Mar 20, 2013

A "Ringing Call For Incrementalism"

     Some excerpts from an address by former Social Security Commissioner Michael Astrue at a Social Security Advisory Board (SSAB) forum on March 8: 
I want to thank the SSAB for inviting me back to Washington.It has involved some sacrifice for me -- I’m going to miss the Early Bird Special this afternoon ... but I should be back in Boston for bingo tonight. ... 
Unlike in the past, we should not expect that this Congress will do a quiet and efficient reallocation of the Trust Funds to cover the OASDI [Old Age Survivors and Disability Insurance] deficit. We do not have a sufficient number of the Daniel Patrick Moynihans & Bob Doles, the Bill Archers & Barbara Kennellys, enough leaders to lead a civil, informed debate on a hard topic . What we must try to do now to is start a process of education and dialogue that could let us avoid another inflamed, last-minute public spectacle, like the fiscal cliffs and sequestration, driven by what Stephen Colbert calls truthiness rather than actual truth....
[I]n order to pay for sexier items, Congress had drained the SSA [Social Security Administration] administrative budget so badly over two decades that the inevitable occurred — backlogs increased not only for hearings, but also for the continuing disability reviews that are the agency’s main weapon against improper payments. Having said that, the level of actual fraud is still extremely low, probably some fraction of one percent of the people receiving benefits. C ritics of the agency have resorted to distoring data that relates to the perfection of documentation — not fraud, not even improper payments — in order to support overheated claims of massive fraud....
The number of people on the rolls is rising substantially, but that rise is a predictable consequence of the baby boomers reaching their disability -prone years, not the product of new rules or management. ...
By contracting with the Bureau of Labor Statistics to supplement the existing O*Net system, the agency has shaved tens of millions of dollars off the cost of replacing the DoT. It may be doable for an additional cost of 10-20 million dollars and periodic costs for updating ... 
I am very concerned , though, about the possibility of another well-packaged but ill- considered reform initiative driven by the OMB [Office of Management and Budget] institutional views, which relies on the fallacy that we can solve problems created by bureaucracy and complexity with ever-more complex bureaucracy and complexity. Like Ahab chasing Moby Dick, they reject all the evidence and experience to date and insist that they can harpoon a system that will be so much more accurate up-front that Congress will be impressed by the back-end savings and fund the added bureaucracy. 
This whale hunt failed with the Clinton Administration’s prototype initiative, and it failed more miserably with the Bush Administration’s DSI initiative. In fact, DSI almost brought the agency to its knees...
OMB should drop its harpoon, let that imaginary whale swim into the mist, and focus its attention on actions that could actually produce real program savings : two-year rather than one - year appropriations cycles; stronger support by the Appropriation Committees for the IT [Information Technology] carry-over fund; and CDR [Continuing Disability Review] funding formulas that would allow CBO [Congressional Budget Office] to score the program savings in a way that would shelter associated administrative costs. ...
I submit to you that the academics, the policy experts, and the advocates of all stripes have not demonstrated an overarching issue in the system that could be the foundation for sweeping reform. Most of the time Social Security disability does exactly what the American people want it to do, which is to provide a safety net for people whose medical problems dictate  that they legitimately cannot work for a year or more. I can tell you better than almost anyone that the system is far from perfect, but the problems result from many very different failings throughout a highly complex system, not one or two overarching issues. In my opinion, there is no magic bullet solution, only scores of detailed answers to very specific problems. ...
My ringing call for incrementalism is hardly sexy, but if you care about supplying a compassionate but cost-effective safety net for the disabled, you will need to have a laundry list of concrete reforms to offer Congress in the next year or so....
Let me “help” you with this list. ...
[B]udgeteers in state agencies have figured out that they can shift their program costs to the administrative budget of SSA by requiring a decision on disability from SSA before allowing people to collect benefits from TANF [Temporary Assistance to Needy Families] or some other state-funded program. .... It is time that Congress closed this loophole and made it explicitly illegal to condition receipt of any benefit upon an SSA disability determination if that benefit is partially subsidized by the federal government....
Another similar area for action is concurrent application for both unemployment and disability....
Congress can also help claimants help themselves by authorizing SSA to direct the state agencies to develop comprehensive, up-to-date websites in each state that include: 1) sources of assistance for free pharmaceuticals; 2) locations of DOL [Department of Labor] one -stop offices; 3) information about services available from the state vocational rehabilitation agency; 4) disease groups that offer supportive services; and 5) a primer about looking for work on the Internet and information about data bases that list available jobs, both locally and nationally.  ...
Congress also needs to give the Commissioner the mandate to begin over the next five years an orderly elimination of the reconsideration step that occurs in most, but not all, states ...
[A]bout half of the [hearing] backlog reduction came from more resources and about half came from increased productivity....
SSA accomplished much of this progress over the intransigent resistance of the Office of Personnel Management [OPM[ They steadfastly refused to reopen the [Administrative Law Judge hiring] list for over ten years — imagine what your hiring would look like if you could only hire off a list that was ten years old! I sat in one meeting where a senior OPM official told John Berry and me that there was no reason to consider new applicants until SSA hired from the last person left on the list. What does that statement say about OPM’s commitment to quality in public service? What makes it worse is that OPM is spending a lot of trust fund money doing very little.  ...
I believe the ALJ position is the only job left in the civil service that requires a test, and it is a test designed by people who have no understanding of the administrative process and no desire to learn. It has become a budget game to pad the OPM budget at the expense of the trust finds. For instance, not long before I left I learned third-hand that trust fund money is going to develop a new on-line testannounced this week will be administered by little cartoon figures on the screen. Little cartoon figures... 
Where are the oversight committees on this critical function? OPM’s work is excruciatingly slow, outrageously expensive, and of unacceptably poor quality —and it has been so since at least the Clinton Administration. OPM damages SSA’s efforts to supply timely, high-quality justice, and it is time for Congress to move OPM’s responsibilities in this area to a federal agency that understands administrative law — either the Department of Justice or the Administrative Conference of the United States. ... 
Congress needs to streamline its statutes on return to work. Congress has tended to have an unrealistic view as to how many recipients can return to work. Somewhere around 60% of the people on the rolls have no realistic expectation of returning to work — they have fatal diseases, like ALS or Huntington’s, that are certain to continue debilitating the person until he or she dies a premature death. Some people have horrific brain damage from car accidents or military service. For many of the 40% for whom a return to work would be difficult but perhaps possible at some point, the layers of new incredibly complex statutes to encourage work have become counter-productive....
When Congress gets serious about addressing the 2016 insolvency of the trust funds, there will be bad ideas floating around too. The one that has the most currency baffles me, which is another try at making hearings adversarial. I was stunned when I first answered questions before Congress on this proposal because none of its proponents knew that the agency had piloted this proposal in the 1980’s and that it failed miserably. It was expensive — probably several hundred million dollars to implement fully in today’s dollars — and it made no difference in outcomes while simultaneously undermining public confidence in the agency.  ...

25 comments:

Anonymous said...

Told you that you would end up missing him.

Anonymous said...

I'm no fan, but the Moby Dick stuff particularly is not just correct, but eloquently stated. He shows his poetic soul.

Of course, his white whale was claimant reps. For some inexplicable reason, his method of dealing with the backlog involved picking fights with claimant representatives over issues such as secret ALJs and changing the rules on filing new applications while a claim is under appeal. We could have been his allies had he not gone out of his way to make us enemies.

Anonymous said...

who cares if claimant's reps are "allies" of SSA?

Anonymous said...

Had he said this while COSS yes, a lot of opinions would have been changed. I have no quibbles with any points made nor how they were made. I'm pleased they were said and hope they gain more views outside this blog and the SSAAB website. But to be fair, OMB oversight of testimony and other related public pronouncements would have made this speech something different.

Anonymous said...

Although he appears to have been addressing particularly T2, The fact is that SSI is rife with waste, fraud and abuse, has massive amounts of incorrect payments, and uses a huge percentage of SSA's administrative budget. To address SSA's administrative budget issues without addressing SSI is keeping one eye closed, for sure.

Anonymous said...

Bingo!

Anonymous said...

@ 5:10pm: SSI, are you talking about Social Security or Supplemental Security Income? SSI is Supplemental Security Income, the payments are need based and at most are $710 a month, though some extra money comes from some of the states for the people that live within their borders, like CA gives an SSP of $156.40 a month and no more than that which is administered by the SSA in this case and added to the SSI check every month for a total of $866.40 and SSI isn't really adequate as the cost of housing exceeds in most cases the size of the check, but not in all cases. In CA no SSI recipient gets Food Stamps cause of an inter government dispute, that's CA vs the USDA/SSA...

Anonymous said...

Yes, Supplemental Security Income. The point made above was not about its adequacy, but rather the programs continued abuse and how labor intensive it it for the agency to administer.

Anonymous said...

Unfortunately, SSI is limited to Approximately $700.00 per month, per person, but there is no family cap. Therefore, a SSI mom with 5 children on the rolls may collect $4,200.00 per month. Too bad that there are family limits for Title II and that same family that had paid into the program would be limited to about $2,500-3,000 a month. But, I guess all is fair in love and war, expecially when one's big goal is to redistribute the wealth to the poor..

Anonymous said...

In over 30 years working for SSA in the SSI program, I have never seen a "SSI mom with 5 children on the rolls." What a ridiculous argument to bring up a mythical situation as an argument that SSI is too generous, which BTW is off topic.

I'd also like to see the research that SSI is "rife with waste, fraud and abuse." There are incorrect payments (both underpayments and overpayments which are usually collected back) because of the complexity of the program and the effect of changing circumstances like extra income, living arrangement changes, etc. This is not the same as fraud and it is an incorrect assertion to claim that fraud is a huge problem. It is not even close to the level of fraud in other programs like agriculture subsidies, tax fraud, etc.

Anonymous said...

Absolutely on the money.I've worked within and outside ODAR. The current CDRs we're seeing are ludicrous and will end up adding to the backlog at the hearing level and causing real, human tragedies to folks who are blindsided by these (computer-generated?) reviews. Suddenly they are faced with "overpayments" in the tens of thousands of dollars. Where did I read that there is actually an incentive to FO personnel who ferret out overpayments and manage some sort of "recovery" which I guess is a repayment plan?

Anonymous said...

I've been a SSI CR for only 5 years and work in an low income urban area. Just had a case thus morning with a mother on SSI and 7 kids: 5 on SSI and 2 getting ADC pmts. I will admit that is rare to have that many, but not mythical. I do however see plenty of cases with multiple children getting SSI. In just the 5 years here, it's my experience that in poor, urban areas, if a parent gets SSI or has a child that gets SSI, they apply for ALL children in the HH. Sometimes it works, sometimes not. But I would guess at least 75% of SSI homes in my area have filed claims far all kids, usually alleging ADHD. They also refer to the pmt as a "paycheck" which also shows their mentality.

Anonymous said...

Anonymous 10:31 said, "There are incorrect payments (both underpayments and overpayments which are usually collected back)." Speaking of mythical, you must be from a mythical place. I have heard many overpayments and they are never paid back. As a matter of fact, on Title XVI, they don't even go after them. Speaking of fraud, I would consider those that request continuing benefits with no ability to pay them back as a form of fraud. One of the dumbest things the Agency does is give the claimant the opportunity to continue to receive benefits AFTER determing they are no longer disabled. The claimants have no incentive to turn down the benefits as they know that the Agency can't do anything to them when it comes time to pay it back. The old blood out of a stone, don't ya know?? Further, just because our fraud doesn't match IRS fraud we should disregard it? Duhhhhh???

Anonymous said...

If anyone has "worked in SSI for 30 years" and not seen significant SSI waste and not seen multiple-eligible famiulies, you have been working with your eyes closed. I worked in SSI for over 35 years and multiple-eligible families are common. I saw 3-4-5-6 people in a family on SSI, with additional members on afdc. Massive numbers of overpayments are the rule, and those are only the ones we caught.

Anonymous said...

The SSI trip into the weeds started because several posters accused Astrue of negligence for not mentioning SSI in his remarks. He did mention SSI in his remarks. It just isn't in the "highlights" Charles posted. To wit:

"Before I conclude, I would like to add a cautionary note about a recurring area of controversy, children receiving SSI. When the story broke a few ago in Boston that parents had killed their four
year old daughter by drugging
her to get her fraudulently onto SSI, we looked at the data we had to try to figure out whether we had a problem on our hands or
not.
The truth is we couldn’t tell. On the one hand, there was nothing in the data that suggested a recent dramatic change or extensive fraud. On the other hand, there were anomalous patterns in a handful of cities around the country which tended to suggest that an unusually high
number of children are on SSI, even adjusting for income and other factors. That is a legitimate
source of concern. My answer was to get an in depth study done, a proposal I thought would be
noncontroversial, but initially
drew fire from both OMB and the advocacy community. As everyone calmed down and talked, I think a
broad consensus developed that a study needs to be the predicate
for policy changes. Statutory changes based on bias or guesses are likely to hurt both children and the taxpayers in the long run."

I'm sure those who have posted here would have preferred that the former COSS had proposed immediately eliminating SSI payments to children, based on hysterical, urban legends from alleged CRs posting here that the system is being abused. The COSS didn't have the luxury, nor the lack of good sense, to propose legislative changes based on anonymous posts on the internet.

Anonymous said...

SSI is the elephant in the room, and cannot be ignored. Of course, SSI has a greater effect on those more generous States such as California, which have become magnets attracting and increasing that segment of the population that prefers living off the efforts of others. SSA offices in California exist more to service the welfare population, and waste, fraud and abuse in SSI are well known and to a great extent tolerated. Fraud is too often renamed “overpayment”, and the overpayment is waived. Abuse is considered too judgmental as a label, perhaps not culturally sensitive, and usually ignored. Field office staff learns quickly to identify waste when they are assigned workloads and follow procedures that take an excessive amount of time and effort that are confusing, vague, contradictory, or meaningless, providing no real benefits to the public or the agency. Too often SSA has one group of employees digging a hole, only to have another group of employees come in to fill the hole up again.
To 11:15 AM March 21, I worked in field offices long enough to see children who received SSI grow into teenaged parents having their own children receiving SSI, adding to an already high SSI “payroll” issued to that household. While SSI can exist as a safety need for the truly needy, it also must be recognized as a way of life for too many. The idea of a household cap for SSI has merit.
Astrue performed his duties as Commissioner in a very transitional time with great integrity and foresight. He speaks as a leader, not someone repeating bullet points prepared by a staffer. His emphasis is on actions based on realities and not emotions.

Anonymous said...

Here's my suggestion to those who post here, claim they work for SSA, and claim they know of specific instances of fraud involving children receiving SSI benefits. Do a fraud referral to the OIG. You know that you not only have the right, but a duty to report fraud, correct?

As the ex-COSS said, eliminating SSI payments to children requires that the Act be amended. He couldn't have made such a change even if he wanted to. If your goal is to have the Act amended, give SSA some ammo to ask Congress to amend the Act. Report the fraud that you claim you are seeing every day.

It's worse than useless to make anecdotal anonymous posts on the internet and expect anybody to act on that.

Anonymous said...

You can't send a fraud claim to OIG when DDS or an ALJ decided the kid was disabled based on ADHD or ODD or whatever--you'd have to have a W.Va. type situation before a determination (normal on its face) would be questioned.

There is another very obvious source of fraud. I see a huge number of claimants who have significant amounts of reported self-employment income (invariably in amounts just shy of either SGA or the amount of income that would maximize the EIC credit... imagine that) and presumably get tax refund checks from Uncle Sam. Yet when confronted about the earnings and the work activity that must have resulted in this income at the hearing, the claimants put on their victim hats and insist someone else used their SSN or their tax guy juiced their returns without their knowledge. And yet, despite ample evidence that somebody committed significant fraud (either the claimants did, people using their socials did, or the tax guy did), we are not allowed to send this information along to the IRS or any other body that might be interested in pursuing the fraud. Yay!

Anonymous said...

I think it's more venting than anything else. If you've ever worked for SSA, you've already accepted no change to SSI is coming. It's political suicide plain and simple.

Anonymous said...

Man, Astrue went hard on OPM. About time somebody did.

I can appreciate his remarks on OPM's absurd expenses. A friend (I know, I know, this is purely anecdotal...) was contracted by OPM to do some really boring database programming stuff for hiring related websites, etc. a little while back and was being paid at a rate of nearly $100,000/year for a year doing about four months' worth of easy work. And the stuff he was working on still took another number of months after his and everyone else's work was done to actually implement.

Anonymous said...

Some insiders suffer from the delusion that "all I see is all there is". But worse than this is someone that receives a bloated federal salary lamenting that an SSI recipient on a less than poverty benefit is milking the system.

Anonymous said...

Right, back to the old "lazy federal worker" bit - nice one!

Anonymous said...

How did Astrue's decision to hire hundreds of lawyers for the Appeals Council fit into his philosophy of incrementalism (or Kaizen, which he referenced in other contexts)? Hundreds of lawyers whose jobs consist mostly of writing up recommendations for other lawyers to deny 80 percent of the request for reviews made to the Appeals Council.

Anonymous said...

Anonymous 5:56 PM noted, "But worse than this is someone that receives a bloated federal salary lamenting that an SSI recipient on a less than poverty benefit is milking the system." Actually, much worse than that is the Rep that takes money out of the claimant's hands without doing 2 hours worth of work and meets him/her in the lobby 20 minutes or less before the hearing.. The Judge makes about $200.00 per hearing with about 3-4 hours of work invested. The Rep walks off with up to $6,000.00 and sometimes/most little to no work. Let's hear it for the Reps!!!

Anonymous said...

to 8:42 am, that's a BINGO! And the reps want to shop around for their ALJ and take their cut off the top instead of seeking payment directly from their clients. Don't they trust their clients to do the right thing and pay their reps out of their retro payments? Where is the trust and respect for their clients?