Figuring out how to administer public and private benefits programs for people with disabilities, and people who are just plain hard to employ, has always been a problem.
In the United States today, one obvious challenge is that the program rules push people with serious health problems, and moderate general employability problems, into panhandling.
When LifeHealthPro.com had its offices in Hoboken, N.J., for example, most of the panhandlers who operated near my office were haggard military veterans waiting for disability claims to make it through Social Security Administration (SSA) or Veterans Affairs Department disability claim determination systems.
Our office moved to Manhattan, and Daniel Famiano (photo, below), a panhandler who recently installed himself by the deli where I buy my breakfast, has been disabled from birth with a condition that causes his aorta (the big blood vessel that goes to his heart) to rupture, over and over again. He was working as a dog walker, and he said he’d still like to be working. But, in part because of his very serious disability, which could kill him at any minute, and in part because of mental and nervous issues, he has a lousy resumé, and the social workers in charge of his case have told him he has to refrain from working for a year to qualify for benefits. So, he panhandles.

In other words: Various government agencies have shifted much of the cost of supporting a man with obvious medical and employability problems off onto the property owners of a block in Midtown Manhattan, and the businesses that rent space from those property owners.
There are tens of thousands of people with similar stories with cups out on sidewalks across America. They may not actually need to be fed. Someone will probably give them food. But they have a hard time coming up with the resources to have a decent, stable life off the sidewalk.