Articles from prior issues of The Advocate

July/August, 1999

Willman Offers Commentary On Redesign Initiatives
by Robert Edwards, Texas DDS

It was Friday morning, April 30th, the last day of the SWADE 1999 Southeast Conference. By the time Doug Willman, Nebraska State administrator and former NCDDD president, stepped to the front of the room to give his presentation, it is safe to say that most members in the crowd were exhausted. It was, however, a good kind of exhaustion. The New Mexico chapter had truly presented an event-filled, entertaining and informational conference. The evening before had been spent at a lovely Los Amigos retreat, just outside of Albuquerque, with Aztec dancers, great food and drink, and a dance floor that was full until the last bus departed close to midnight. So, when Keith Odom introduced Willman by saying, “perhaps we have saved the best for last”, we all settled in for what has become a conference tradition - Doug’s take on Redesign. Doug began by enumerating the many ways that NADE had been effective in communicating with SSA. He noted that the program has been shaped to an extent by feed back from our organization and that Central Office has eagerly sought out and acted on our advice regarding the future of the disability program. Doug was particularly pleased with the effective partnership that NADE and NCDDD have forged. NCDDD is composed of 52 members and a number of associate members while NADE and its chapters is considerably larger. However, our objectives are largely the same. We seek to craft a better program for the claimants and taxpayers and advocate for what is in the best interest of the DDSs. So, working together we have been able to get in and help advise SSA about how the program should go. The result, he suggested, is a saner and more rational disability program. Mr. Willman then discussed Redesign. He compared his role in this topic to that of a commentator. If previous SSA administrators at the conference had provided the “Dan Rather” factual perspective, he would prefer his role to be that of the “Paul Harvey” commentator. Look at history of Redesign, he noted. How did we get into this saga and where are we now? We began five years ago when SSA provided irresponsible promises of what redesign would be. We were told of decreased mean processing times, increased PPWY, an end to fraud, etc. Some of us said that was unrealistic. And that is the way it turned out five years later. How did such a saga begin and continue? Perhaps because there was almost a total lack of involvement of front line workers initially. The ideal model of the “Blue Book” was fiction. And perhaps the most encouraging thing we can say today is that we can burn the blue book. In addition, SSA has acknowledged that there will not be any “big bang” returns on redesign. John Dyer said dramatic improvements simply have not happened. Instead, SSA has now narrowed its focus more towards the “kernels” of improvements that hold some potential for enhancing public service. Next, Mr. Willman commented on when all of the new redesign initiatives were supposed to happen. Prototypes begin October 1, 1999, and the final rollout will not occur before March of 2001 which allows a period of time for experimentation with the prototypes.

How has NCDDD reacted to the new plan?

Willman said NCDDD is pleased that many original components of redesign are gone. There are some modest improvements in service delivery. It is always a good idea to take a fresh look at the program and to have some states involved in prototype activities. Moreover, SSA has stopped over promising. And most important, in the last five years, SSA has involved front line personnel. SSA has made no major redesign decisions without input from NADE and NCDDD. Consequently, it is Mr. Willman’s opinion that what’s left of redesign is a saner and healthier plan. Now the time for quibbling about the decision is over. We must continue to work with SSA and move forward. Regarding remaining doubts and reservations, Doug assured everyone that NADE and NCDDD would not be negative, but will be vigilant and attentive to potential problems in the redesign prototype roll-outs. Potential problems include Process Unification (PU) rationales. Writing these rationales, combined with a pre-decision interview is an extremely expensive, time-consuming and labor-intensive process. It may be the right thing to do based on what the states have said, but it is incompatible with SSA’s emphasis on productivity, mean processing time and cost. We need a realistic estimate of what we are to accomplish. SSA has willed the ends without the means. In Nebraska, since the beginning of the rationale pilot, the weekly production of the examiners involved in the project has dropped from about 17 cases a week to about nine. In addition, SSA is probably incorrect in its assertion that eliminating reconsideration will pay for the other program changes. This will not pay for PDI, rationales, PU - no pilot state has had this experience. The pilot states will face real problems with front line support if these prototypes are not realistically drafted, practically applied and honestly evaluated.

How will OHA fare?

A greater number of people will appeal to OHA. OHA has been the component, which has been unable to keep up. During recent years, the DDSs have helped. There was also additional staff with decisional making capabilities. SSA provided additional positions to OHA, which increased the level of expertise. These support mechanisms helped to reduce processing time.