paper illustrate the potential for youth with disabilities to leverage project services and move into employment. Show more

Keywords: Transition, youth, disabilities, Social Security, SSA, demonstration, intervention, evaluation

DOI: 10.3233/JVR-2009-0464

Citation: Journal of Vocational Rehabilitation, vol. 30, no. 3, pp. 241-251, 2009