Proposed Psychiatric Listings Changes Remain Controversial

From UBM Medica Psychiatric Times (emphasis added):

Mental health groups are fighting the Social Security Administration (SSA) over the agency’s proposed changes to disability requirements for mental disorders. The requirements for adults and children, which can vary, were last modified in 1986 and 1990, respectively, and they are respectively based on the now outdated DSM-III and DSM-III-R [Diagnostic and Statistical Manual III Edition, Revised].

There have been differences of opinion, too, with the Mental Health Liaison Group (MHLG), which is composed of advocacy groups and professionals—physicians and non-physicians—who treat people with psychiatric disorders. The MHLG could not agree on a common response to the changes the SSA announced last August in a proposed rule. The American Psychiatric Association (APA) argued against use of the Psychiatric Review Technique by adjudicators to determine functional shortcomings because of mental problems. Some members of the MHLG supported use of that. ...

Much of the controversy stemming from the August proposed rule deals with paragraph B, which contains 4 mental abilities. Under the proposed rule, an individual could show a marked limitation of 2 abilities or an extreme limitation of 1 ability to qualify as mentally disabled. These are the abilities to understand, remember, and apply information; interact with others; concentrate, persist, and maintain pace; and manage oneself.

In what was considered a major policy change, the proposed rule stated that SSA adjudicators could use standardized tests to determine paragraph B limitations for adults. Tests were already approved for use in child determinations. However, the SSA did not specify what tests it had in mind, and mental health groups uniformly complained that no such tests existed. Mark Lassiter, press officer at the SSA, asked for detailed e-mailed questions on the testing issue, but he did not respond to them. ...

The APA, a longtime member of the MHLG, assailed continued use of the Psychiatric Review Technique. “The APA finds this scale to be unanchored, allowing wide latitude for subjective interpretation of what qualifies as a ‘marked’ or ‘extreme’ level of functional impairment,” said James Scully, MD, who is CEO and medical director of the APA. “Without more specific guidance for assigning functional limitations on this scale, which is not currently contained in the proposed rule, we believe use of the five-point scale could bring a false level of precision to determining functional impairment.”

Social Security Highlights Problems Caused By State Furloughs

From Federal Computer Week:

The Social Security Administration has started an interactive online map to highlight the 19 states that have lost $65 million in federal funds collectively by furloughing workers whose salaries are paid by the SSA.

Under a joint federal-state funding relationship, SSA pays the full salaries of state employees who do initial processing of disability claims under the federal Disability Determination Services program.

As a budget-reduction measure, governors in recent months have adopted furloughs for their state workforces. The mandatory time off without pay included the disability-processing workers in 19 states, despite cautions from SSA not to include them.

Wimping Out

From The Hill:

House Budget Committee Chairman Paul Ryan (R-Wis.) will largely give Social Security a pass in his highly anticipated budget while proposing a significant overhaul of Medicare and Medicaid, according to sources briefed on the plan.

The 2012 budget resolution, which committee Republicans are still finalizing, is scheduled to be unveiled on Tuesday. It will not back specific benefit cuts to Social Security or suggest raising the retirement age, sources said. ...

On Medicare, the budget will propose a modified version of what has become known as the Ryan-Rivlin voucher proposal, named after Ryan and former Office of Management and Budget Director Alice Rivlin.

Under the Ryan-Rivlin plan, citizens who turn 65 in 2021 or later would not enroll in the current Medicare program but instead would receive a voucher to buy private health insurance.

Come on, Republicans. You keep promising the Tea Party that you'll "reform" Social Security, the government program for which you have the deepest, most longstanding hatred. Here's your chance to actually propose something specific and you wimp out. That's not the red meat that will get your base excited.

Deal?

From George Stephanopoulos of ABC News:

Sources tell me that budget negotiators on Capitol Hill have tentatively agreed on a deal that would involve at least $33 billion in spending cuts from this year’s budget. That’s $23 billion dollars more than Democrats have previously agreed to in short-term continuing resolutions, and $28 billion less than Republicans previously passed in the House. ...

The deal could still fall apart over the composition of the cuts, or policy “riders” previously passed by the House.

We're Gonna Kick Their Ass

The Senate Majority Leader, Harry Reid, went to the Senate floor today to say that House Speaker John Boehner has come back to negotiations with him over the budget impasse. Reid implied that the problem has not been Boehner but far right Republicans.

Meanwhile, Boehner, in talking about budget negotiations, vowed that “We’re gonna kick their ass.”

AFGE Plans Rallies On Budget

The American Federation of Government Employees (AFGE), the union the represents most Social Security employees is planning a series of rallies for April 6 to protest plans to cut Social Security's administrative budget. Click on the attached flyer to see it full size.

Where Do We Stand?

There is lots of news on the budget front but where it leaves us is most unclear.

From the Washington Post:

Having difficulty finding consensus within their own ranks, House Republican leaders have begun courting moderate Democrats on several key fiscal issues, including a deal to avoid a government shutdown at the end of next week.

The basic outline would involve more than $30 billion in cuts for the 2011 spending package, well short of the $61 billion initially demanded by freshman Republicans and other conservatives, according to senior aides in both parties. Such a deal probably would be acceptable to Senate leaders and President Obama as long as the House didn’t impose funding restrictions on certain social and regulatory programs supported by Democrats, Senate and administration aides said.

The fact that Republican leaders have initiated talks with some Democrats shows some division within House Republicans just two months after taking over the House.

From The Hill:

Conservatives are turning to a new message in the escalating budget fight: A government shutdown is not actually a shutdown.

It’s a “slowdown,” according to the new refrain from Tea Party leader Rep. Michele Bachmann (R-Minn.). Or as House Majority Leader Eric Cantor (R-Va.) put it on Monday, the stalemate over spending could cause the government “to partially shut down.”

From the New York Times:

The most visible element of the budget fight in Congress is the one over the scale of spending cuts this year. But increasingly, other deeply contentious policy issues that House Republicans insist must be addressed in any budget deal are as much of a stumbling block as the final dollar figure.

They include efforts to take away money to carry out the new health care law, to limit regulation by the Environmental Protection Agency and to cut federal financing for organizations like Planned Parenthood that provide abortions. ...

While two sides can ultimately agree on dollars, coming together on ideologically polarizing policy matters is far more difficult: Some things you are either for or against.

From the National Journal:

In a purely symbolic move in the ongoing budget and spending cut negotiations, House Republicans plan to pass on Friday a measure called the “Prevention of a Government Shutdown Act. Passage will do nothing to avoid a government shutdown ...

According to TPM, the Prevention of a Government Shutdown Act "would deem controversial Republican spending cut legislation the law of the land if Congress blows past an April 6 deadline."

From the Associated Press:

Democrats indicated Tuesday they may be willing to accept Republican-backed curbs on the Environmental Protection Agency and other federal regulators as part of an overall deal on spending cuts, a rare hint of compromise in private negotiations marked by public rancor.

Santorum Says That Social Security's Problems Are Caused By Abortion

From the Los Angeles Times:

Social Security's future insolvency problem is caused in part by abortion, former U.S. Sen. Rick Santorum said Tuesday.

The presidential aspirant and devout social conservative told a New Hampshire radio station on Tuesday that the cash shortfalls facing the 76-year-old Social Security system could be lessened if not for the country's "abortion culture." He was responding to a caller who made similar comments.

"Well, a third of all the young people in America are not in America today because of abortion," he said. "We are depopulating this country, and we're seeing the birth rate is below replacement rate for the first time in history."