THE SOCIAL COSTS OF DANGEROUS PRODUCTS: AN EMPIRICAL INVESTIGATION METHODOLOGY FOR EXTENDED COSTS I. Introduction In most studies that estimate the costs associated with dangerous products, the range of costs considered are direct costs only – and usually costs to the company that produces the hazard. This paper, on the costs of dangerous products, looks at the medical and productivity costs of the victim, but it looks at many other costs as well. It reviews a range of out-of-pocket costs to the victim not usually considered. It includes the many costs to the family unit and to other individuals in the family of the victim. It considers costs to employers of family members and also costs to federal, state, and local governments. The impact of one disabled or sick individual, or the impact of one fatality, can affect many people and many organizations. These costs may be as high or higher than the traditionally measured costs of most studies. II. General Method Scenarios were developed based on examples and circumstances in the literature. Family members of victims lose employment, housing, and opportunities to pursue education. As a result they may need help and support for far more than their medical bills. Society incurs far more burdens than simply lost work time of the injured party. Three scenarios were developed for each of 3 case studies in the paper: Ford/Firestone rollovers, Baycol, and three-wheeled ATVs. The scenarios developed were higher, medium, and lower levels of family impact. In all, 9 scenarios are incorporated into the paper. Clearly the monetary impact would differ if the scenarios were different. The scenarios were developed to be as realistic as possible and every time an assumption was made, an effort was made to be conservative. In addition, the monetary impact would have been different if the sources were different. In each case, an effort was made to have the most credible and recent source possible. In most cases government or peerreviewed journals were used. In a few cases this was not possible. All sources are clearly listed. III. Specific Method Research on costs of a range of family impacts was broad-based. Tables were developed to capture major costs associated with dangerous products. Table 1, on extended costs to individuals and families, illustrates the most frequent sources used, based on the most common family impacts of dangerous products. Table 2 focuses on costs to the private sector and Table 3 lists costs to the public sector. All costs were converted to 2007 constant dollars according to the inflation calculator on the web site of the U.S. Bureau of Labor Statistics. Present value was calculated using a 3 percent discount rate. This, of course, can significantly reduce the calculated costs of dangerous products, because the impacts may span several decades. P. 1 TABLE 1 EXTENDED COST TO INDIVIDUAL AND FAMILY COST IN DOLLARS • ADULT DAY CARE: $61/day, national average, 2007. 1 • ALCOHOL RELATED ILLNESS: ASSISTED LIVING: $10,660 2 • • $2969/month, or $35,628/year, 2007. 3 BANKRUPTCY: 50% bankruptcies in families related to medical events. More likely to lose health insurance 40% lost phone service 20% went without food 50% went without doctor/dentist 40% went without prescription medicine The long-run impacts of having to file for bankruptcy include: Turned down for job, mortgage, car loan, apartment rental “…homeowners who filed for bankruptcy between 1991 and 1994 are about 28 percent more likely to lose their houses within the four years after bankruptcy filing compared to similar homeowners without a bankruptcy record.” 4 “The incidence of bankruptcy 5 years post injury was 3.5%...Better rehabilitation, workforce reintegration, and disability programs might reduce bankruptcy post injury.”5 1 Metlife Mature Market Institute and Life Plans, Inc., The MetLife Market Survey of Adult Day Services & Home Care Costs, September 2007, http://www.metlife.com/WPSAssets/18746211091190810760 V1F2007ADSHCC Study.pdf, retrieved March 7, 2008. 2 Siegel, Michael cited in National Alliance to End Homelessness, “The Cost of Homelessness,” http://www.endhomelessness.org/section/tools/tenyearplan/cost, retrieved February 11, 2008. 3 Metlife Mature Market Institute, “Private and Semi-Private Nursing Home Room Rates Increase 3% in 2007 Assisted Living Rates Remain Steady, According to MetLife Market Survey,” Mature Market News, October 2007, http://www.metlife.com/WPSAssets/40608978001193759945V1FNursing HomeAsstLiving2007L.pdf, retrieved March 7, 2008. 4 Long, C., Colgate College, conference paper, “Negative Effects of Personal Bankruptcy for Homeowners: Lost Homes and Reduced Credit Access,” July 2005. 5 Hollingworth, W., Relyea-Chew, A, et al., “The Risk of Bankruptcy Before and After Brain or Spinal Cord Injury: A Glimpse of the Iceberg’s Tip,” Medical Care, APHA, 45(8), August 2007. P. 2 TABLE 1 EXTENDED COST TO INDIVIDUAL AND FAMILY COST IN DOLLARS • • • 6 DEPRESSION . – Untreated, depression is costly. Those with depression use two to four times more health care than people without mental illness. 7 EMERGENCY AND AMBULANCE SERVICES – at the time of the initial accident; for service demands due to paralysis and associated breathing and other problems FAMILY CARETAKERS Cost of becoming a caretaker An individual provides approximately $10,400 a year in unpaid care (based on $9.63 per hour for 20 hours a week). In addition, family and friends who are caregivers spend an estimated $2400 per year for groceries, medicine, and other out of-pocket cash outlays. Caregiver Risk Older care-giving spouses, who report strain from care-giving, suffer a 63% higher mortality rate than older spouses not involved in care-giving. 9 Depression among caregivers is a serious risk factor for coronary heart disease, cancer and diabetes. Accident: $8800, 2003 Emergency Room Visit median: $560; average: $299, 2003 Ambulance $350-1000, 2003 8 $10,400/year $2,400/year 10 6 Cannuscio, C.C. et al., “Reverberations of family illness: A longitudinal assessment of informal caregiving and mental health status in the nurses’ health study,” American Journal of Public Health, 92, 2002, http://www.ajph.org/cgi/reprint/92/8/1305? ck=nck, retrieved March 10, 2008 and National Institute of Mental Health, Older adults: Depression and suicide facts, Publication no. 01-4953, Rockville, M, 2001, http://www.nimh.nih.gov/health/publications/older-adults-depression-and-suicidefacts.shtml, retrieved March 10, 2008. 7 Goff, V. V., “Depression: A decade of progress, more to do,” Issue Brief No. 786, National Health Policy Forum, George Washington University, 2002 in Gray, Leslie, “Caregiver Depression: A Growing Mental Health Concern,” Policy Brief Family Caregiver Alliance, September 2003. 8 U.S. Department of Health and Human Services, Machlin, S. R., Expenses for a Hospital Emergency Room Visit, 2003. Statistical Brief #111, January 2006, Agency for Healthcare Research and Quality (AHRQ), Rockville, MD, http://www.meps.ahrq.gov/mepsweb/data_files/publications/st111/ stat111.pdf, retrieved March 9, 2008. 9 Schultz, R. and Beach, S. “Caregiving as a risk factor for mortality: The caregiver health effects study, Journal of the American Medical Association, 282, 1999, http://jama.amaassn.org/cgi/reprint/282/23/2215.pdf, retrieved March 10, 2008. 10 Mary Jo Gibson & Ari N. Houser, Valuing the Invaluable: A New Look at the Economic Value of Family Caregiving, Issue Brief, AARP Public Policy Institute, June 2007 (indicating the value of informal care-giving as $10,400 per year), http://assets.aarp.org/rgcenter/ il/ib82_caregiving.pdf, retrieved December 2007. P. 3 TABLE 1 EXTENDED COST TO INDIVIDUAL AND FAMILY COST IN DOLLARS • HOME HEALTH AIDE: $19/hour, national average, 2007 11 • HOMEMAKER/COMPANION: $18/hour, national average, 2007 12 • LIFE-TIME EARNINGS Cost to a child of becoming a high school dropout Adults who do not finish high school earn 65 percent of what people who have high school degrees earn. $8,161/year 13 $513,520 over 40 years, undiscounted $12,858/year 14 Cost to a child of not going to college Those with a high school degree have median annual earnings 36 percent below those with a Bachelor’s degree. In 1996, this meant a salary of $23,317 per year vs. $36,155. 11 Metlife Mature Market Institute and LifePlans, Inc., The MetLife Market Survey of Adult Day Services & Home Care Costs, September 2007, http://www.metlife.com/WPSAssets/18746211091190810760 V1F2007ADSHCCStudy.pdf, retrieved March 7, 2008. 12 Metlife Mature Market Institute and LifePlans, Inc., The MetLife Market Survey of Adult Day Services & Home Care Costs, September 2007, http://www.metlife.com/WPSAssets/18746211091190810760 V1F2007ADSHCCStudy.pdf, retrieved March 7, 2008. 13 U.S. Department of Labor, Bureau of Labor Statistics, in Occupational Outlook Quarterly, October 23, 1998, http://www.bls.gov/opub/ooq/ooqhome.htm and Organisation for Economic Co-operation and Development (OECD), “Education at a Glance 2006,” (2006), available at http://www.oecd.org/dataoecd/51/20/37392850.pdf. The average graduate earns $23,317 and high school dropouts on average earn 65 percent less than this amount. The difference is calculated as: $23,317 - (0.65x$23,317) = $8,161 per year. 14 U.S. Department of Labor, Bureau of Labor Statistics, in Occupational Outlook Quarterly, October 23, 1998, http://www.bls.gov/opub/ooq/ooqhome.htm. [$36,155-$23,317]. P. 4 TABLE 1 EXTENDED COST TO INDIVIDUAL AND FAMILY COST IN DOLLARS • LOSS OF HOME $108,000 17 If one owns a home valued at $200,000 and has (54.0% average equity on ones home) $100,000 equity in it when foreclosure begins, there is $108,000 of wealth lost to the family, which must then come up with a first month, last month, and security deposit in order to rent a place to live. One-quarter of those surveyed by The Access Project, said housing problems resulted from medical debt. 15 Over 10% said they were unable to qualify for a mortgage, over 10% said they were unable to pay their rent or mortgage, over 6% said their rental application was rejected and over 5% said they were forced to move. Seventy percent were likely to have a housing problem if sued for medical debt and nearly 40% were likely to have a housing problem if contact by a collection agency for medical debt. Homelessness can be the result of a disability. According to the National Coalition for the Homeless, “a serious illness or disability can start a downward spiral into homelessness, beginning with a lost job, depletion of savings to pay for care, and eventual eviction.” 16 15 Rakavina, M., Executive Director, The Access Project, Boston, Massachusetts, “Hearing on Working Families in Financial Crisis” Medical Debt and Bankruptcy,” Testimony submitted to the House Committee on the Judiciary, Subcommittee on Commercial and Administrative Law, July 17, 2007. 16 National Coalition for the Homeless, “Why are People Homeless?” NCH Fact Sheet #1, June 2007, http://www.nationalhomeless.org, retrieved February 2008. 17 Average equity in one’s home 2007, 54.0%. See Alan Greenspan & James Kennedy, SOURCES AND USES OF EQUITY EXTRACTED FROM HOMES 27 (Federal Reserve Board, Finance and Economics Discussion Series No. 2007-20, 2007), available at http://www.federalreserve.gov/pubs/feds/2007/200720/200720pap.pdf. P. 5 TABLE 1 EXTENDED COST TO INDIVIDUAL AND FAMILY COST IN DOLLARS • • MENTAL HEALTH SERVICES: $202,575/year for an inpatient bed 18 $106.08 average per hour for therapy, 2004. 19 NURSING HOME: Institutionalization The costs of early institutionalization have burdens $213/day, or $77,745 for a private room; beyond the family – extending to taxpayers. Most $189/day, or $68,985 for a semi-private families pay 1/3 of nursing home costs, but most is room, 2007. 21 paid by publicly funded programs, with Medicare and Medicaid, for example, paying 58% of nursing home costs. 20 18 State of Washington ($555/day); State of Washington, Washington State Department of Community, Trade and Economic Development, Housing Division, Olympia (360-725-2930), Ten-Year Homeless Plan, July 2006, http://cted.wa.gov/_CTED/ documents/ID_3356_Publications.doc, retrieved February 2008. 19 Brown, E., Jr. and Beauregard, K., Regional Differences in Total and Out-of-Pocket Expenditures for Selected Types of Office-Based Visits, 2004, Statistical Brief #157, January 2007, Agency for Healthcare Research and Quality (AHRQ), Rockville, Md., http://www.meps.ahrq.gov/ mepsweb/data_files/publications/st157/stat157.pdf, retrieved March 9, 2008. 20 Kaiser Family Foundation, Medicaid’s role in long-term care, Kaiser Commission on Medicaid Facts, Washington, DC, 2001 in Schultz, R. and Beach, S. “Caregiving as a risk factor for mortality: The caregiver health effects study,” Journal of the American Medical Association, 282, 1999, http://jama.ama-assn.org/cgi/reprint/282/ 23/2215.pdf, retrieved March 10, 2008. Cannuscio, C.C. et al., “Reverberations of family illness: A longitudinal assessment of informal caregiving and mental health status in the nurses’ health study,” American Journal of Public Health, 92, 2002, http://www.ajph.org/cgi/reprint/92/8/ 1305?ck=nck, retrieved March 10, 2008 and National Institute of Mental Health, Older adults: Depression and suicide facts, Publication no. 01-4953, Rockville, MD, 2001, http://www.nimh.nih.gov/health/publications/older-adults-depression-andsuicide-facts.shtml, retrieved March 10, 2008. 21 Metlife Mature Market Institute, “Private and Semi-Private Nursing Home Room Rates Increase 3% in 2007 Assisted Living Rates Remain Steady, According to MetLife Market Survey,” Mature Market News, October 2007, http://www.metlife.com/WPSAssets/40608978001193759945V1F NursingHomeAsstLiving2007L.pdf, retrieved March 7, 2008. P. 6 TABLE 1 EXTENDED COST TO INDIVIDUAL AND FAMILY COST IN DOLLARS • SOCIAL SECURITY: An individual who earned average hourly earnings and retired in 2007 at age 66, would receive $324 per month less if he/she spent the last 20 years without income, caretaking for a disabled family member. If they lived until 80, this would represent, at $3,888 per year, a loss of Social Security income of $54,432. 22 (See Table A, footnote 7 for other scenarios.) • STRESS The average number of days of the job, for workers who must take time off for stress, anxiety, or a related disorder, is 20 days. 23 • SUBSTANCE ABUSE: • • 22 $8360 if in treatment $14,740 if not in treatment 24 $22,667 for non-hospital residential care $3767 for outpatient methadone treatment $3347 for outpatient non-methadone treatment 25 Loss in Social Security, with no promotions lost, from years totally or partly out of the workforce. Table A Social Security Monthly Social Security Monthly Payment: Retire end of 2007, Payment: Retire end of 2007, age 62, begin working 1964 age 66, begin working 1964 35 years working full time $1167 $1556 Last 10 years earning ½ time $1157 $1542 Last 10 years not earning $1146 $1528 Last 20 years earning ½ time $1046 $1394 Last 20 years not earning $924 $1232 23 U.S. Department of Labor, Bureau of Labor Statistics, reported in National Institute for Occupational Safety and Health, “Stress… At Work,” Publication No. 99-101, 1999. Http://www.cdc.gov/niosh/stresswk.html, retrieved February 11, 2008. 24 For California. National Alliance to End Homelessness, “The Cost of Homelessness,” http://www.endhomelessness.org/section/tools/tenyearplan/cost, retrieved February 11, 2008. 25 1997 estimated cost per enrolled client per day for substance abuse treatment were $62.10 for nonhospital residential care, $10.32 for outpatient methadone treatment, and $9.17 per outpatient nonmethadone treatment. U.S. Department of Health and Human Services, The ADSS Cost Study: P. 7 TABLE 1 EXTENDED COST TO INDIVIDUAL AND FAMILY COST IN DOLLARS TRAUMATIC BRAIN INJURY Many TBIs go undiagnosed, but still can have serious health and economic impacts. “In many instances, no link is made between the blow to the head the person sustained and subsequent physical, cognitive, behavioral or emotional sequelae. TBI has been called the ‘silent’ or ‘hidden’ epidemic because many individuals are not identified by the health care system and their neurological, neuropsychological and neurobehavioral symptoms and functional difficulties are attributed to etiologies other than brain injury ... headaches, sleep problems, fatigue, blurred vision, dizziness, loss of hearing, and in a small percentage of cases, seizure disorders… changes in cognitive, behavioral and emotional functioning… increased irritability, depression or anxiety…impulsive behavior, reduced frustration tolerance, lack of empathy, emotional liability apathy or aggression.” 26 Co-occurring Psychiatric Diagnoses, accompanying TBI: 27 Disorder Major depression Substance abuse Post-traumatic stress disorder Other anxiety disorders % Incidence 14-77% 5-28% 3-27% 3-28% “individuals who have experienced a loss of consciousness are four times more likely to attempt suicide than those who have not. Additionally, Simpson and Tate reported that co-morbid depression and substance abuse in individuals with TBI increased the risk of suicide twenty-one times.” 28 “Only 42% of couples were able to sustain their relationship for more than 5 years after injury.” [TBI] 29 “A mild brain injury frequently causes cognitive and behavioral impairments or deficits that are not obvious, but result in life altering changes. These impairments may be short term or last throughout the person’s life….Adults with traumatic brain injury who can walk, talk, and look ‘normal’ are refused services, even though they cannot maintain themselves in the community without help. Cognitively impaired people frequently lack executive skills…have difficulty functioning independently… Results in a growing number of Texans with traumatic brain injury whose only service delivery system is a homeless shelter, a prison or a Costs of Substance Abuse Treatment in the Specialty Sector, http://www.oas.samhsa.gov/ADSS/ADSSCostStudy.pdf, retrieved February 2008. July 2003, 26 Ashman, T., Gordon, W., Cantor, J., and Hibbard, M, “Neurobehavioral Consequences of Traumatic Brain Injury,” The Mount Sinai Journal of Medicine, Vol. 73, No. 7, November 2006. 27 Ashman, T., Gordon, W., Cantor, J., and Hibbard, M, “Neurobehavioral Consequences of Traumatic Brain Injury,” The Mount Sinai Journal of Medicine, Vol. 73, No. 7, November 2006. 28 Ashman, T., Gordon, W., Cantor, J., and Hibbard, M, “Neurobehavioral Consequences of Traumatic Brain Injury,” The Mount Sinai Journal of Medicine, Vol. 73, No. 7, November 2006. 29 Kreutzer, J., “Consequences of Traumatic Brain Injury for the Family,” at NIH Consensus Development Conference on Rehabilitation of Persons with Traumatic Brain Injury, Bethesda, Maryland, October 1998. P. 8 TABLE 1 EXTENDED COST TO INDIVIDUAL AND FAMILY COST IN DOLLARS state institution, thereby costing Texas more for their care than it would have been had these individuals received the necessary rehabilitation and community based services.” 30 Results of Kentucky Traumatic Brain Injury Prevalence Study: 31 o 24% reported increased memory problems after the injury o 21% experienced increased depression after the injury o 23% experienced increased anxiety after the injury o 6% reported increased substance abuse problems o 5% needed substance abuse counseling o 23% needed personal care assistance o 30% needed mental health services o 26% needed specialized equipment o 40% needed physical, occupational, or speech therapy o 11% needed vocational training o 22% needed residential treatment or rehabilitation o 3% needed environmental modifications o 32% were reported needing professional service following this injury o 45% reported losing a job or school placement (but 84% were eventually able to return to work or school) 15% of professional services were paid by Medicaid and Medicare and 19% out of pocket by the injured party (60% was paid by private insurance). • VOCATIONAL REHABILITATION: • • $5,577/person, with orthopedic disability 32 $2923, vocational rehabilitation average, 2003 33 30 U.S. Department of Health and Human Services, HRSA, Maternal and Child Health Bureau, State Traumatic Brain Injury Grants, “The Texas Traumatic Brain Injury Advisory Council Presents A Summary of Gaps in Services in the Texas Health and Human Service Delivery System,” March 1999. 31 University of Kentucky, Center on Drug and Alcohol Research, “Kentucky Traumatic Brain Injury Prevalence Study,” CDAR Technical Report No. 2004-01, January 2004. 32 2003 average for those with orthopedic disability, University of Massachusetts-Boston, http://www.statedata.info/datanotes/datanote.php?article_id=167. 33 University of Massachusetts, Boston, http://www.statedata.info/datanotes/Datanote.php?article_id =167. Private vocational rehabilitation can cost as much as $5000/month or more. P. 9 TABLE 2 COSTS TO PRIVATE SECTOR COST IN DOLLARS TO EMPLOYER OF VICTIM • Lost productivity for victim who continues working, temporary replacement and then reduced ability to maintain job performance • Lost productivity to hire and train new person $22,000 34 For a manager, 150% of salary 35 TO THE EMPLOYER OF CARETAKER • Lost productivity due to caretaking $3600/year • Lost productivity due to depression $3600/year 36 TO LOCAL UTILITY COMPANIES • Requests for help with utility payments – gas, electricity, water TO PRIVATE HEALTH INSURANCE COMPANIES • More illness as a result of stress, victim and family members $312/month average for assistance with heating costs 37 34 National Highway Traffic Safety Administration (NHTSA) for serious auto accident, The Economic Impact of Motor Vehicle Crashes, 2000, May 2002, By L. Blincoe, A. Seay, E. Zaloshnja, T..Miller, E. Romano, S.Luchter, R.Spicer, NHTSA Technical Report DOT HS 809 446, http://wwwnrd.nhtsa.dot.gov/Pubs/809446.PDF, retrieved February 2007. 35 Bliss & Associates Inc., “The Business Cost and Impact of Employee Turnover,” http://www.blissassociates.com/html/articles/employee_turnover01.html, retrieved March 9, 2008. 36 Walter F. Steward, Judith A. Ricci, Elsbeth Chee, Steven R. Hahn, David Morganstein, Cost of Lost Productive Work Time Among US Workers with Depression, 289 J. AM. MEDICAL ASSOC. 3135 (2003). 37 For heating assistance only. A 2003 study by the U.S Department of Health and Human Services found that average household benefits, through the Low Income Home Energy Assistance Program (LIHEAP), for heating costs was $312. About 48 percent of households that received assistance had at least one person with a disability. U.S. Department of Health and Human Services, Executive Summary – Low Income Home Energy Assistance Report to Congress for FY 2003, August 2003, http://www.acf.hhs.gov/programs/ocs/liheap/publications/execsum.html, retrieved February 11, 2008. P. 10 TABLE 3 COST TO PUBLIC SECTOR COST IN DOLLARS • EMERGENCY SHELTER BED $8067/year • FOOD STAMPS $480-1668/person 2000 39 • JOB TRAINING $3800-$4700/person 40 • MEDICAID • MEDICAID PRESCRIPTION 38 $2215 per year, 2006 41 $204.95 per month, or $2459 per year, blended cost FY03 42 Disabled individuals on Medicaid cost approximately $12,855 per year (16% of the Medicaid population), 2003 43 $13,303, 2003, for permanently and totally disabled persons 44 $866.85/year FY03 45 38 When funded through the Department of Housing and Urban Development’s Emergency Shelter Grants program, is approximately $8,067; U.S. Department of Housing and Urban Development, Office of Policy Development and Research, Evaluation of the Emergency Shelter Grants Program, Volume 1: Findings, September 1994, as reported in National Alliance to End Homelessness, “The Cost of Homelessness,” http://www.endhomelessness.org/section/tools/tenyearplan/cost, retrieved February 11, 2008. 39 U.S. Department of Agriculture, “Food Stamp fsp/applicant_recipients/BEN.HTM, retrieved May 1, 2008. 40 U.S. Government in Boston Globe, Davis Bushnell, “Retraining funds higher but more seen needed,” September 2004, http://www.boston.com/jobs/globe/articles/091904_retrain.html. 41 Social Security Administration, “Medicaid,” http://www.socialsecurity.gov/policy/docs/statcomps/ supplement/2006/medicaid.pdf, retrieved March 10, 2008. 42 State of Texas, “Healthcare Costs in Health and Human Services Programs,” Presentation to Senate Finance Committee, October 24, 2001, http://www.hhsc.state.tx.us/news/presentations/Healthcare Costs_102401.pdf, retrieved March 2008. 43 Social Security Administration, Office of Policy Data, Annual Statistical Supplement, 2006, June 2007, http://www.socialsecurity.gov/policy/docs/statcomps/supplement/ 2006, retrieved March 2008. 44 Social Security Administration, Office of Policy Data, Annual Statistical Supplement, 2006, June 2007, http://www.socialsecurity.gov/policy/docs/statcomps/supplement/ 2006/medicaid.pdf, retrieved March 2008. 45 State of Texas, “Healthcare Costs in Health and Human Services Programs,” Presentation to Senate Finance Committee, October 24, 2001, http://www.hhsc.state.tx.us/news/presentations/ HealthcareCosts_102401.pdf, retrieved March 2008. Program,” http://www.fns.usda.gov/ P. 11 TABLE 3 COST TO PUBLIC SECTOR • MEDICAID NURSING FACILITY SERVICE COST IN DOLLARS $23,882/year, 2003 46 • MEDICARE $14,000-$134,000/year 47 • NEED FOR SUBSIDY/PUBLIC HOUSING $451/month for occupied subsidized units 48 • PRISON $23,876 average annual per prisoner operating costs 49 The typical cost of a prison bed in a state or federal prison is $20,000 per year. 50 The average cost per year per person in an average county jail (in Washington state) is $17,485, or $47.90 per day. In a Washington State prison it is $32,000, or $87.67 a day. 51 46 Social Security Administration, Office of Policy Data, Annual Statistical Supplement to the Social Security Bulletin, 2006, June 2007, http://www.socialsecurity.gov/policy/docs/statcomps/ supplement/2006/supplement06.pdf, retrieved March 2008. 47 Many sites on Medicare web page. 48 U.S. Department of Housing and Urban Development (HUD), 1998, http://www.hud user.org/publications/pdf/economic.pdf; the average operating cost of a single room occupancy for Section 8 housing is $298 per month, or $3570 per year. In addition 47% of sponsors also provided such support services as health exams, substance abuse counseling, job counseling and literacy training. National Coalition for the Homeless, “Section 8/Single Room Occupancy (SRO),” http://www.nationalhomeless.org/publications/facts/federal.html, retrieved February 11, 2008. 49 Costs ranged from $13,009 in Louisiana to $44,860 in Rhode Island in 2005. The capital expenses per bed for medium security were approximately $65,000. The Pew Center on the States, “One in 100: Behind Bars in America 2008,” http://www.pewcenteronthestates.org/uploadedFiles/ One%20in%20100.pdf, retrieved March 5, 2008. 50 Slevin, Peter, “Life After Prison: Lack of Services Has High Price,” in Washington Post, April 24, 2000 as reported in National Alliance to End Homelessness, “The Cost of Homelessness,” http://www.endhomelessness.org/section/tools/tenyear plan/cost, retrieved February 11, 2008. 51 State of Washington, Washington State Department of Community, Trade and Economic Development, Housing Division, Olympia (360-725-2930), “Ten-Year Homeless Plan,” July 2006, http://cted.wa.gov/_CTED/documents/ID_3356_ Publications.doc, retrieved February 2008. P. 12 TABLE 3 COST TO PUBLIC SECTOR • SCHIP (CHILDREN’S HEALTH) • SOCIAL SECURITY DISABILITY INSURANCE • SPECIAL EDUCATION SERVICES • TANF (TEMPORARY ASSISTANCE FOR NEEDY FAMILIES) COST IN DOLLARS FY2003 average $1,178 52 From $42/month per child age 11-18, male, south Delaware to $418/month for child less than 1 year in Kansas, 1999 53 $938/ per month, or $11,256/year, average for disabled workers, 2005 54 $978/month for disabled workers, $258/month for spouses of disabled workers and 290 average monthly benefit for children of disabled workers for 2006 55 $9369 above average student cost of $7,552 56 $397/month average family 2004 57 52 State of Mississippi, A Limited Analysis of the State Children’s Health Insurance Program (SCHIP), Performance Audit Report #91, March 29, 2005, http://www.osa.state.ms.us/documents/performance/ Schip.pdf, retrieved March 2008, [Mississippi FY2003 average was $1648] 53 National Conference of State Legislatures, “SCHIP: Money Matters,” http://www.ncsl.org/programs/health/moneymat.htm, retrieved March 4, 2008. 54 Social Security Administration, Office of Policy Data, Annual Statistical Supplement, 2006, June 2007, http://www.socialsecurity.gov/policy/docs/statcomps/supplement/ 2006/oasdi.pdf, retrieved March 2008. 55 Social Security Administration, Fast Facts & Figures About Social Security, SSA Publication No. 1311785, September 2007, http://www.socialsecurity.gov/policy/docs/chartbooks/fast_facts/2007/fast_ facts07.pdf, retrieved March 2008. 56 National Education Association (NEA), “Special Education and the Individuals with Disabilities Education Act” http://www.nea.org/specialed/index.html, retrieved March 9, 2008. 57 Social Security Administration, Annual Statistical Supplement, 2005, Public Assistance, “Temporary Assistance for Needy Families/AFDC and Emergency Assistance (9.G),” http://www.ssa.gov/policy/docs/statcomps/supplement/2005/9g.pdf, retrieved March 6, 2008. January 2000, P. 13 TABLE 3 COST TO PUBLIC SECTOR • UNEMPLOYMENT INSURANCE • VETERANS’ BENEFITS • WORKERS COMPENSATION COST IN DOLLARS Approx $25-500/week with $400/year Administrative cost in 2004 58 $266.60 average weekly benefit, for 15.3 weeks, 2006. 59 $911 non-service-connected disability, maximum per individual; $1801 with one dependent in need of aid and attendance, 2006 60 $351-1173/week 61 58 Five state web sites: IL, OR, RI, MD, AZ. Feibelman, A., “Defining the Social Insurance Function of Consumer Bankruptcy,” American Bankruptcy Institute Law Review, Vol. 13, 2005, http://papers.ssrn.com/sol3/papers.cfm?abstract_id= 708583#PaperDownload, retrieved March 7, 2008. 59 Social Security Administration, Office of Policy Data, Annual Statistical Supplement, 2006, June 2007, http://www.socialsecurity.gov/policy/docs/statcomps/supplement/ 2006, retrieved March 2008. 60 Non-service-connected disability is for wartime veterans with limited means. 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