Articles from prior issues of The Advocate

May/June 2001

NADE Continues To Network And Voice Views

The NADE Board was fortunate to have an opportunity during the MidYear Board meeting in March to meet with members of the Government Accounting Office (GAO), NCDDD, Social Security Advisory Board, Ken Nibali, and the House Subcommittee on Social Security.

Government Accounting Office Kay Brown, Carol Peterson and Dan Bertoni Kay Brown, Assistant Director, was accompanied by Carol Peterson and Dan Bertoni. Kay stated there has been reorganization into “Clusters” or areas of responsibility in GAO. The “Cluster” which includes disability issues deals with all issues affecting people “from the cradle to the grave.” The three GAO personnel who spoke to the Board work on SSA Operations issues.

Ms. Brown began by discussing work that has recently been published and describing what is planned for the future. Ms. Peterson reported that work on the disability program has been far-ranging. They have done studies on disability in the private sector. They also looked at disability programs in Germany, Sweden, and the Netherlands. The Netherlands had high rates of people on disability so their unemployment rates didn’t look as bad. Ms. Brown added that the idea is to look across different disability programs and operational issues such as prototype and redesign. Ongoing work has included looking at SGA levels and what happens if there are changes.

Mr. Bertoni discussed SSI issues. GAO studied the question of attorneys delaying processing to increase their fees. They also studied customer service goals and accuracy rates for initial and reconsideration claims. They will look at these items to see if it is realistic. The GAO also conducts studies on waste, fraud and abuse in the SSI program. They are looking at what has changed and what is going on with overpayments. They plan to begin looking at Prototype, as well as the Hearing Process Improvement (HPI) plan soon..

The NADE Board raised several issues with the GAO representatives, including the proposed rollout of Prototype, the problem of inconsistency on SDM qualifications, backlogs in both Prototype and non-Prototype states, and Process Unification ramifications. The Board assured the GAO staff that we support the goals of the Prototype process in regards to providing the best decision and good service, but stressed that the resources are not sufficient for national implementation. Board members expressed concern over the hiring freezes and low pay in some states, backlogs in many states and the impact of resultant low morale.

NCDDD Tommy Warren and Linda Dorn

Tommy Warren, Alabama DDS Director, and Linda Dorn, Michigan DDS Director, described a meeting they had with the National Governors Association’s Legislative Liaison. This included a discussion of the under funding of the DDSs, the growing number of backlogged cases and the strong likelihood that the DDSs will become hot items very soon. They also pointed out that the DDSs are “the bargain of the century” for work in the disability program. Prototype has some very positive aspects—but can afford this process? The bottom line is that we do not have an affordable model that SSA will fund. However, going backward is not an option because it is asking for additional lawsuits.

NCDDD is not sure what is happening with the Disability Claims Manager (DCM). Now the Field Office managers have come in with a proposal that would have DCMs in the field offices to perform the same work that the DDSs do. NCDDD has elected not to respond other than orally. However, they believe—and have expressed that to the Field Office Managers Association — that this proposal steps over the state / federal relationship.

They noted the upcoming “One SSA” which is a planning session that will occur in early June will have representatives from the Office of Disability, Regional Offices, DDS directors, Area Directors, and other invited parties will get together for some dialog about the program. It will include reviews of what is going on and what can we do to improve.

Social Security Advisory Board Ms. Margaret Malone and George Schuette

Ms. Malone and Mr. Schutte began by reviewing some of the high points of the report they have just published. Their report was designed to educate and provide an outline of the major issues for the new President and the Congress to consider when looking at reform of the Social Security program, including the disability program.

They have written to the President urging the appointment of a permanent Commissioner because there are so many critical issues that need to be resolved now. While everyone is very happy with Larry Massanari as an acting commissioner, without being permanent he cannot make the decisions that have to be made. Ms. Malone conveyed a sense of urgency about this and it is clear that she sees the risk of allowing things to just continue down the current track. At some point inertia will prevent even a permanent Commissioner from changing directions.

Change will be difficult and will require the support of Congress, SSA, and all the stakeholders. The Board recommends that NADE be very active in educating everyone we can about the program and about the critical issues in redesign. The Board also recommends that we work to achieve consensus on issues such as prototype.

Many board members shared concerns regarding prototype. The consistent message was that roll-out of the current prototype model is a bad idea. The Board was unanimous in expressing concerns about morale in the Prototype states and what could be expected with national roll-out.

The Board expressed concerns that data being used to determine success is not useful and is being used to force bad decisions. Example: increased allowance rate is being used as a measure of success so the DDSs are being pressured to push up their allowance rate. The allowance rate is determined by simply dividing the intake by allowances. Without a screening process for the intake, the only way to control allowance rate is to either increase or decrease allowances to match intake. What that means when there is an influx of non-qualifying applications is that examiners may feel pressured to allow claims that should never be allowed.

The Board was asked how NADE felt about certification since that was an issue the SSAB addressed in their report. We told them that we are very ambivalent. We have a record of being supportive of the concept. We have a certification process of our own and have had for years. However, we do not believe that SSA will be able to use certification to affect salaries in the DDS. The federal/state relationship leaves all of us as state employees with salaries controlled by the classification and wage structures in our respective states. We pointed out that we did a simple, informal survey and determined that the majority of responding Directors did not believe that a certificate, that guaranteed the bearer was qualified to do the job, would make any difference to their ability to hire or to offer any salary incentives. We also have concerns about a certification process driven by some group other than the professional organization.

Look for the Social Security Advisory Board reports on their web site: WWW.SSAB.GOV

Ken Nibali, Associate Commissioner of Disability

Certification has taken on new importance in light of the Advisory Board report. Mr. Nibali suggested that the low allowance situation in Texas is driving the discussion of certification related to consistency from state to state. Without going into specifics, he pointed out that low allowance rate and significant variation between the OHA offices in Texas have contributed to the problem.

Relative to the salary issue, Ken believes that SSA does not have the authority to set state salaries directly and that there would be significant problems trying to do anything like that through statute.

Good news! SSA has been able to allocate an additional $10 million to share among all the DDSs and Mr. Nibali is hoping that even more money will come to the DDS program by the end of the year.

Prototype has been tough. About half of the states have a pretty good handle on prototype and the rest don’t yet because they have backlogs they haven’t been able to get out of. He talked about some of the problems they have tried to address and described some of the process they have used to address those problems, including the workgroup they pulled together to come up with short term fixes.

The next step in the solution process will involve pulling together a high level group to look at the issue of what it will take to make this work. Mr. Nibali asked for NADE members to provide feedback on what can be done to improve the system. He is looking at a very short time frame for this.

A new issue for the Office of Disability to deal with is the Electronic Disability Folder (E-dib). This is an attempt to salvage some of the software developed in the Reengineered Disability System (RDS) which was primarily for the FO. In recent times it has become a tool expected to solve many issues for the DDSs as well as FOs and has so far been less than satisfactory. It really has not achieved performance objectives. As a result, the decision has been made to have OD take the lead for e-dib. Lenore Carlson will be the most visible representative of OD. They will be discussing the issue in Austin about the middle of April at a systems meeting.

Mr. Nibali wrapped up by talking about the new Acting Commissioner who will have the charge of keeping the administration running, dealing with some of the issues we are talking about now, and avoiding any new initiatives. Mr. Massanari has made it clear that operations of SSA and DDS are among his top priorities for the time he is in the acting role.

Kim Hildred and Jenna Lewis House Subcommittee on Social Security

Agenda: Solvency is still a major issue. President Bush has announced the formation of a commission to study Social Security and there will be a report to Congress in the fall.

With the split of representation between Republicans and Democrats everything will be tough.

Rep. Clay Shaw, Chair of the Subcommittee on Social Security ( R-FL), has introduced legislation regarding the misuse of SSNs. It is a very comprehensive bill that is being looked at by a number of other committees as well.

Attorney fees will be another issue for discussion by the Subcommittee.

The Ticket to Work Incentives Regulation is under review by the Subcommittee. They did hold a Hearing on this and heard an number of concerns from advocates and others involved in drafting the legislation that the Regulations do not meet the intent of the legislation. Those concerns and the results of the hearing are now back in SSA.

The disability program will be up “soup to nuts” review by the Subcommittee. The definition of disability, how decisions are made, and how the program is managed are among the issues they will be examining.

Members of the Texas congressional delegation have raised concerns regarding the number of cases denied for no significant impairment and the low number of medical/vocational allowances in their state. They were given a presentation by SSA officials to discuss the issues.

Budget – Chairman Shaw is committed to finding more funding for the Agency. In the past, he promoted and got through a bill that allowed a special cap outside the normal cap for CDRs and that provided significantly more money for processing those cases. They are talking about the possibility of taking SSA’s administrative costs out from under the cap. The subcommittee is working with the administration on this issue.

In the education process, Kim recommends that we talk with our legislators and that we specifically point out the goals and the performance outcomes (increased backlogs, longer processing times, etc.) are a specific result of the budget they voted for.

On the issue of reduction of the waiting period, Kim says that it may be great policy but it is also horrendously expensive. Cost is clearly going to drive political activities. Her guess is that this will get looked at but that it has a very slim chance of passing. Whatever gets done in relation to Social Security reform cannot break the bank no matter how good it might be. The Advisory Board is seen as very credible and a great source for education in many areas. Specific changes in the law that would make this process work better need to be brought to the committee.