National Alliance on Mental Illness
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Employment and Income Supports
The unemployment rate of persons with severe mental illnesses remains extraordinarily high – up to 80-90%, according to some estimates. Persons with severe mental illnesses are one of the largest populations on the federal disability rolls. They are more likely to enter the disability rolls at a younger age and remain on them longer than persons with other types of disabilities. To address this issue Congress in recent years has passed several changes to federal disability income and employment programs. Among these are the new Ticket-to-Work and Work Incentives Improvement Act of 1999 (PL 106-170) - amendments modifying the Rehabilitation Act of 1973 and the Workforce Investment Act. Despite these efforts, barriers to employment remain.
Disincentives to Work Still Dominate Social Security’s Disability Programs
In 1999 Congress passed the Ticket-to-Work and Work Incentives Improvement Act (TWWIIA), the most sweeping change in federal disability policy since the Americans with Disabilities Act. TWWIIA created the Ticket-to-Work Program at the Social Security Administration (SSA), created three new state Medicaid options for people with disabilities, extended free Medicare Part A coverage for an additional six years, and made several other changes that will reduce barriers to employment. However, despite this new law, several barriers remain that will thwart the progress made under the Ticket-to-Work program. Congress and the Bush Administration need to continue pressing SSA to fully and immediately implement the Employment Support Representative Program that was a part of the Ticket-to-Work legislation.
Vocational Rehabilitation Unresponsive to Needs of Individuals With Mental Illness
Congress is currently considering changes to the Department of Education’s State-Federal Vocational Rehabilitation (VR) program as part of legislation reauthorizing the Workforce Investment Act (WIA). Over the years, the VR program has had difficulty getting services to persons with mental illnesses. In part, a lack of funding is the root of the problem. Many state VR agencies are under an "order of selection" meaning that there is not enough funding to serve all people who are eligible. The Order of Selection is designed to ensure that when funding falls short, people with the most severe disabilities are served. Unfortunately, some states put mental illness far down on the Order of Selection list of disabilities. NAMI supports the following changes to the VR program to promote more effective services for persons with mental illness:
Department of Labor Workforce Programs – Accessing the Mainstream System
Since 1997, the Workforce Investment Act (WIA) has required that the Department of Labor’s (DoL)Workforce programs address the needs of persons with disabilities. Most of the employment services offered by the DoL are made available through "One-Stop Shop" state employment offices. Unfortunately, these offices and their staffs are not always aware of their mission and in some cases staff refer people with disabilities to the state VR program - a violation of federal law. The DoL Office of Disability Employment Policy (ODEP) is tasked with developing and implementing policies and programs for people with disabilities at DoL and in the states. WIA is up for reauthorization in 2004 (HR 1261), presenting an opportunity for Congress to improve the performance of the One-Stop system.
Reforms Needed for SSA’s Representative Payee Program
Many SSI and SSDI recipients with mental illness receive their monthly cash benefits through Representative Payees that assist them in managing their benefits. For nearly five years, Congress has been working on legislation to reform the Representative Payee program to protect the interests of vulnerable beneficiaries in cases of fraud and abuse perpetrated by for-profit and institutional Representative Payees. Among other reforms, this legislation would make it easier for SSI and SSDI beneficiaries who are victims of fraud and abuse to receive restitution of back benefits. In 2003, the House passed HR 743, the Social Security Protection Act. A compromise version of this bill cleared the Senate in December and now must come back to the House before being sent to the President. NAMI urges the House to expedite passage of HR 743 early in 2004.