Coalition for Whole Health Issues Public Comment on Social Security Administration Proposed Rule

WASHINGTON, Feb. 15 -- Ron Manderscheid and Paul Samuels, co-chairs of the Coalition for Whole Health, have issued a public comment on the Social Security Administration's proposed rule entitled "Rules Regarding the Frequency and Notice of Continuing Disability Reviews". The comment was written on Jan. 31, 2020, and posted on Feb. 13, 2020:

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The Coalition for Whole Health is a broad coalition of local, State, and national organizations in the mental health and substance use disorder (MH/SUD) prevention, treatment, and recovery communities. Although we appreciate the opportunity to comment on the proposed rule to increase the frequency of reviews to determine eligibility for disability benefits, we strongly oppose the proposed rule. We are extremely concerned that the proposed rule will make it more difficult for many people with mental health and substance use disorders to access the social security and supplemental security income benefits for which they are eligible. On behalf of our constituencies, we urge the Social Security Administration (SSA) to withdraw this proposed rule.

Social security and supplemental security income benefits are critical supports for people with disabilities, including many of those with mental health and substance use disorders. Continuing disability reviews (CDRs) already create a significant administrative burden for people with disabilities. Increasing the frequency of these reviews will impose additional stress and burden on many people with disabilities, their families, and the health and social service agencies that serve them. Should the proposed rule be implemented, it is likely that the increased administrative burden would prevent many people with MH/SUD from accessing critically important benefits for which they are eligible. In addition to the direct impact of the increased administrative burden on people with MH/SUD, requiring SSA to conduct additional review would also increase waiting time for all beneficiaries.

In the proposed rulemaking, the SSA fails to provide evidence that the proposed changes are necessary. The proposed rule doesn't include any estimate on the number of people who will lose benefits. Without this information, the public is unable to fully comprehend the scope of the potential changes and the impact on individuals and families. We urge SSA to withdraw this rule until the agency provides the public with a full analysis of the projected impact of implementing this rule.

In the midst of the nation's increasing suicide rate, and epidemic levels of overdose deaths, this proposed rule would put the benefits for thousands of people, including many of those with MH/ SUD, at further risk. Instead of making it more difficult for individuals to access these crucial supports, SSA should consider policy changes to better support beneficiaries with mental health and substance use disorders. As one example, under current law a person is not eligible to receive SSI or SSDI benefits if his or her addiction is a contributing factor to the determination of disability. Since this change became effective in 1997, hundreds of thousands of individuals with substance use disorders have become ineligible for monthly income and have lost a pathway to critically important Medicare or Medicaid coverage. In the years since Congress terminated SSI/DI benefits for people whose substance use disorders contributed to their disabilities, science and policymakers, including Congress, have all recognized that SUD are preventable, treatable chronic diseases. In 2008 Congress passed the Wellstone/Domenici Mental Health Parity and Addiction Equity Act and in 2010 the Affordable Care Act identified SUD services as essential health benefits. While this progress towards the understanding of SUD as a chronic disease has not yet resulted in changes to the legal restraints under which the SSA must operate when determining eligibility for these programs, the SSA should utilize its flexibility in this area to consider what is in the best interest of SSI/DI applicants and beneficiaries.

The system to access social security benefits is already too complicated. We urge the administration not to make the system even more complex for people with disabilities, including those with mental health and substance use disorders. We oppose SSA's proposed changes and urge the agency to withdraw the rule.

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The proposed rule can be viewed at: https://www.regulations.gov/document?D=SSA-2018-0026-0001

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