From Nancy Altman writing for The Hill:
“Program integrity” is the sort of technical term that sounds good. Who wouldn’t want to run Social Security with integrity? But unfortunately, in the Alice-in-Wonderland world of Washington-speak, the phrase doesn’t mean what you think.
Administering Social Security with integrity sounds as if it means ensuring that the right payments go to the right people in the right amounts. You would think it means that the Social Security Administration (SSA) helps working families get the benefits that they have earned. Instead, it means the opposite.
“Program integrity” is insider-code for saving money. How is money saved? By going after people who have done nothing wrong. By going after people with serious disabilities who must prove over and over again that they are unable to support themselves. By going after people whose benefits SSA claims were wrongly paid out, often because of mistakes made by SSA itself. ...
SSA must return to its roots, to its core mission of helping everyone get the benefits for which they are eligible. It should devote at least as much effort to underpayments as it does to overpayments. It should focus more on educating the public about the benefits for which they are eligible and less on challenging previously-awarded benefits. ...
It has become clear that Social Security advocates are working to improve Social Security's administrative budget difficulties by liberalizing what "program integrity" funds can be used for. At the moment, Social Security doesn't have enough money to answer its phones or to put people on benefits in a timely manner but it has abundant funding to cut people off benefits. We need balance.
It isn't a fiscal issue, although it wears that mantle to garner support and to hide behind. It's a moral issue in that it's the belief that no one should ever get government help, other people's money, for not working except those who "truly" need it. No, I misspoke - those who "deserve it" (Hence little argument against clear physical disabilities, and a ton of pushback on hidden or mental health disabilities.) And hence the focus on who program integrity. A form of morality police looking for the undeserving not to save money but because they are undeserving.
ReplyDeleteWhen Congress votes extra money to SSA to conduct CDRs, there is no option for SSA to say they'd rather use the money to hire people to answer phones. The money is designated by Congress to go for particular workloads and that's where it has to be spent.
ReplyDeleteProgram integrity also involves going after fraud which some may think is very rare but look at the unemployment benefit fraud from the past year to see what happens when no one is guarding the chicken coop.
Here's a conservative's take: I'm not fond of the idea of the government giving people money. I think social security should be set up as private, heavily regulated and insured investment accounts that could be passed to the next generation. However, I also believe that when the government does establish a program, it has an obligation to administer the program competently, fairly and to provide due process. Neither the agency nor its ALJs are responsible for deciding whether people should be getting these types of benefits or worrying about the burdens on the taxpayer or budget. Their job is to apply the regulations and laws fairly and competently. Those other considerations are left to Congress.
ReplyDeleteProgram integrity isn't insider code for anything. Within the agency, it means paying the right person, the right amount, at the time time -- a concept rooted in our mission. Unfortunately SSA is plagued with quality issues that stem from policy complexity and inadequate automation that has, for the past two decades, focused on online intake with zero regard for downstream processing. None of what's happening should come as a surprise.
ReplyDeleteFrankly, I find Ms. Altman’s statements irresponsible and offensive. She echoes this sentiment that FO employees are ‘out to get’ applicants and beneficiaries, which is wholly ridiculous. FO employees are NOT paid by commission by the number of people that get cut off from benefits. Attorneys essentially get paid by commission to put people on benefits. The vast majority of FO staff are just applying the law, regulation and policy to the best of their ability. So, let’s just dispense with the narrative that FO staff are these black-hearted, evil people that get a rise out of other people’s misery - because it broadbrushes many of the people who work for the agency who do everything they can to help people.
ReplyDeleteBy law, regulation and policy, CDRs must be done and redeterminations must be done. “Program Integrity” was invented 15 or so years ago, in the Barnhart days, to help connect the kinds of work that must be done by law to SSA funding in a time of funding reductions. There it is. Is Ms. Altman recommending that CDRs and redeterminations be done away with? Fine, then she should use her position to change the damned law and not paint FO work as something purely malicious. Make DIB and SSI into a UBI benefit, then there would be no need for any disability decisions nor any need for income and resource determinations. But, then, there would be no need for attorney representation, either.
8:12 AM. Did you actually read the article? She is not complaining about FO "out to get" claimants, she is referring to Congress. Specifically, she is (without naming them) referring to Senators Tom Cotton, Rand Paul, James Lankford, and former members of Congress, such as Sam Johnson. These, and a few others, are the ones who wanted the CDRs to be funded. Just like there are plenty of anecdotal stories of people who should be found disabled that are denied, there used to be stories of people who "weren't disabled" that did get benefits. One of these alleged people was the "tree trimmer" that Senator Tom Coburn (whom Lankford replaced) claimed would only accept cash, so it wouldn't hurt his disability payments. Naturally, the Senator nor the press furnished the information necessary to judge whether the alleged person was or wasn't disabled. Mainly, the diagnosis(es) and other conditions that lead to the person getting approved in the first place. Some reports suggested he was a soldier with PTSD. Coburn didn't indicate that he had contacted SSA. Why do that when you can use it as an excuse to demonize the disabled? Frankly, I have my doubts about the "story." It seems too convenient.
DeleteThe real problem here is that the rules being applied are often arbitrary... With little or no proof that they truly indicate disability. They seem DESIGNED to deny at the initial and reconsideration stages... While giving ALJs the power to deny or approve at their discretion. Their decision need only be supported by "substantial evidence"...which CAN mean only a little supports it. This leads to inconsistent application of the law that seems very arbitrary to lay people.
Yes, Tim, I read the article. And, yes, she spends the first half of the article expounding on how the work of FOs is out to torture beneficiaries. I have done the work, and I can tell you that the vast majority of FO staff find their motivation in HELPING people. Did you actually read my earlier comment? I am supplying a picture of how this REALLY plays out in the real world.
ReplyDeleteWhat is really disappointing is that Ms. Altman is supposed to be in a non-partisan advocacy role, but goes off on this wide-eyed rant that is massively political. I explained the history of “Program Integrity” and what it really means. Situations similar to children who are overpaid, then are called to repay decades later - that has nothing to do with “Program Integrity.” It means that they were, probably justifiably, overpaid for some reason, the overpayment sat on the record under the beneficiaries’ SSN and then came to life when that person filed for retirement. AND, if that person contacts the FO, chances are extremely likely that FO staff will HELP them, faithfully apply policy and advise them what they can do to resolve it. Does Ms. Altman say THAT? NO, because it does not fit her narrative.
Just like anywhere - there are incompetent people everywhere. There are nonsensical policies in government and in private industry. I don’t pretend to say there aren’t issues. I don’t do disability decisions and I don’t pretend to say that they are easy. I see what seems like arbitrariness. But, I can tell you that the folks who are making the decisions, most often, are doing their best to be faithful to their instructions and weighing the information to the best of their ability. There are always headshakers…. I have seen hundreds of them. I have given encouragement to these people who are affected by these decisions and done what I can for them to respond.
Just like anybody, I hate seeing political figures on either side of the aisle rant about something they poorly understand. Nearly every time, it’s as if they don’t really want to know and would rather scaremonger, because falsely framed anecdotes play better than facts.
9:31 AM/8:12 AM. It's almost as if we read 2 different articles. I reread the article 3 times. Her complaint seems to be be about SSA as a whole, not the FO per say. I still haven't found where she mentioned them. As for "program integrity," it clearly means different things to different people. When used as the "critics" of SSDI/SSI use it (the ones voting to fund CDRs-aka Congress), it clearly means to remove "unworthy" or "not truly" disabled people... Based upon the perception that disability is too easy to get. As for me... Well, my "anecdotal" experience was less than "satisfactory."
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