Counties in California bear large hidden costs for individuals with disabilities who are indigent or homeless. A large share of this cost is health related – costs that would be paid through Medi-Cal if the individuals were receiving Supplemental Social Security Income (SSI).
In the typical monthly General Relief/General Assistance statewide caseload, an estimated 51,000 individuals have disabilities, but are not receiving SSI. Eligibility rates for SSI increase markedly with age, rising from less than 20% among recipients 18-25 years of age to half among recipients 46-55 years of age. California counties could save $42 million per month and private hospitals could save another $13 million if eligible General Relief recipients with disabilities in the typical monthly caseload were moved onto SSI.
County health costs for indigent residents will be ameliorated when the Medicaid Expansion provisions of the new Federal Health Law take effect in 2014 (and to a lesser extent by the 1115 Medicaid waiver), but the extent and amount of federal offsets are not known at this time. Counties are likely to face some level of continuing costs for these residents, and there are likely to be continuing financial benefits for counties’ healthcare and GR budgets when low-income individuals with disabilities are enrolled in SSI.
This study from the Economic Roundtable examines opportunities for counties to avoid costs by moving individuals with disabilities who are General Relief recipients, medically indigent hospital patients, and homeless hospital patients onto SSI and Medi-Cal.