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Tom Crook leans against the brick wall of the St. Vincent de Paul Society Social Services Center, smoking a cigarette. Squinting against dust swirling past the Howard Street office, he glances at his watch, gauging the time until his afternoon Alcoholics Anonymous meeting.
Crook is one of 50 people enrolled in the center's payee program. He receives $625 a month in federal Supplemental Security Income (SSI), an entitlement program for the disabled. What disables Crook is alcoholism.
Crook, 32, says he started receiving SSI in Washington state for severe depression. When he moved to San Francisco in early 1995, he applied to have his benefits transferred. A background check revealed a history of substance abuse, and his disability status was changed from mental health to drug and alcohol addiction. He began receiving benefits in San Francisco in October, but recent federal legislation may cut him off.
In March, President Clinton signed the Contract With America Advancement Act into law. This bill prevents SSI and medical benefits going to individuals for drug and alcohol addiction as of Jan. 1, 1997, unless they can show they are disabled by another condition.
Two hundred thousand people nationwide are affected by the new law, 43,000 in California alone, says Jack Louie, assistant district manager for the local Social Security office at U.N. Plaza. More than 3,000 SSI recipients in San Francisco are being notified this month of the changes in their status. Beneficiaries have until July 28 to request a new medical determination of their claim to be disabled.
Social Security must make these evaluations by the end of the year; a denial of a disability claim may be appealed, but benefits would stop with the new year if drugs or alcohol was still found to be the primary disability.
"The police and social workers saw these people putting their checks into drugs and brought it to the congressman's attention," McArthur says. "This legislation came out of discussions around that local problem."
Victor Palma, coordinator of the St. Vincent de Paul Society's payee program, says the changes will have a devastating effect on recipients and shift costs to California's financially strapped welfare programs.
"They'll have to go to General Assistance, which will reduce their income by half," Palma says. "It will be the same as losing a job without unemployment stepping in."
Despite his misgivings about costs and effects, Palma supports the reduction "in principle."
"When you're a payee, it becomes a game on how they can scam you so they can spend their money on dope," he says. "Out of my 50 clients, I'd say five are trying to get into programs. All the others are trying to avoid treatment and just spend and collect their money."
Jack Louie says his office is not debating the merits of the new law.
"We're not apologists for Social Security," he says. "The problem is with the policy, but all we do here is implement it."
Louie does expect problems, though.
"I'm concerned about the safety of the employees," he says. "When we tell people their benefits are cut off, that's eliminating their only means of survival. They may not take it well."
The law gives recipients 120 days to reapply for benefits, but with notification just starting experts argue there won't be enough time to do proper evaluations.
"Everybody will have to work very fast to get this done by January 1," says John Carvaleas, staff attorney for Social Security's regional office. "You rarely see addiction alone. It's usually associated with other problems. We're afraid that some people will fall through the cracks."
The Social Security Administration estimates $12 million in savings in 1996 from the cuts, and $161 million of savings in 1997. But service providers say those projections do not reflect financial impacts on state and county governments. San Francisco's Department of Social Services, for example, expects to spend an additional $3.6 million in 1997 resulting from the SSI cuts. The loss in MediCal drug revenues could be as high as $1 million.
Financing additional substance abuse treatment programs would be more cost-effective than reducing disability rolls, argues Larry Merideth, director of Community Substance Abuse Services.
He says more than 1,000 people seek treatment services each day in San Francisco. And, he notes, a 1994 report, "California Drug and Alcohol Treatment Study," shows that alcohol and drug programs "are a solid economic investment saving taxpayers about $7 for every $1 invested in such programs."
The Social Security branch in San Francisco expects 80 percent of those discontinued under the new law to be re-eligible under another disability plan. But service providers say the reapplication process is complex; those who retain lawyers or are persistent may be reauthorized, but others will fall through the safety net.
Kelly Wilconsin, director of Support Services for the Cannon Kip Community House, a 104-unit apartment building south of Market Street, says that some of her tenants may well become homeless because of the disability cutoffs.
"Our people are housed now and engaged in activities to get their lives back on track," she says.
"At the same time, they are struggling with psychiatric problems, AIDS, physical disabilities, cancer, diabetes -- as well as alcoholism. Having to suddenly fight to maintain their meager income will be quite a setback for them."
Crook does not know what the future will hold. Right now he just wants to hold onto his room.
"I live in the All Star, a cockroach hotel in the Mission," he says. "But it's nice to at least have a bed.