I am getting feedback from Social Security employees to the effect that the House Republican draft of an appropriations bill covering Social Security sounds OK to them. As I understand it, their argument goes like this:
- Social Security gets more money. That is good for this fiscal year and it increases the baseline for future years, which would be even better.
- Social Security would be able to do more Supplemental Security Income (SSI) redeterminations and Continuing Disability Reviews (CDRs). Both need doing.
- With the additional money, Social Security would be able to avoid furloughing employees. This may be the most important consideration for Social Security employees.
That is all true and I agree with these points. I cannot blame anyone for wanting to avoid a furlough. However, there are other important considerations that lead me to believe the House draft bill would be bad news for the public. Here are my concerns:
- The draft bill would give more money to Social Security but would require that a huge portion of all the money appropriated to Social Security be spent on SSI redeterminations and CDRs. This would reduce the money available to be spent on everything else that Social Security is supposed to do. This will cause increased backlogs and poorer service generally.
- The money could not be spent wisely on SSI redeterminations and CDRs in the approximately nine month time period that would be left in the fiscal year by the time an appropriation is agreed to and Social Security can start to implement the appropriation. I am pretty sure that Social Security does not currently have enough personnel trained in SSI redeterminations to do all that would be required. Personnel would have to be retrained. That takes time. By the time the people get trained, the fiscal year would be about over. Disability Determination Services (DDS) personnel could do the CDRs but anyone who is cut off benefits gets the right to a reconsideration hearing. These hearings are not before Administrative Law Judges but before DDS hearing officers. There are few DDS hearing officers. Many more would be needed. It would take months to train all the needed personnel. By the time this is done, the fiscal year would be over and there would be a huge backlog of CDRs awaiting reconsideration hearings.
If I am not understanding the proposal, please correct me, but it looks to me like the result would be a wasteful crash program that would accomplish little in the short run except to make backlogs at Social Security much worse. That would be poor public policy. Avoiding furloughs of Social Security employees is an important consideration but not be the only consideration.
Social Security should be given the time to ramp up to do the increased SSI redeterminations and CDRs in an orderly fashion that doesn't trash everything else the agency is supposed to be doing.
Social Security should be given the time to ramp up to do the increased SSI redeterminations and CDRs in an orderly fashion that doesn't trash everything else the agency is supposed to be doing.
9 comments:
Charles,
The point you insist on missing is that there is no difference between the House and Senate bills in the level of funding dedicated to CDRs and SSI redeterminations. The language is written differently, but both bills earmark $896 million for CDRs and RZs. This is a funding level that was agreed upon this summer and is exempted from spending caps established by the Balanced Budget Control Act. (see page 4 of http://www.gpo.gov/fdsys/pkg/BILLS-112s365enr/pdf/BILLS-112s365enr.pdf -- $896M is the $623M identified in the language plus the $273M identified in the President's FY 2011 budget and the FY 2012 Senate bill as CDR funding already in the base LAE appropriation)
This is less than the $938 million proposed in the President's budget earlier this year. See page 1181 here: http://www.whitehouse.gov/sites/default/files/omb/budget/fy2012/assets/ssa.pdf -- $938 million is the total of two funding earmarks -- $315M in base funding (paragraph 2 of the proposed LAE language) and additional $623M (paragraph 3).
With that level of funding, SSA was proposing to do 200K more SSI redeterminations that in FY 2011 (about an 8% increase), and 232K more medical CDRs (about a 64% increase).
This isn't something the Republican House made up -- the House, Senate, and President are all proposing about the same level of program integrity funding.
With respect to your concerns that SSA couldn't process this work effectively:
SSA was planning to do this work anyways -- they have 12 months, not 9 to accomplish it, because even under a continuing resolution, SSA will process CDRs and redeterminations. SSA almost certainly has suffcient trained claims reps to process a modest increase in redeterminations.
Your concern about a backlog of CDR reconsideration hearings is probably overstated, as most CDRs don't result in someone getting their benefits terminated anyways. Based on their latest published CDR report to Congress (here: http://ssa.gov/legislation/FY%202009%20CDR%20ReportREV.pdf) they only ceased benefits in 75,000 cases, out of about 1.1 million reviews.
Finally, you don't understand the value of more funding included in the House bill. Since the House and Senate are earmarking the EXACT SAME AMOUNT OF MONEY for CDRs and SSI redeterminations, all of the additional funding in the House bill (compared to the Senate's) will almost certainly be used for, to quote you, "everything else that Social Security is supposed to do".
Like or dislike the House, their bill provides more for SSA to carry out it's mission than the Senate bill does.
All SSI CR's know how to do redeterminations. There are a few differences between paying SSI claims and doing SSI redeterminations, but we use the same computer program and ask virtually the same questions and apply the same policies as we do when we make payment decisions for claims. With an increase in number, we'll have to spend more time doing it which would mean less time for claims. But furloughs would also mean less time for claims.
Redeterminations for SSI have been part of our core workload since 1974, when SSI began. Somewhere along the way, we morphed into an agency that's primary focus was on disability issues and OHA (Office of Hearings and Appeals) became ODAR (Office of Disability Adjudication and Review). The name of the hearings office even changed to the focus being disability.
Politicians talk about Social Security as if it was only a retirement system but in the day-to-day, the biggest workload is disability.
I have worked in 4 Social Security offices, three in California. In the California offices, some managers have kept SSI claims reps doing only SSI post-entitlement and redeterminations for years and years. There is plenty of knowledge in the FO to complete redeterminations. But like everything else, there has never been enough time.
CDR knowledge may be distributed among fewer staff members. Finding the comparison point folder is probably the hardest thing to do. The rest is not substantially different than taking new disability claims.
Most SSI redeterminations have been done in a routinely shoddy fashion for a number of years. all that matters is numbers cleared, not quality of clearances, so virtually anyone can do redeterminations once they have been shown the basic framework and the necessary shortcuts. Congress is not saving any money by manadating that these redets be done for "program integrity" purposes, since their exists virtually no quality control. CDR's are different, and can save the taxpayers a boatload of money if done routinely and timely, because they depend on actual medical edvidence and determinations by folks outside of the FO's, which are too understaffed to do much of anything well anymore.
The SSI program should be frozen as of a date certain--say, Jan 1, 2012, or Apr 1, 2012--and no new applications taken. Anyone not qualifying for T2 DIB would then just be on welfare, as was the case prior to 1974. SSI is totally out of control and a complete shambles, and it is past time to let it die off and save the taxpayers billions of wasted dollars.
"That is all true and I agree with these points. I cannot blame anyone for wanting to avoid a furlough. However, there are other important considerations that lead me to believe the House draft bill would be bad news for the PUBLIC."
I'm sure in his mind Public= Attorneys getting paid.
If it comes between me getting furloughed or him getting paid, screw him. Go chase another ambulance.
AN INSIDER -- The fact is that SSA has been doing few SSI redeterminations and CDRs for years, with the focus on new claims. Little or no time should be needed for most SSA employees to "ramp up".
Most of this boils down to sending check-the-blocks post cards to see if the beneficiary is alive and at least has someone in the USA to cash their check....
The reference points used can be hit and miss (in part refecting difficulty in getting prior files, paper or electronic), and all to often 'creative' ways to not make a new initial determination with the prior file can not be obtained or is grossly inadequate.
From what is seen in ODAR, the DDS hearing officer "hearings" and form "decisions" are of little value, frequenly done by telephone or waived, provide little insight, and almost always rubberstamp the DDS's doctor and any CE(s). Some are noticably off-the-wall in gunning down the beneficiary and uniquely anti-claimant versions of the disability program. A minority try to do the job, involve time and thought, and show some independence and care.
SSA employees are reacting somewhat favorably to the House bill because we feared things could have been a lot worse. Could the bill be better from SSA's perspective? Sure. Could it be worse? You betcha. We are just hoping that it doesn't get any worse than this.
I can't imagine any fiscally responsible person thinking that increased CDR's is a bad thing.
In lean times, all organizations re-evaluate how they are spending money. SSA spends lot's of money that it shouldn't (according to numerous studies) paying disability to people who are no longer disabled. What's wrong with ensuring that beneficiaries are actually disabled?
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