Thousands of Addicts, Alcoholics to Lose Aid

California counties are bracing for the first financial hit from the welfare revolution, when thousands of Social Security recipients will be forced off the rolls in January by a new law that strips drug addicts and alcoholics of federal benefits.

California’s counties--the safety net of last resort--are expecting to inherit the burden of providing for about 33,000 people ejected from the Social Security system. Local programs like general relief, which furnishes aid to poor adults, will be flooded with new requests for assistance.

“We’re going to be facing a crisis come January,” said Margaret Pena, legislative representative for the California State Assn. of Counties.

Of all the states, California has the most residents affected by the new federal law. And of all this state’s counties, Los Angeles has the most people affected.

Many officials and advocates for the poor worry that the social impact of the new law may overshadow its financial consequences.

They see the potential for a jump in crime once many drug addicts and alcoholics are no longer required to enroll in treatment programs as a condition of receiving benefits. Public health officials fear an increase in communicable diseases as drug addicts and alcoholics--already vulnerable to illness--lose much of their access to health care.

The law, passed by Congress in March, has generally escaped notice because it was approved as separate legislation, not part of the massive welfare package that overhauls the nation’s social service system.

Nevertheless, the law touches one of the deepest nerves in the debate over government’s responsibility to the poor: Should society help those whose inability to earn a living is arguably a consequence of their own bad judgment? Or should addiction be regarded like any other disability?

The measure overturns a provision of federal law just a decade old, which extended Supplemental Security Income benefits to those disabled by drug and alcohol addiction.

Under the new law, anyone receiving SSI benefits solely because of an addiction no longer qualifies after Wednesday for federal assistance.

In California, that means that recipients not only lose SSI but benefits from Medi-Cal, the state and federal program that provides medical care for the poor.

The new law swept through Congress with little debate and scant opposition, fueled by revelations that many recipients were using their benefits to support drug and alcohol habits. It was introduced as an amendment to a bill that increased Social Security benefits for working retirees and was signed into law by President Clinton shortly thereafter.

To supporters, the new law was a chance to clean up a program that had become rife with fraud and abuse.

“We’re finally waking up to the fact that deadbeats work the system to a certain extent,” said Rep. Bill Thomas (R-Bakersfield), “and that we want to make sure that if we’re going to spend this money, we’re going to spend it for people who really need it.”

Advocates for the poor and disabled complained that the measure passed so hastily that there was no time to marshal opposition.

“It’s one thing to stand up for a population group for which there is widespread public sympathy, but to stand up for your local drug addict--that’s just something that you don’t find many politicians doing,” said Gerald McIntyre, directing attorney of the Los Angeles National Senior Citizens Law Center.

Immediately after Clinton signed the law, the Social Security Administration stopped accepting new applications for benefits from those with drug and alcohol problems. Those already receiving SSI were allowed until year’s end to find work or other support or to file an appeal asking that benefits be continued because they have other disabilities--which many addicts have.

Social Security officials said 44,083 people in California--21% of the national total--were initially sent termination notices. Of those, 29,883 have filed appeals, but only 11,000 have been granted, said Pam Reim, a regional deputy director of public affairs for the Social Security Administration.

Los Angeles County has 5,864 of those terminated, about 13% of the statewide total. In surrounding counties, the impact was far less. Only 404 Orange County residents and only 697 people in Ventura County received termination notices.

Most of the about 33,000 statewide who don’t qualify for continued benefits received their final checks earlier this month.

The controversy that sparked the elimination of drug addicts and alcoholics from SSI had been simmering for years. It centered on both the skyrocketing costs of the SSI program and the philosophical debate over addiction.

“We finally came to the conclusion that this is self-induced,” said Thomas, an influential member of the House Ways and Means Committee, “and why should someone simply because of that get disability payments?”

SSI was added to the Social Security Act in 1972 and took effect in 1974 as a program that would provide cash assistance to low-income aged, blind and disabled people. Unlike Social Security, it was funded out of general revenues rather than payroll taxes; recipients did not have to pay into the program to be eligible for benefits.

Over the years, SSI was gradually expanded to include disabled children; dependents of those with disabilities; and, in 1986, those who were unable to work because of drug and alcohol abuse.

Accompanying the expansion were escalating costs. In 1988 the federal government paid $10.7 billion to support 4.5 million recipients. By 1993, the number of recipients had increased by a third and the cost had doubled. Clinton’s 1996 budget estimated that the annual cost of the program would grow another 60%, to more than $30 billion, by 2000.

The heightened concern over the costs of SSI coincided with a series of media reports about addicts who were using SSI benefits to purchase drugs or alcohol.

The Bakersfield Californian drew attention to the story of one heroin addict who had more than $5,000 in cash when she was arrested in 1992. Police discovered the cash had come from Social Security: It was part of an $8,585 lump-sum payment to reimburse the woman for delays in getting her application for monthly benefits approved.

In response, Congress passed reforms in 1994 requiring tougher scrutiny of “representative payees”--the person or organization designated to receive an addict’s benefit check and then dispense the funds. Lawmakers mandated that addicts couldn’t get benefits unless they were in a treatment program. And they limited the length of time that addicts could receive payments to 36 months.

Those reforms had only been in effect a year, however, when Congress decided to cut drug addicts and alcoholics from the SSI program altogether.

“What we were discovering was that in making these disability payments, not only did we not create the discipline necessary for recipients to break away from [addiction], but what we were doing was in essence being enablers by providing them funds to continue it,” Thomas said.

Rob Peters, project director for Social Security issues at Mental Health Advocacy in Los Angeles, argued that Congress never really gave the reforms a chance to work, and may have created unanticipated problems by terminating all benefits.

He predicted that because addicts will no longer be required to enroll in a treatment program and will no longer have Medi-Cal to help pay for it, many of the more severely addicted will fall back into their old drug or alcohol habits. Most, Peters said, will apply for county general relief, whose maximum benefit for single adults in Los Angeles County is $212 a month, compared with the average SSI benefit of $487.86.

“They’re going to steal and that kind of thing, because you’re talking about very hard-core addiction here,” Peters said. “And that’s very difficult to control.”

Thomas disagreed, saying that Congress believed there were sufficient low-cost drug and alcohol rehabilitation programs to serve those who will lose SSI benefits.

Nevertheless, the specter of drug addicts losing treatment and Medi-Cal is something that has worried health officials throughout the state, said Tom Peters, president of the County Health Executives Assn. of California and health and human services director for Marin County.

“The irony of this particular bill is that it takes by definition the people who are the most dysfunctional and the most disruptive in many communities and leaves them with the least avenues of treatment,” he said.

Of particular concern, he said, is the potential for the spread of sexually transmitted diseases and illnesses such as AIDS that can be transmitted through dirty needles.

Under the previous regulations that tied SSI to enrollment in treatment programs, Los Angeles and some other counties have provided counseling services for addicts to help them maintain their benefits, said Mary Robertson, a human services administrator in Los Angeles County’s Department of Public Social Services.

Robertson said it has been in the county’s financial interest to keep as many as possible on the Social Security rolls. For every 586 who apply for general relief, she said, the cost to the county of providing benefits for the remainder of the fiscal year will be $700,000.

Because California supplements SSI benefits, state government will realize substantial savings as a result of the new law. Out of the $487 average monthly benefit for the disabled, for example, the state contributes $173. California’s counties tried without success during the last legislative session to get some of that savings passed to local government, lobbyist Pena said.

NEXT: The faces behind the story.

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Less Benefits

The cash benefit paid to families on welfare has steadily declined since 1991. Graph below is a typical grant for a family of three.

7/’89: $694

9/’91: $663

10/’92: $633

12/’92: $624

9/’93: $607

6/’96: $594

1/’97: $565

1/’97*: $538

* Applies to recipients living in rural counties.

Source: California Department of Social Services