QUESTIONS SUBMITTED BY THE SUBCOMMITTEE

ZEBLEY SUPPLEMENTAL APPROPRIATION

Question. The administration is requesting $232 million in a supplemental to implement the Sullivan v. Zebley Supreme Court decision. According to your budget justifications, you only plan to spend about $94 million of this amount in fiscal 1991; the balance will not actually be utilized until fiscal 1992 and 1993 to process an estimated 237,000 retroactive childhood disability claims.

Why shouldn't Congress just give you the $94 million needed to get through fiscal 1991, and consider the rest in connection with the regular fiscal 1992 appropriations bill?

Answer. These youngsters with disabilities have already waited too long and we need to assure them that we will begin to address their cases and continue that process to completion in the next 2 to 3 years.

Question. I understand that the courts still have not decided how far back you must go to review previously denied cases. Based on this delay do you have a more current estimate of what is needed in 1991 and 1992 to process the Zebley case?

Answer. The court order was signed on March 14th. Settlement is based on a class starting date of January 1980, and the current estimate of $232 million is based on the assumption that the class starting date would be January 1980.

Question. What actions have you taken so far in anticipation of this supplemental being enacted?

Answer. Last year when the Supreme Court issued its decision, I immediately established an intercomponent task force to plan implementation of this important decision. SSA has worked closely with the Department of Justice and plaintiffs' counsel regarding the implementation plan.

We have revised our childhood disability regulation to bring it into conformance with the Court's decision. A final regulation with request for comments was published February 11, 1991. We will now make an individualized assessment of the child's ability to function, as well as determining whether or not the child meets the medical disability listings. With the court settlement now final and Congressional action complete on our supplemental appropriation, SSA is ready to begin implementation of the decision. As stated in our Congressional justification, start-up and planning activities, incurred prior to enactment, will be charged back to the supplemental.

Question. What will the consequences be if the supplemental appropriation is delayed?

Answer. If the supplemental request is not approved, SSA would be unable to absorb the additional work related to the Supreme Court decision within the funds currently available without

significantly hindering our ability to keep pace with the projected increases in regular disability workloads.

SSA is under a court order so we must process these cases. If we process Zebley cases along with regular disability cases, it would cause processing times for all disability workloads to increase to unacceptable levels. Our regular cases are backing up due to funding shortages and increasing workloads.

If we use contingency funds, it will cause problems in other areas where these funds are needed, i.e., to process regular disability workloads, "800" number service, and implementation of key sections of the Omnibus Budget Reconciliation Act of 1990.

UNUSED CONTINGENCY FUNDS

Question. Congress provided your agency with a $146 million contingency reserve, to be used for unexpected workloads. I understand you requested OMB to release these funds, but OMB has refused.

What did you request these funds for, and how do you intend to manage without them?

Answer. Our latest formal request for release of contingency funds was sent to OMB by HHS Friday, February 15, 1991. SSA requested $125 million of the $146.4 million contingency reserve, OMB approved use of $100 million of the contingency reserve on March 14th. The contingency funds will be used primarily to process higher than budgeted disability workloads, as well as to address the "800" number where the unanticipated degree of success leading to the high number of calls has driven busy rates to unacceptable levels, and to begin taking on new requirements mandated by the Omnibus Budget Reconciliation Act of 1990.

Question. How do you explain your request for a $232 million supplemental, when you've still got an unused reserve of $146 million?

Answer. Using contingency funds to process the Zebley workload will cause problems in other areas where these funds are needed, i.e., to process regular disability workloads, "800" number service, and implementation of key sections of the Omnibus Budget Reconciliation Act of 1990.

PENDING DISABILITY CLAIMS

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Question. Information taken from your own budget shows a continually growing backlog in claims for disability benefits. the end of fiscal 1992, it will take more than 5 months, on average, to get a determination of disability benefits, that now takes 3 months, and used to take just 2 months a year ago. In sending Congress a budget that admits to a growing backlog, are you saying these delays are acceptable?

Answer. No. Taking an average of 5 months to process an initial disability claim is not acceptable to SSA. Within the resources requested for FY 1992, we have provided additional resources to the Disability Determination Services (DDSs) to keep

delays from worsening.

The funds budgeted for the DDSS rise from

$800 million in FY 1991 to $868 million in FY 1992. Although I do expect an increase in processing time and pendings, I think we will be able to do better now that much of the FY 1991 contingency reserve has been made available to us.

Question. What would you consider an acceptable backlog?

Answer. SSA currently uses a frame of reference of three months for making a disability determination. A few years ago the normal time frame was 2 months or 60 days. We have never pinned down what are generally considered to be acceptable service level requirements. DDS resource needs are driven largely by workloads generated from the public over which we have little control. Recently, SSA has experienced an unexpected increase in the rate of filing, coupled with new regulations regarding childhood disability and the impending workload of the Zebley class claims following the Supreme Court decision. We recognize these difficulties and have directed resources to the DDSs to try to alleviate the problem. are developing service standards for the time needed for a disability decision as part of our Agency Strategic Plan.

We

We must, however, balance our resources to maintain acceptable service in other areas of responsibility; retirement claims, issuing Social Security numbers, "800" number, etc. Reducing the backlogs will depend on adequate resources, appropriate technological support, and effective and prudent management of workloads and available resources.

HEARINGS AND APPEALS

Question. Persons who have their claims denied and ask for a hearing have another long wait. In July, it took 208 days to process hearings cases, but now it takes an average of 215 days-more than 7 months. Is this an acceptable processing time?

Answer. No, we believe that claimants are entitled to as speedy a hearing and decision as is possible, consistent with necessary case development. We are not satisfied with recent increases in processing times and are taking several steps to reduce processing time. For example, we hired 115 new administrative law judges last year and intend to hire an additional 115 this year. We also believe that our continuing effort to upgrade hearing office computer equipment will result in more efficient case processing and improved service to the public.

Question. How long will the average hearing processing time be in fiscal 1992?

Answer. If current workload assumptions remain valid, we believe we can steadily reduce hearing processing time to 200 days by September 1992; however, if hearing level receipts increase over current projections, our progress will be slower.

USE OF CONTINGENCY FUNDS INSTEAD OF SUPPLEMENTAL

Question. You have a $146 million contingency fund, which can be used immediately to help meet the unanticipated growth in

disability claims, as well as to begin reviewing previously denied children's SSI claims as required by the Supreme Court's Zebley decision. Why wait for a supplemental, when all OMB has to do is release contingency funds?

Answer. We asked for a $232 million supplemental

appropriation in order to process the 237,000 cases we expect to rework as a result of the Zebley Supreme Court decision and the cases we expect to reevaluate as a result of the interim Zebley regulations. We want to ensure that these youngsters with disabilities can be assured that we will begin to address their cases and continue that process to completion in the next 2 to 3 years. The supplemental appropriation as requested will be used to process Zebley cases only. Contingency funds are needed to process workloads exclusive of Zebley court cases. OMB released $100 million from the contingency reserve in order to permit us primarily to address the increased workloads resulting from the growth in SSI and Social Security disability claims filed, as well as "800" number call volumes, and recently enacted budget reconciliation legislation.

"800" NUMBER SERVICE

Question. Busy rates on the Social Security Administration's national "800" number have grown to a situation where in January 43 percent of calls didn't get through; on peak days more than half of all calls get busy signals. Do you feel this is an acceptable

rate?

Answer. I was not satisfied with busy rates in January and we are continuing to take steps to improve the public access to the "800" number. However, our performance in January this year improved significantly compared to the same period last year. The "800" number handled 223,000 more calls this January, and at the same time there was an improvement in the average busy rate of 9 percent and in the peak day busy rate of 11 percent. On twothirds of the days in January, more than 70 percent of the calls reached the "800" number without a busy signal. We expect to see improvement in the busy rates as the call volumes decline as we move beyond the traditionally heavy calling period of January through March.

"800" SERVICE STANDARD

Question. I understand that the Social Security Administration's stated busy rate standard is 5 percent, and therefore you are not meeting your own standard. But your budget says significant improvement in busy rates is unlikely even at the requested funding level. Does this mean you are changing your

service standard?

Answer. Our current goals in this area call for 20 percent busy rates on peak days-- that is, the day monthly Social Security benefit checks are issued and the following 2 days, every Monday and days following a holiday--and 5 percent busy rates on non-peak days. We are, however, exploring the possibility of supplementing the busy rate data with a better measure of access to the national "800" number. The problem with the busy rate alone is that it

masks the true relationship between demand and our capacity to respond because of the many immediate redials that occur.

The alternative we are considering counts the number of people who attempt to contact us on a given day and the percentage who actually get through to one of our teleservice centers. This "access" measure keys off of the unique phone numbers calling in, with an adjustment for people and organizations who need to call more than once a day. We believe the new "access rate" will be helpful in managing the national number, particularly in improving the match between widely fluctuating demand and our available

resources.

While a measure of the public access to the national "800" number is an important indicator of the level of telephone service we are providing, it may not be the best indicator of the level of service being provided by the "800" number. We are evaluating various other indicators, such as the accuracy of the information being provided and caller satisfaction, to determine the best measures to use in evaluating the service being provided by the "800" number.

Question. If not, why didn't you request more resources to bring down the busy rate?

Answer. As I stated before, the busy rate is not the only measure of service to consider. Our budget request for FY 1992 provides for an increase of 263 workyears--or 6.4 percent--above the estimated FY 1991 resource level for the "800" number telephone service. This request, while recognizing the need for fiscal restraint, also recognizes the need to provide the resources necessary to keep pace with the anticipated increases in calls to the "800" number. With the full level of resources requested we will be able to stabilize the performance of the "800" number system and begin to lay the groundwork that will enable us to eventually achieve the stated busy rate goals.

AGENCY STRATEGIC PLAN/AGENCY RESOURCE NEEDS

Question. The Department's February 4th press release states that HHS is developing strategies to maintain or improve the quality of service in the face of rapidly rising workloads and slowly rising resources. It goes on to say that the Social Security Administration is preparing an Agency Strategic Plan, expected to be completed this summer, which will provide a vision of how the Social Security Administration will function in the future. The plan will define service requirements, means to increase productivity and efficiency, projected investments in new technology, etc.

Will this plan become the "blueprint" that the Social Security Administration follows in the next few years to "enable the Social Security Administration to do more with less resources?"

Answer. The Agency Strategic Plan (ASP) is not a detailed blueprint of the future. The plan will create a comprehensive vision for the agency that is cognizant of the operating realities faced by most Government agencies. The vision presented in the ASP