Articles from prior issues of The Advocate

September/October, 2000

KC Deputy Regional Commissioner Foard Provides Updates on FY 2000 Goals and Prototype Progress

The Great Plains Regional Conference welcomed the Kansas City Deputy Regional Commissioner, Howard Foard. He outlined the FY 2000 progress and the three goals, which were established for the DDSs for FY 2000, plus an emphasis on improving quality. At mid point in the 4th Quarter, here is our progress:

Goal #1. Concentrate on maintaining the initial pending (at the 10/1/99 level)

As a region, our initial pending has increased by over 27%.

Initial pending has increased in all 4 states over FY 99 levels.

Nationally, initial pending is up by 13%.

Goal #2. Processing the budgeted CDRs.

Through 84% of FY, we had processed almost 90% of our budgeted CDRs. After some concern earlier in the year, it appears we are well on our way to meeting this target.

We went into the year understanding that Missouri, because of prototype, would need help in processing their budgeted CDRs.

Special thanks to Iowa for processing an additional 500 CDRs, and particularly to Kansas for processing an additional 3500 CDRs, to help the region achieve this goal. By the end of September, it appears both of these states will easily surpass even these increased totals.

The Flexible Disability Unit (FDU) has processed 4300 Missouri CDRs and will complete another 1500 by the end of September. In addition, the FDU has (or will by the end of September) processed around 4100 Missouri pipeline recons.

Goal #3. Keeping overall disability claims processing times below 100 days. This includes both field office and DDS processing time. For the latest month available (June 2000):

Title II – KC region – 81.4 days, National – 90.3 days

Title XVI – KC region – 89.9 days, National – 106.2 days

Both processing times are the best in the country!

Emphasis on Quality: We have a slightly mixed message regarding quality.

DDS net accuracy for this year is exactly the same as for FY 99 and is .9% better than the national average.

Combined initial claims accuracy is slightly below the FY 99 level and .6% less than the national average.

CDR and reconsideration accuracy are have improved by 1.1% over FY 99 and now exceed the national average. In our region, we have done a good job of balancing the quality and timeliness of the service we provide our claimants and beneficiaries.

The challenge we face is continuing to find the right balance of quality and timeliness in our service to the public. This will not get any easier as we continue to undergo changes in the next few years.

Experience with Prototype

Prototype has been a real learning experience. We will use these lessons as we prepare to roll out prototype to other states beginning in October 2001.

Having single decision-maker capability has proven to be a time-saver. Some have expressed concern about their ability to make medical decisions, but please remember that the doctors are available for consultation on any case, even if they don’t have to sign off on it. By not having to sign off on every cases, the medical consultants are free to act more as “consultants.”

Although there was initial concern about the claimant conferences, they have not proven to be a problem. We’ve found that very few have been conducted face-to-face.

Addressing the process unification issues has proven to be more troublesome than any other aspect of prototype. Some have struggled to fully address the claimant’s allegations, weigh credibility and treating source opinion, and fully explain their decisions in writing. To address this concern, Missouri DDS Director Neil Scully was instrumental in convincing SSA of the need for the analytical writing training that was presented by IVT on August 17.

In this respect, our region is better prepared than most for moving forward with prototype. Iowa and Nebraska are fully involved in the enhanced development and fully explaining their decisions, while Kansas is to a large extent.

When the non-prototype states were recently surveyed on their willingness and readiness to be in the next group of states to rollout prototype in October 2001, all 3 of our states volunteered.

As expected, productivity has been adversely affected. Nationally, the year-to-date PPWY for the prototype states is only 83.4% of their FY 99 PPWY.

Prototype Performance

After a slow start, the Missouri DDS' productivity has shown great strides in the last five months.

Their performance ranks at the top among the prototype DDSs in PPWY, weeks work pending and claims processing time.

Missouri’s rolling 4-week PPWY is the best among prototype states and exceeds the national prototype average by 20.

Missouri’s processing time exceeds the overall national average by 13 days in Title II and 15 days in Title XVI.

Activities of Other DDSs

Letters were mailed in May to around 15,000 potential Laird class members in Iowa. This has resulted in a large number of field office inquiries and, to date, around 150 new applications.

Nebraska completed their training in preparation for processing their own Surrell settlement workload. While we don’t have final numbers, it’s estimated there will be approximately 5000 potential class members. We are tentatively scheduled to mail letters to these people at the end of August. As part of the settlement, the DDS has fully implemented the enhanced development and full explanation of decisions on both initial and recon cases.

Kansas continues its participation as a rationale summary implementation pilot site, with much of their staff doing rationales as well.

Iowa and Kansas continue to be involved in the Disability Claims Manager (FDU) pilot. The gathering of information for the evaluation should be completed in November, with a decision on its future next year. The DDSs have been asked to support the DCM through June 2001.

What will we need to do in the coming months?

As one agency committed to making the disability adjudication process the best it can possibly be, we all have challenges ahead of us in the coming months.

1. As we prepare for prototype rollout in the other states, we need to have our workloads in the best shape possible so that the learning and transition period causes the least disruption to our customers.

2. One of the prototype lessons learned is that the better prepared we are for the enhanced development and full written explanation of decisions, the smoother the transition.

3. Continue to improve the quality of our work product, in the field offices, DDSs and Flexible Disability Unit (FDU).

4. Continue the communication between all components involved in the disability process. The level of communication and cooperation between the field offices and DDS has never been higher. We must all work together to continuously fine-tune the disability claims & CDR process.

5. Continue our efforts to control medical costs through judicious requests for medical evidence and consultative examinations. The DDS budget will be equally challenging next year.

6. OHA faces the challenge of implementing the Hearing Process Improvement process in their remaining offices.

7. The Flexible Disability Unit has a challenging year ahead of them as they train their staff so they’ll be in a position to help as more prototype states rollout in October 2001.

8. DQB will be challenged to provide meaningful feedback and find the proper balance between quality and service.

9. The regional office will be challenged to provide the tools and information needed by everyone to implement these quality initiatives and process changes. In conclusion

¨ SSA recognizes that all of these activities take time and the challenge we face to maintain our balanced service during this transition period.

¨ Mr. Foard concluded, “I feel that the effort we will put into implementing these process changes will be justified in the end if we can deliver a better medical decision to our customers at the earliest possible stage in the process. Michael (Grochowski, Regional Commissioner) and I pledge our commitment, and that of our staff, to all of these initiatives. SSA will do all that we can to support our DDSs during this time of change.”