Underground Railroad 2001

EDITOR'S NOTE: Twenty-three years ago today Willie Robinson, a consumer of Disability Connection Midsouth, left a Tennessee nursing home for a home in the community in Colorado. Back then, Deborah Cunningham, the Executive Director of MCIL, called this our Underground Railroad. Please note the progress that this Center for Independent Living has made.

People with disabilities leave the state of Tennessee to avoid nursing home incarceration. 

Willie Robinson has lived in Tennessee all his life. Today he is leaving because the unfair Medicaid policy will only provide him with services in the least desirable and most expensive place – an institution. 

Willie Robinson is moving from a Tennessee nursing home to his own apartment in Denver Colorado. Mr. Robinson is not only capable of living independently; he will be starting over in Denver Colorado where he already has his own place with attendant services. Willie is optimistic about job opportunities in Denver that are non-existent for Tennessee nursing-home residents. 

"Because Tennessee has no attendant services, I have lost my job, my home, and my car," said Willie Robinson to Tennessee Senator Bill Frist at the Memphis Center for Independent Living. "I live in a nursing home now and I have no choice about what time I get up in the morning, what I have for meals and what time I go to bed at night." 

The small programs that Tennessee has adopted to expand home and community-based services in our state may be effective in preventing or delaying some individual’s entry into a nursing home, however; Tennessee remains 50th in the nation at providing options to institutions. Every other U.S. state offers more cost-saving home and community-based services to provide citizens choices other than an institution. 

Missouri, for example, with a larger total population than Tennessee, spends nearly $100 million less of state money on nursing facilities and over $200 million less in federal funds [Medicaid Financial Management Report FY 2000]. Tennessee is the most chronic example of the need for national Medicaid reform. Ninety five percent of the public funding for long-term care is funneled into the nursing home industry. 

The for-profit nursing home industry gets more than half of its revenues from Medicaid, yet they are the fourth-largest lobby generously giving money to state lawmakers [Tennessee Registry of Election Finance]. The nursing home lobby has been involved in the guidance of the new programs for home and community based living and made sure that they did not cut into the nursing home industry's profits. 

Willie has been working to change the system in Tennessee that concentrates almost all the Medicaid long-term care funding to the nursing home industry. Senators Harkin (D-Iowa) and Specter (R- Pennsylvania) will introduce bipartisan legislation this session to reform Medicaid and give people with disabilities choices in long-term care. Willie will see the MEDICAID COMMUNITY ATTENDANT SERVICES and SUPPORTS ACT (MiCASSA) become law from his own home - his new home in Colorado.

Social Security Eliminates Overpayment Burden

Social Security Eliminates Overpayment Burden for Social Security Beneficiaries – Automatic Overpayment Recovery Rate Reduced to 10 Percent

March 29, 2024 

By Jeffrey Buckner, Acting Deputy Commissioner for Communications
Reading Time: 3 Minutes; Last Updated: March 29, 2024

Social Security announced it will decrease the default overpayment withholding rate for Social Security beneficiaries to ten percent (or $10, whichever is greater) from 100 percent, significantly reducing financial hardship on people with overpayments.

“Social Security is taking a critically important step towards our goal of ensuring our overpayment policies are fair, equitable, and do not unduly harm anyone,” said Martin O’Malley, Commissioner of Social Security.  “It’s unconscionable that someone would find themselves facing homelessness or unable to pay bills, because Social Security withheld their entire payment for recovery of an overpayment.”

The agency works to pay the right people the right amounts at the right time, and Social Security issues correct payments in most cases.  However, there is room to improve, as people count on the agency to prevent overpayments from happening and make it easier to navigate the recovery and waiver processes when they occur.

When a person has been overpaid, the law requires the agency to seek repayment, which can create financial difficulties for beneficiaries.  As of March 25, 2024, the agency will collect ten percent (or $10, whichever is greater) of the total monthly Social Security benefit to recover an overpayment, rather than collecting 100 percent as was previous procedure.  There will be limited exceptions to this change, such as when an overpayment resulted from fraud.

There will be a short transition period where people will continue to experience the older policy.  People placed in 100 percent withholding during this transition period should call Social Security’s National 800 Number at 1-800-772-1213 to lower their withholding rate.

The change applies to new overpayments.  If beneficiaries already have an overpayment with a withholding rate greater than ten percent and would like a lower recovery rate, they too should call Social Security at 1-800-772-1213 or their local Social Security office to speak with a representative.  If a beneficiary requests a rate lower than ten percent, a representative will approve the request if it allows recovery of the overpayment within 60 months – a recent increase to improve how the agency serves its customers from the previous policy of only 36 months.  If the beneficiary’s proposed rate would extend recovery of the overpayment beyond 60 months, the Social Security representative will gather income, resource, and expense information from the beneficiary to make a determination.

Social Security launched a comprehensive review in October 2023 of agency overpayment policies and procedures to address payment accuracy systematically. Learn about Overpayments and Our Process and read our Press Release.  This procedure change is a direct result of the ongoing review.  This change and the adjustment to 60-month repayment are part of four recently announced key updates to address improper payments.  The agency also is working to reduce wage-related improper payments by establishing information exchanges with payroll data providers that will significantly reduce the number of improper payments, once implemented.  The agency will continue examining programmatic policy and making regulatory and sub-regulatory changes to improve the overpayment process.

Additionally, people have the right to appeal the overpayment decision or the amount.  They can ask Social Security to waive collection of the overpayment, if they believe it was not their fault and can’t afford to pay it back.  The agency does not pursue recoveries while an initial appeal or waiver is pending.  Even if people do not want to appeal or request a waiver, they should contact the agency if the planned withholding would cause hardship.  Social Security has flexible repayment options, including repayment of as low as $10 per month.  Each person’s situation is unique, and the agency handles overpayments on a case-by-case basis.