title: Environment-Level Strategies to Support Independent Control of Finances: A Response to the SSA Review of Financial Capability Determination Review.
abstract: The Social Security Administration (SSA) recently completed an evaluation of the process by which representative payees are assigned. The SSA report is welcome, particularly for its focus on developing more accurate, real-world assessments of a person's financial capability and its recognition of the need for more flexible options for people with disabilities. Crucially, the report discusses the impact of the broader environment-specifically, conditions related to living in poverty. However, it provides no guidance about environmental interventions that could enable more beneficiaries to manage their funds without a payee. Innovative financial products could be offered to beneficiaries, and the retail industry could develop processes to support responsible financial management by people with mental illness. Changes to SSA benefits systems, including raising benefits levels and asset limits, could enable more beneficiaries to manage their funds independently.
authors.affiliation: The authors are with the Department of Psychiatry, Yale School of Medicine, Yale University, New Haven, Connecticut (e-mail: annie.harper@yale.edu ). Steven S. Sharfstein, M.D., Haiden A. Huskamp, Ph.D., and Alison Evans Cuellar, Ph.D., are editors of this column.
authors.forename: Annie
authors.initials: A
authors.lastname: Harper
authors.affiliation: The authors are with the Department of Psychiatry, Yale School of Medicine, Yale University, New Haven, Connecticut (e-mail: annie.harper@yale.edu ). Steven S. Sharfstein, M.D., Haiden A. Huskamp, Ph.D., and Alison Evans Cuellar, Ph.D., are editors of this column.
authors.forename: Michael
authors.initials: M
authors.lastname: Rowe
mesh_terms: D004777:Environment; D006801:Humans; D028642:Persons with Psychiatric Disorders; D026684:Personal Autonomy; D012943:Social Security / Q000592:standards*; D014481:United States; D019131:United States Social Security Administration / Q000592:standards*
keywords: Patient autonomy; Patient rights; Representative payees; Self-direction; Social Security disability benefits; Social issues