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4 State Variation in the SSI Program for Children
Pages 91-104

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From page 91...
... State-level analysis is necessary to determine whether the national trends are representative of all states, or whether trends in individual states have different trends with potentially different causes. This chapter reviews the state variation in the rates of reported mental health disorders; the variation in the numbers of determinations, in the numbers of recipients, and in the allowance rates across states in 2013; and the changes in the number of determinations between states from 2004 to 2013.
From page 92...
... . State-to-state variations in reported prevalence exist for all types of health conditions as well as for overall child health status.
From page 93...
... However, even after controlling for the number of children in low-income households within each state, in FY 2013 the rate of SSI child initial determinations from a state's population of children in low-income households varied significantly. Using children under 18 in families with income less than 200 percent of the federal poverty level (FPL)
From page 94...
... MISSOURI NEW JERSEY WISCONSIN MASSACHUSETTS SOUTH CAROLINA MARYLAND OKLAHOMA ARIZONA WASHINGTON MINNESOTA CONNECTICUT IOWA WEST VIRGINIA OREGON NEW MEXICO COLORADO KANSAS NEVADA IDAHO MAINE DELAWARE RHODE ISLAND DC UTAH NEBRASKA NEW HAMPSHIRE MONTANA SOUTH DAKOTA HAWAII Number of Denials VERMONT NORTH DAKOTA Number of Allowances ALASKA WYOMING FIGURE 4-1  Number of determinations, broken down by allowances and denials, for 10 selected mental disorders, per state, for 94
From page 95...
... . NOTE: The Current Population Survey table creator was used to generate numbers of children below 200 percent of the federal poverty level.
From page 96...
... According to an SSA analysis of 1990s program data for the SSI adult claimants, about half the variation in the allowance rate from the national mean could be explained by factors external to the SSA, including application rates, economic factors such as the poverty rate, disability prevalence rates, demographic factors, and health indicators such as insurance coverage (Strand, 2002)
From page 97...
... TEXAS NEVADA DC IOWA WISCONSIN NEBRASKA OKLAHOMA WEST VIRGINIA MINNESOTA ARKANSAS MARYLAND VIRGINIA KENTUCKY NEW JERSEY ARIZONA FLORIDA MISSOURI RHODE ISLAND CONNECTICUT ILLINOIS MICHIGAN INDIANA OHIO ALABAMA TENNESSEE NORTH CAROLINA MISSISSIPPI LOUISIANA Allowance Rate DELAWARE SOUTH CAROLINA GEORGIA Mean Median FIGURE 4-4  Child SSI initial allowance rate for 10 selected mental impairments, by disability determination service: fiscal year 97
From page 98...
... been done of the SSI child allowance rates. As illustrated by Figure 4-5, another potential factor could be related to geography: A cluster of states with low determination rates appears in the Southeast, and states with high allowance rates appear to cluster in the Northwest and West.
From page 99...
... MARYLAND DELAWARE OHIO MICHIGAN NEW HAMPSHIRE SOUTH CAROLINA MISSOURI NEW JERSEY INDIANA KANSAS NORTH CAROLINA TENNESSEE OREGON CONNECTICUT ILLINOIS MINNESOTA SOUTH DAKOTA IOWA IDAHO WASHINGTON NEW MEXICO CALIFORNIA GEORGIA MONTANA NEBRASKA WYOMING UTAH ALASKA NEVADA ARIZONA NORTH DAKOTA COLORADO HAWAII Mean Median FIGURE 4-6  Percentages of children in low-income households in each state who are recipients of SSI benefits for the 10 selected 99
From page 100...
... FIGURE 4-8  Percentages of children in low-income households who are recipients of SSI benefits for the selected mental disorders, by state, for 2013.
From page 101...
... SUMMARY OF STATE VARIATIONS IN 2013 The state-to-state variation in the numbers and rates of children being determined for, being allowed, and receiving SSI disability benefits for the selected mental disorders is a significant and concerning observation. A number of factors could contribute to these disparities, including stateto-state variation in the rates of disability caused by the selected mental disorders; however, the degree of between-state variation observed in the SSI program cannot be reasonably explained solely, or even in substantial part, by a variation in the rates of disabilities and mental disorders between
From page 102...
... Parameters used to generate the numbers include get count of: persons in poverty universe (everyone except unrelated individuals under 15) ; years: 2004 to 2013; Census 2010 weights; row variable: age; column variable: income-to-poverty ratio; and customized formatting: income-to-poverty ratio percent cutoff of 200 percent.
From page 103...
... Other factors that likely contribute to the observed variation include state-specific benefit policies and state-specific approaches to the implementation of public benefit programs, such as substituting SSI benefits (which are federal dollars) for Temporary Assistance for Needy Families benefits (which use state dollars)
From page 104...
... Although studies have shown state variations in prevalence rates for children's mental health disorders, these preva lence variations cannot fully explain differences in state allowances or recipients. REFERENCES Fulton, B


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