DEAP – A Wise Investment for the Future

The Disability Entitlement Advocacy Program (DEAP) works to help qualified, indigent individuals obtain Supplemental Security Income (SSI) benefits and to provide a major flow of federal dollars into the economy of Maryland. Health Management Associates, Inc. (HMA), provides case monitoring, advocacy and representation services to recipients of Temporary Disability Assistance Program (TDAP) stipend on the basis of a contract with the Department of Human Resources (DHR). DEAP is a highly successful partnership between government and business that has won national recognition for its application of the principles of reinventing government. Neither DEAP, nor HMA, charges any fee for representing disabled individuals applying for SSI and SSDI through the DEAP program.

DEAP clients are indigent, disabled individuals with mental, physical, or dual/ multiple diagnoses impairments certified as permanently disabling. DEAP clients typically suffer from severe, often terminal, illnesses such as MS, lupus, hepatitis, HIV/AIDS, tuberculosis, end stage cancers, malignant hypertension and mental illness. While some DEAP clients have a history of substance abuse, they also suffer from other impairments judged to be the primary cause of disability. The State Department of Health and Mental Hygiene (DHMH) reported that, in the past, Marylanders who were allowed SSI as a result of substance abuse, only, were less than 2% of the total SSI recipients in the State.

DEAP monitors SSI applications for all TDAP recipients, who are required as a condition of TDAP to apply for SSI. However, DEAP carefully screens the applications of individuals whose SSI claims are initially denied and only represents those in the appeals process whose claims have merit. Since May 1992, DEAP has declined to pursue appeals for about 30% of the cases it monitors because of questionable merit. Thus, DEAP is a mechanism to limit the abuses and excesses that the press sensationalizes. Of the cases denied at the initial SSI application stage that DEAP appeals to a reconsideration then an administrative hearing, 88% are approved for SSI benefits. In fact, more than 57,000 of Maryland’s SSI recipients are receiving benefits as a direct result of DEAP’s advocacy efforts.

DEAP clients approved for SSI benefits receive a monthly stipend of  $674 compared to the $185 monthly TDAP grant. DEAP guarantees that a significant number of Maryland’s indigent disabled ultimately receive critical assistance through SSI. In fact, it is their only remaining safety net.

Since 1988, DEAP has provided net benefits to the State in terms of cost savings and cost recovery of public assistance payments in excess of $ 544 million. Maryland has also realized over $ 2 billion in federal dollar cash flow as a direct result of DEAP’s success in getting disabled persons approved for SSI. By the end of June 2010, $80 million per year in additional federal dollars (in SSI payments to DEAP clients) will be flowing into the State’s economy. With DEAP’s help, that number continues to increase. Furthermore, as a result of eligibility for Social Security disability, medical assistance costs to the State are reduced by converting the State’s expense to a purchase of Medicare after the 24th month of eligibility.

DEAP is clearly a wise investment for Maryland. The savings and recovery generated by DEAP, up to 50% of whose operational expense is reimbursable by the Federal government as part of FFP, dramatically offset social services programs expenditures. The increased federal dollar cash flow produces jobs and tax revenue critical to Maryland’s economy. The cost to operate DEAP produces a return on investment that Maryland cannot afford to abandon, just as it cannot afford to abandon its indigent, disabled citizens.