the states. Third, the states should be required to provide emergency assistance to all SSI recipients whose check is lost, stolen, undelivered or issued in an improper amount.

The first suggested modification, the deletion of the financial emergency provision, is necessary because when an SSI check does not arrive the recipient is, in the vast majority of cases, per se facing a financial emergency and should not be required to prove anything more than his check did not arrive or that it was in an improper amount. By requiring a showing of financial emergency the local welfare department may end up determining, for example, that an individual who receives a $50.00 check, instead of a $167.80 check, does not face a financial emergency. The welfare department could perhaps also view the fact that the recipient has a relative somewhere who could theoretically sustain the recipient while he waits for a replacement check from Social Security as negating a financial emergency.

In either of these cases the SSI recipient is in fact facing a financial emergency by any reasonable definition and should be provided assistance. Under the bill, however, he may be denied such assistance at the whim of the local welfare agency.

In any case, requiring the welfare department to make a determination that financial emergency exists will necessarily delay the actual issuance of an emergency check while forms are filled out, allegations are verified and the investigationn regarding financial emergency is completed. This type of decision-making runs counter to the very purposes of the bill, that is, to provide a swift and efficient procedure for providing emergency assistance.

Thus, since most SSI recipients face, by definition, a financial emergency when their check does not arrive or is less than anticipated, the bill should provide for emergency replacement in any case where their check is lost, stolen, undelivered or issued in an improper amount, without a further, time consuming determination of financial emergency.

The second and third suggested modifications of Section 8 are interrelated and are both aimed at assuring that emergency payments will actually be made. The bill as written does not require the states to participate in the emergency assistance program nor does it require the states to actually provide emergency assistance to SSI recipients. All the bill calls for now is reimbursement to the states when they in fact provide emergency assistance.

We suggest that the bill be modified to provide that the agreement entered into between the Secretary and the state, referred to in subsection (h) (4) of Section 8, shall require the state to establish a procedure to assure the prompt provision of emergency replacement to all SSI recipients whose SSI check is lost, stolen, undelivered or issued in an improper amount. This modification would require states to actually provide the needed assistance. In addition, we suggest that the entire emergency replacement be made mandatory on the states. This could easily be accomplished by making the state's receipt of funds under another benefit program, such as Titles IV, IXX or XX of the Social Security Act, dependent on their participation in the emergency replacement provisions of the bill.

The emergency replacement of checks provided for in Section 8 of the bill is an extremely important provision from the recipient's perspective and the states should be required to provide this assistance. The changes we have suggested would assure that emergency replacement will actually be made by the states in a swift and orderly manner.

AN ALTERNATIVE APPROACH FOR EMERGENCY REPLACEMENT OF CHECKS Providing emergency replacement for lost, stolen or undelivered SSI checks through the states will necessarily create some problems. Sending elderly, blind and disabled individuals from office to office will impose difficulties on the recipients. In addition, the use of two systems, i.e. the local welfare department and the Social Security Administration, will necessarily increase the risk of further errors either in withholding benefits or issuing the proper amounts.

Hence, it seems greatly preferable to have the emergency replacement of loct, stolen or undelivered checks be issued directly by the Social Security Administration. This would reduce the risk of further errors and would permit elderly, blind and disabled recipients to straighten out their problems all at one office. Thus it would be far superior from the recipient's perspec

tive to have emergency assistance issued directly by the Social Security Administration and we hope that achievement of such a system will be a future priority both of the Social Security Administration and the Congress.

ELIGIBILITY OF INDIVIDUALS IN CERTAIN MEDICAL INSTITUTIONS

Section 11 of the bill which deals with the eligibility of individuals in certain medical institutions provides basically that individual SSI recipients who enter an extended care facility, nursing home or intermediate care facility shall continue to receive the full SSI benefit amount until the fourth consecutive month following their institutionalization.

This bill obviously goes a long way towards solving the problems of individuals who enter an institution for a relatively short period of time, recuperate and then leave the institution. While they are briefly institutionalized their expenses of maintaining their home and their economic life outside the institution generally continue. Circumstances may vary for individuals institutionalized for a couple of months and then permitted to return home. It is of utmost importance that he or she have a home to return to. By continuing their SSI benefits without regard to temporary institutionalization of limited duration, the bill permits these recipients to meet ongoing. fixed costs which continue while they are in the institution and generally to maintain their existing living arrangements. This section of the bill is thus a very positive and important step forward.

The only modification of this provision that we suggest is to grant institutionalized individuals, who now receive $300.00 per year or $25.00 per month, the general cost of living increases which all other SSI recipients receive. This $25.00 per month, which is the only "spending money" available for institutionalized SSI recipients, has not been increased since the inception of the SSI program. This $25.00 per month is necessary for personal items including clothing, laundry, soap, shaving materials and the like; essential personal services such as haircuts and hairdressing services; and for reading materials such as books, magazines and newspapers. In addition, this $25.00 per month is used to make contact with friends and relatives outside the institution, by long-distance telephone call, mail and for some individuals occasional bus or taxi trips outside the institution.

These items have been affected by inflation to the same extent as the economy generally and individuals in such institutions should be given costof-living increases along with the rest of the SSI population.

Since these institutionalized individuals have never been granted a cost-ofliving increase, the first increase should encompass the cost-of-living increases already given the SSI population since January 1974 when the program began.

The cost to the government of providing cost-of-living increases to institutionalized individuals would be relatively minor but such increases could make a substantial difference to institutionalized individuals and their financial ability to both take care of their personal needs and to maintain contact with individuals outside the institution.

The above suggestions are all relatively minor modifications of the existing bill. We do think, however, that these modifications would significantly improve the bill from the recipient's perspective, and would also be helpful in carrying out the apparent intent of the legislation.

We thank the committee for receiving and considering our comments.
Mr. JACOBS. I have no questions.

I was going to congratulate you for being the last witness, but I understand there is one more.

Mr. JENSEN. I want to thank you for the opportunity we have had over the past couple years to work with you and for your contribution to the SSI program by legal services lawyers in their efforts to get SSI benefits to recipients.

Mr. CORMAN. Thank you very much.

Our final witness is James Gashel, chief, Washington office, National Federation of the Blind.

Thank you for appearing before the subcommittee.

STATEMENT OF JAMES GASHEL, CHIEF OF THE WASHINGTON OFFICE, NATIONAL FEDERATION OF THE BLIND

Mr. GASHEL. Mr. Chairman, it is a real pleasure to wind up at the end of this hearing because it has been such a beneficial one and I think particularly rewarding, and I don't say this lightly, because of the attention that the members of this subcommittee have been giving this really complex and critical issue which faces the blind and disabled, elderly, and poor of this Nation.

I am going to respect all of our need to move along and I will simply summarize my statement.

Mr. CORMAN. Without objection, your full statement will appear in the record at this point and we would be pleased to hear your

summary.

[The prepared statement follows:]

PREPARED STATEMENT OF JAMES GASHEL, ON BEHALF OF THE NATIONAL FEDERATION OF THE BLIND

Mr. Chairman, my name is James Gashel. I am Chief of the Washington Office of the National Federation of the Blind. My address is Suite 212, Dupont Circle Building, 1346 Connecticut Avenue NW, Washington, D.C. 20036.

In representing the National Federation of the Blind before this Subcommittee, I speak for the representative voice of the blind of this country. Our broadly based membership can be found in every state and the District of Columbia. The 450 local chapters of the National Federation of the Blind can be found in most sizeable urban areas in the United States.

In our character as a national membership organization of blind people, we are the blind speaking for themselves. We organized the Federation in 1940, largely as a response to the increasing federalization of programs for the blind, as represented by the passage of the Randolph-Sheppard Vending Stand Act, the inclusion of the blind in federally supported vocational rehabilitation programs, and, of course, the adoption of the Social Security Act. Just as those who seek to provide services and assistance to the blind regularly come before the Congress to discuss their program needs and budgetary requirements, the blind, who are the beneficiaries of those services, must have their own voice-hence, the National Federation of the Blind.

According to the most recent data available from the Social Security Administration, approximately 76,000 blind persons receive some amount of monthly Supplemental Security Income (SSI) benefits. We were pleased to support and to witness the passage of several important provisions of HR 8911 in the 94th Congress, especially those relating to excluding the value of a home from consideration as a resource for eligibility purposes and a partial move toward mandating the pass-through of federal cost-of-living increases to recipients living in states which add a supplementary payment to the federal SSI amount.

HR 6124 (known as the Supplemental Security Income Amendments of 1977) seeks to pick up where we left off in the 94th Congress. Mr. Chairman, we commend you for its introduction and for holding these early hearings. HR 6124 contains several broadly supported provisions to which we add our salute. While our interest is keener in some provisions than in others, we feel that the passage of the bill as written would be a step forward. The following is a discussion of specific provisions of interest to the blind, together with some suggestions for amendments.

Section 3 of HR 6124 directs the Secretary of Health, Education, and Welfare to "carry out a program designed specifically to assure that all individuals who are or may become eligible for Supplemental Security Income benefits under this title will be fully informed as to the availability and nature of such benefits and of the steps to be taken in obtaining them." We strongly urge the Subcommittee and the Congress to adopt Section 3 and thus to mandate an SSI outreach program.

In our role as a voluntary grassroots organization, we have attempted to perform an outreach function, but our ability to achieve the widespread consistency of approach which is essential in an effective outreach program is obviously constrained by financial and personnel resource limitations.

There is a particular need for outreach to blind individuals. In the first place, many persons who may be entitled to benefits on the basis of blindness are unaware of their potential SSI eligibility because they do not regard themselves as blind, although they may very well have a visual restriction which places them within the legal definition of blindness as set forth in the Social Security Act. People tend to think of the term "blind" as meaning "totally blind," and this fallacy results in their not presenting an application for SSI benefits.

A second and equally important reason for the establishment of an outreach effort specifically aimed at blind individuals is the fact that there are certain entitlement provisions in Title XVI which apply only to the blind. For example, since blindness is defined as a disability, blind individuals are free from the restriction of the "substantial gainful activity test," which is used in determining whether other recipients or potential recipients under age 65 are disabled. Also, blind individuals are entitled to a work expenses exclusion from their earned income. Our experience is that many claims representatives are not aware of these and other special provisions for the blind and thus fail to process claims in the most favorable manner possible under the law.

Since the number of blind SSI recipients remains at about 2% of the total number of SSI recipients, the errors which are made are not surprising. As a solution, we have recommended to the Social Security Administration that special staff be employed in the larger Social Security offices to assist blind claimants. Thus far, Social Security has resisted this suggestion, arguing that claims representatives should be able to serve all who come to them. Our response has been that this may be so, but someone could still be designated as a claims representative for blind Title II and Title XVI applicants or recipients.

When the Subcommittee marks up legislation establishing the new SŚI outreach program, we urge that the foregoing be kept in mind and that appropriate language be inserted to require the Social Security Administration to designate specialized personnel to handle specific types of claims, especially in larger district offices. This action could well be considered an outreach effort conducted by the SSA itself, and is an essential supplement to other outreach efforts which might be conducted under the new section 1635.

Section 7 of HR 6124 seeks to increase the amount of benefits payable to "presumptively eligible individuals." The provision has our full support. Beginning December 1, 1976, because of clarifying amendments adopted by the Congress in 1976, blind persons became entitled to receive payments on a “presumptive blindness" basis for the first time. We advocated this change in the law, too, but we are concerned now with how it is being implemented (or rather not implemented) by the Administration.

Specifically, SSA's Disability Insurance State Manual Supplemental Transmittal issued to the state disability determination services on January 20, 1977, sets forth the procedures to be used in "identifying and processing cases of presumptive blindness." In at least two respects the procedures set forth in this Supplemental Manual Transmittal seem designed to circumvent the intent of Congress in adopting the presumptive blindness provision. First, the procedures will apparently restrict presumptive blindness benefits to persons who allege total blindness and who as observed by the district office representative appear to have no useful vision. This is far too restrictive, since only approximately 20% of the blind population is totally blind. It would be more reasonable to educate district office representatives somewhat in the matter of how blindness is determined and to supply them with a series of questions which could be asked of newly appearing applicants who might be presumed to be blind. Such questions as "Can you read a newspaper with your glasses?" would be definitive.

Second, the procedures call for acceptance of presumptively blind individuals as "presumptively disabled on the basis of blindness." The exact instruction reads: "If the formal determination. after input of the presumptive blindness decision confirms that the claimant is statutorally blind, notify the DO of this by telephone so that they may make a type of claim' change from blindness on the system."

The rationale for this procedure is difficult to comprehend. Why not, we ask, just accept the claimant as presumptively blind and not worry about converting him from "presumtively disabled" to statutorally blind. Beyond being a confusing and cumbersome procedure, it also allows for the greater possibility of errors in payments to claimants. In some states there are higher payment amounts for the blind than for others. In all states the blind persons are entitled to exclude certain earned income which covers their work expenses. If the DO believes that such persons are disabled (and not blind), it will not process their claims properly. Even before this new procedure, we have already seen cases where blind persons were treated as disabled because disability determination personnel failed to realize that there might be a difference in this system.

All of this is to suggest that the Administration is failing to carry out the intent of Congress with regard to individuals who may be presumed blind when applying for SSI. These matters may be resolvable without new legislative action, but we urge the Subcommittee to conduct an investigation and to clarify for the Administration the procedures the Committee believes should be followed for equitable treatment of the blind under the new presumptive blindness provision.

Beyond these specific comments on the provisions of HR 6124, Mr. Chairman, we wish to address several other issue swhich we hope the Subcommittee will consider as possible amendments or modifications to the bill.

(1) The National Federation of the Blind supports the concept that all SSI recipients should be entitled to receive the full amount of the annual federal cost-of-living increases. New section 1618 of the Social Security Act does provide that states which make supplemental payments to SSI recipients must pass along these cost-of-living increases, but this requirement applies only to the extent that such states are not required to increase the total amount of their state supplementation payments to SSI recipients. In essence the new law fails to insure SSI recipients the full amount of the annual cost-of-living increases.

Mr. Chairman, we support repeal of Section 1618 (d) of the Social Security Act, the effect of which would be to guarantee all individual claimants the full amount of cost-of-living increases. The National Federation of the Blind is on record as supporting legislation to require all states to suplement SSI payment amounts at the level of 50 percentum of the federal share, but this proposal goes far beyond what we are suggesting here. All we are arguing for now is the guarantee of the recipient's full share of cost-of-living increases, since we do not believe that the SSI program was designed to assist state treasuries-it was designed to assist the aged, blind, and disabled.

(2) Next I wish to address the so-called deeming policy, which applies when there is an eligible and an ineligible spouse. The statutory language for this policy is found at Section 1614 (f)-"income and resources of individuals other than eligible individuals and eligible spouses." Subsection 1614 (f) (1) currently reads: "For purposes of determining eligibility for and the amount of benefits for any individual who is married and his spouse is living with him in the same household but is not an eligible spouse, such individual's income and resources shall be deemed to include any income and resources of such spouse whether or not available to such individual except to the extent determined by the Secretary to be inequitable under the circumstances."

Since the beginning of the SSI program the Secretary has implemented the above-quoted deeming policy by placing what we regard as unrealistically strict limitations on income of the ineligible spouse. Accordingly. we recommend that the Subcommittee amend Section 1614 (f) (1) in a manner so as to permit the ineligible spouse to retain at least a minimum of $400 net income earned during any month before any of his or her income is deemed to be available to his or her eligible snouse.

On January 18, 1977, former HEW Secretary F. David Mathews did publish new "interim final" regulations setting forth a revised (and somewhat more liberal) deeming policy, but we still believe that it is too restrictive. As one of our leaders (and the former Chief of the Blind Division in the California Department of Public Welfare) wrote: "I view this as a very restrictive, even punitive. policy reminiscent of the Elizabethian poor laws of 1601. Such an inequitable provision constitutes a powerful incentive for the working spouse to cease being a self-supporting, productive member of society."