Apr 2, 2011
Apr 1, 2011
NCSSMA Newsletter
Proposed Psychiatric Listings Changes Remain Controversial
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children, which can vary, were last modified in 1986 and 1990, respectively, and they are respectively based on the now outdated DSM-III and DSM-III-R [Diagnostic and Statistical Manual III Edition, Revised].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.”
Mar 31, 2011
Social Security Highlights Problems Caused By State Furloughs
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
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.
Mar 30, 2011
Deal?
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
Meanwhile, Boehner, in talking about budget negotiations, vowed that “We’re gonna kick their ass.”