Social Security learns from remote experience, plans field office openings

Published on December 13, 2021 in RINewsToday

On March 17, 2020, as the COVID-19 pandemic rapidly spread throughout the nation, the Social Security Administration  (SSA) issued a press release announcing that its offices would only offer phone service and online services.

However, in-person appointments at SSA were scheduled for critical issues, specifically for those who were without food, medicine, shelter, or those needing to apply for benefits or to reinstate them. This decision allowed SSA to provide critical services while protecting its employees and older beneficiaries, many with underlying medial conditions. 

Congress Expresses Concern Over Closing of SSA Field Offices  

Almost four months later, House Ways and Means Social Security Subcommittee chairperson John B. Larson (D-CT) and Republican Leader Tom Reed (R-NY) sent two letters to the SSA Inspector General Gail S. Ennis asking for a review of SSA’s telephone service during the COVID-19 pandemic and SSA’s process for obtaining medical evidence for disability claims.

The correspondence to SSA’s Office of Inspector General (OIG) noted that as the COVID-19 pandemic continues, beneficiaries are relying on their Social Security now more than ever. Except in dire need, beneficiaries are unable to access in-person services and are relying instead on telephone services.

Members of Congress warned that beneficiaries, especially those from vulnerable populations who lack internet connection especially in rural areas or don’t have a reliable phone number or mailing addresses, are struggling to gain access SSA while field offices are closed.

“As highlighted in the OIG’s recent report, even before the current crisis the pubic relied heavily in SSA’s telephone services, but often could not access timely information or assistance. In fiscal year 2019, SSA’s national 1-800 number and field  offices received over 143 million calls – but handled fewer than to 3 of these calls. Callers who did not get a busy signal or give up while on hold waited to speak with an SSA employee for an average of 20 minutes on the 1-800 number and three minutes at field offices.

In addition, SSA requests millions of medical records each year from health care facilities and health professionals across the country to obtain evidence of an individual’s medical condition. The medical records request is an important part of the disability process, but the most recent report on this topic from the OIG is from 2001 and does not reflect changes to the process over the past nearly 20 years.

“Social Security benefits are earned by hard-working Americans, and we must do everything we can to ensure people are receiving the quality customer service they deserve.  These reports will provide important information to make sure Americans are receiving the service they expect and deserve from SSA,” said Larson and Reed.

SSA Responds to the Closing of Field Offices 

Almost two weeks ago, Ennis released a 58-page Congressional Response report, “The Social Security Telephone Service Performance,” detailing the impact on the closing of about 1,300 field offices.

The OIG found that in FY 2020, SSA received over 150 million calls, more than any other federal agency surveyed, and handled over half of those calls. Calls to field offices increased dramatically, from an average of 4.6 million calls per month leading up to the COVID-19 pandemic to an average of 7.5 million calls per month from April to Sept. 2020.

According to the OIG’s report, SSA’s telephone services shifted to more calls to field offices in FY 2020 when the agency closed its offices and provided the public with more field office telephone numbers. The increase in field office calls resulted in increased busy messages and wait-times toward the end of FY 2020. During the pandemic, SSA adjusted national 800 number operations to reduce wait times and the number of callers who received a busy message. National 800 number performance began to decline toward the end of the fiscal year, though it was still better then pre-pandemic performance.

When comparing SSA to 13 customer service call centers from 10 other federal agencies, SSA had a higher call volume in FY 2020 with similar or better performance.

To reduce wait times, improve caller experience, and ensure more calls are handled SSA hired additional 800-number staff, modified automated service options, and plans to implement a new telephone system.

“This [IOG] report highlights that SSA’s telephone services are vital to the American public. While I applaud the hard work of SSA employees, especially during the pandemic, the report also highlights actions that SSA is taking to reduce telephone wait times, handle more calls and improve caller experience, said Larson, noting that SSA will need more funding to do so and that is why he is supporting House Appropriations and Chair DeLauro’s proposal to give SSA an additional $1.1 billion in FY 2022.

Adds Reed, “This report provides clear evidence that with determined agency leadership and the hard work of dedicated staff, the SSA was able to respond to the largest management crisis in its history. With the almost 65 percent increase in phone calls during the pandemic the report also demonstrates the public’s clear and continued demand for access to the SSA’s vital services.” 

Opening the Doors

According to newly released 19-page SSA reentry plan, after more than 18 months working from home, senior SSA leadership are beginning to return to their offices, in early December. Employees are scheduled to return to their desks by Jan. 3. Along with in-person appointments, the agency will now also embrace telework. 

The agency will lift its current “work from home by quarantine” policy starting Jan. 2, at which point related collective bargaining agreements and pandemic policies will end as well. Reentry dates could change with the spread of the delta and omicron variant.

“We will use the evaluation period to develop, assess, and, if necessary, adjust any personnel or operational policies to provide public service and accomplish our mission as well as or better than, before the pandemic,” the SSA reentry plan reads. “Each [deputy commissioner] will evaluate their operations to identify ways to improve service, hire and retain the best employees and to operate efficiently including the consideration of potential space savings resulting from increased telework and information technology improvements.”

Over the next six months, the agency will review metrics on customer satisfaction, employee experience, service availability, workload, and environmental considerations.

“Throughout the pandemic, Social Security has helped many people through in-person appointments for certain situations in local offices nationwide and through options like online, telephone and video service,” Nicole Tiggemann, an SSA spokeswoman, said in an email to AARP, reported by Writer John Waggoner in his Nov. 11 blog posting, “Social Security Takes Steps to Reopen Field Offices.

“We know that those options do not work for everyone, says Tiggemann. “In order to improve service, especially for people who have had difficulty reaching us during the pandemic, Social Security will begin implementing the reentry process agencywide as soon as possible, including taking steps to increase in-person accessibility,” she said.

AARP applauds a return to normalcy at SSA. “Obviously, from our point of view, we’d like to see those offices open and staffed as soon as possible,” says Joel Eskovitz, director of Social Security and Savings at the AARP Public Policy Institute,” in Waggoner’s blog posting.

Bill Protects Nursing Home Residents, Providers

Published in the Pawtucket Times on June 1, 2020

This month, U.S. Senator Bob Casey (D-PA) and Senator Sheldon Whitehouse (D-RI) throw a bill in the legislative hopper to slow the spread of novel coronavirus (COVID-19) in nursing homes. It’s a common-sense legislative proposal and needed.

A recently released Kaiser Family Foundation study reported, “COVID-19 has had a disproportionate effect on people who reside or work in long-term care facilities, including the 1.3 million individuals in nursing homes; 800,000 in assisted living facilities; 75,000 in intermediate care facilities; and 3 million people who work in skilled nursing or residential care facilities.”

Combatting COVID-19 in Congregate Settings

With COVID-19 quickly spreading throughout the nation’s nursing homes and intermediate care facilities, Casey and Whitehouse’s legislative proposal, S. 3768, The Nursing Home COVID-19 Protection and Prevention Act, seeks to provide needed resources to facilities to protect frail residents and staff. Residents in these facilities are among the most vulnerable because of their age and underlying medical conditions. According to an analysis conducted by Gregg Girvan for the Foundation for Research on Equal Opportunity, as of May 22, in the 39 states that currently report such figures, 43 percent of all COVID-19 deaths have taken place in nursing homes and assisted living facilities

As more than 20,000 nursing homes residents and workers have died due to COVID-19, according to the latest reports, on May 19, 2020, Casey and Whitehouse introduced S.3768 to help states, nursing homes and intermediate care facilities put the brakes on the spreading of the deadly COVID-19. The legislative proposal, with 14 Democratic cosponsors (including Rhode Island Senator Jack Reed}, would help states implement strategies to reduce the spread of COVID-19 in congregate settings, including through the purchase of personal protective equipment (PPE) and testing and to support nursing home workers with premium pay, overtime and other essential benefits.

S. 3768 was referred to Senate Health, Education, Labor, and Pensions. As of March 30, 2020, a Congressional Budget Office cost estimate or this measure has not been received.

Days after the introduction of 25-page Senate legislative proposal, a House version (H.R. 6972) was introduced by Rep. Ana G. Eshoo (D-CA), cosponsored by Reps. Janice D. Schakowsky (D-IL), Donna E. Shalala (D-FL), Madeleine Dean (D-PA), Seth Moulton (D-MA) and David N. Cicilline (D-RI). The House bill was referred to House Energy and Commerce

“This virus spares no state, no county, no facility. The unprecedented crisis unfolding in our Nation’s nursing homes demands an immediate, extraordinary response. Reports indicate nursing home residents and workers account for roughly 1 in 4 deaths from COVID-19 in the United States,” said Casey, who serves as Ranking Member of the U.S Senate Special Committee on Aging, in a statement announcing the bill’s introduction. “The Nursing Home COVID-19 Protection and Prevention Act would provide $20 billion in emergency funding [for staffing, testing, Personal Protective Equipment, etc.] to devise a sorely needed national, coordinated response to stem the spread of this terrible virus in nursing homes and intermediate care facilities,” notes Casey.

According to Casey, the Senate bill would also require the U.S. Department of Health and Human Services (HHS) to develop guidance on cohorting best practices, including on how to safeguard resident rights. It would also instruct HHS to collect and publish data on COVID-19 cases and deaths in nursing homes and intermediate care facilities, and finally fund surge teams of nurses, aides, and other critical staff to fill in at facilities where multiple residents and staff members have been infected.

“COVID-19 poses an immediate threat to the more than 1.3 million Americans, including more than 7,000 Rhode Islanders, who live in nursing homes,” says Whitehouse, noting that frontline staff across the nation are “doing heroic work under very challenging circumstances.”

“We need to get vastly more personal protective equipment and tests to nursing homes, which care for the patients who are most vulnerable to the coronavirus. Our legislation would also help states fund surge teams, sending additional staff reinforcements to facilities where they are needed to care for patients and prevent infection,” adds Whitehouse.

Before S. 3768 was officially introduced, in early March, Washington, DC-based AARP announced its support for the Senate proposal. “AARP supports the draft of the Nursing Home COVID-19 Protection and Prevention Act that would help protect the health and save the lives of people in nursing homes and other facilities by supporting testing, personal protective equipment, staffing and more,” said Megan O’Reilly, Vice President of Government Affairs for AARP. “The proposal would also improve public transparency and help protect the rights of residents and their families, adds O’Reilly, calling on Congress “to act immediately to stem the loss of life and slow the spread of the virus.”

In the House Chamber, Rhode Island’s Cicilline, a member of the House Democratic Leadership as Chair of the Democratic Policy and Communications Committee, has also pushed for Congressional funding to stop the spread of COVID-19 in nursing homes. The fifth term Congressman has called for additional funding for the Public Health and Social Services Emergency Fund in the next package for congregate care facilities, including nursing homes. He also signed a letter to HHS Secretary Azar and Administrator Verma, of the Centers for Medicare and Medicaid Services (CMS), urging that HHS and the CMS to ensure that a significant portion of the newly allocated $25 billion for testing in the recently passed CARES Act be utilized for testing in nursing homes and other congregate living facilities.

State-wide Efforts to Combat COVID-19 in Nursing Homes

With Governor Gina Raimondo declaring a state of emergency on March 9, 2020, with the COVID-19 arriving in Rhode Island, the deadly pandemic virus spread quickly throughout the state’s nursing homes. At press time, it has been reported that 75 percent of all related COVID-19 deaths are in nursing homes.

According to Joseph Wendelken, Public Information’s Officer for the Rhode Island Department of Health (RIDOH), the state moved quickly to stop the spread of the COVID-19 virus in the community and in nursing homes. He stated: “We curtailed and then prohibited visiting early on, and we have been doing extensive testing in every assisted living facility in the state. We are doing cyclical testing, meaning that we are continually testing all residents in all homes on a rotating basis. We are giving tailored infection control guidance to specific homes, and we are helping them procure additional PPE.”

Adds Wendelken, RIDOH has established two COVID-19 Specialty Nursing Homes [at Oak Hill Center in Pawtucket and Oakland Grove Health Care Center in Woonsocket] to be a COVID-19 Specialty Nursing Home. “These are centralized facilities to accept patients who are being discharged from the hospital and who are COVID-19 positive but no longer require acute-level care. This strategy allows COVID-19 positive patients leaving the hospital to receive specialized rehabilitation and step-down, post-acute care while reserving hospital beds for patients who need acute-level care,” he said.

On Smith Hill, the Rhode Island House Republican Caucus has recently called for members of the House Committee on Oversight to meet to address the increasing COVID-19 death rate in the state’s nursing and assisted living facilities.

Putting Politics Aside…

With less than 156 days until the upcoming 2020 Presidential election, will S. 3768 reach the Senate floor for a vote. Since the beginning of 2019, more than 350 House-passed bills—including hundreds that have bipartisan support—have been buried by Senate Majority Leader Mitch McConnell (R-Kentucky) in his legislative graveyard. With no Republican Senators supporting Casey and Whitehouse’s COVID-19 bill, will it even reach the Senate floor for a vote?

It’s time for McConnell, who has called himself the “grim reaper” of Democratic legislation, to lay down his deadly scythe, making the safety of millions of residents who reside in the nation’s 15,583 skilled nursing facilities a legislative priority. The GOP Senator from Kentucky, who is in a close Senate race with Democratic opponent Amy McGrath, might consider putting politics aside during a raging COVID-19 pandemic sweeping across the nation to work with Senate Democrats to protect frail residents and nursing home staff. Kentucky voters might view protecting residents against COVID a bipartisan issue.

Search on for GOP Senators to Protect Medicare

Published in Woonsocket Call on January 29, 2017

Since President Donald Trump took the oath of office on January 20, he is making good on some of his hundreds of campaign promises. During his first week in office Trump signed three executive orders declaring new government policies and eight presidential memoranda detailing the priorities of his new administration.

But, for aging groups, with Trumps arrival in Washington, D.C, the skirmish officially begins to protect Medicare in this new session of Congress.

With Trump and Congressional Republican Leadership on record for their support of repealing the 2010 Affordable Care Act, popularly known as Obamacare, President and CEO Max Richtman, of the National Committee to Preserve Social Security and Medicare (NCPSSM), clearly sees the writing on the wall. If successful, Richtman warns that GOP legislative actions will severely damage Medicare impacting 57 million seniors and disabled adults who rely on the program for their health care.

Building A Firewall Against Privatizing Medicare

With the GOP holding a slim majority of the U.S. Senate seats, 52 to the Democrats 48 seats, Richtman sees swaying Republican Senators away from their party’s position on privatizing Medicare to protect the federal health care program.

On January 24, 2017, Richtman urged Senator John McCain (R-AZ), Senator Susan Collins (R-ME), Senator Charles Grassley (R-IA), and Senator Lamar Alexander (R-TN) to be the Senate’s “firewall against Medicare cuts.” His correspondence asked them to vote against proposals to privatize Medicare, raise the Medicare eligibility age from 65 to 67, and repeal provisions in the Affordable Care Act (ACA), President Barack Obama’s landmark health care law, that provided additional benefits to beneficiaries.

Richtman reminded the GOP Senators that the Affordable Care Act (ACA) improved Medicare benefits and extended the solvency of the Part A Hospital Insurance Trust Fund by more than a decade. ACA’s closing of the prescription drug donut hole has put money into the pockets of Medicare beneficiaries. The health care law also added coverage of an annual wellness visit and eliminated copays for preventive services like cancer screenings, he said.

“I am also troubled by “premium support” [GOP] proposals to privatize Medicare,” says Richtman. According the aging advocate who was a former staff director of the U.S. Senate Special Committee on Aging and a 16-year veteran of Capitol Hill, under previous privatization plans, beneficiaries would not enroll in the current program; rather, they would receive a capped payment or voucher to be used to purchase private health insurance or traditional Medicare. Private plans would have to provide benefits that are at least actuarially equivalent to the benefit package provided by fee-for-service Medicare, but they could manipulate their plans to attract the youngest and healthiest seniors. This would leave traditional Medicare with older and sicker beneficiaries whose higher health costs would lead to higher premiums that they and others may be unable or unwilling to afford, reducing the fee for service risk pool even further resulting in a death spiral for traditional Medicare.

GOP Medicare Fix Financially Hurts Beneficiaries

Richtman also told the GOP Senators that NCPSSM opposed the raising of the Medicare eligibility age from age 65 to 67 because the proposal would increase costs for millions of older Americans. Absent the guarantees in the existing ACA, such as requiring insurance companies to cover people with pre-existing medical conditions and limiting age rating, millions of seniors 65 and 66 without Medicare would find private insurance unaffordable. Raising the eligibility age would also increase average costs for Medicare as younger, healthier seniors are eliminated from the risk pool and costs are spread across an older, less-healthy population, he says.

Richtman urged the GOP Senators to oppose efforts underway in the 115th Congress to block grant Medicaid, cap Medicaid payments on a per-beneficiary basis (per capita caps) and/or repeal the ACA’s Medicaid expansion. He noted that these policy changes would “financially hurt states and lead to states cutting services, quality and eligibility for the most vulnerable of our senior population.”

Many seniors would not be able to absorb the loss of coverage and increase in their costs that would occur if these proposals became law. In fact, half of all Medicare beneficiaries in 2014 had incomes below $24,150 and Medicare households spent over two times more than the average American household on out-of-pocket health care costs,” he says.

“If Senate Democrats stand strong, we only need a handful of Republicans to protect the commitment to Medicare,” says Richtman. “We hope Senators McCain, Collins, Grassley, and Alexander to do the right thing for seniors in their states – and across America.”

Richtman correspondence to the four GOP Senators is part of NCPSSM’s pro-active legislative strategy to protect the existing Medicare program. The letters sent quantify the economic impact that proposed Medicare cuts would have on seniors in the four GOP Senators’ states: Arizona (with 1.3 million beneficiaries), Maine (306,000 beneficiaries), Iowa (nearly 572,000 beneficiaries), and Tennessee (1.2 million beneficiaries).

“We know that these four Republican Senators have the wisdom and judgment to protect seniors in their states from legislation that would impose painful Medicare cuts,” says Richtman. “It’s time to slam the brakes on any attempts to pass harmful legislation.”

Senate Democrats Attempt to Block HHS Nomination

Two days before Trump was sworn in as president, the Senate Health, Education, Labor and Pensions (HELP) Committee held confirmation hearing on Rep. Tom Price, (R-Ga), Trump’s nominee to oversee the Department of Health and Human Services, the federal agency that oversees the Medicare program. In confirmed, he is expected to play a key role in the GOP’s efforts to privatize Medicare.

No formal vote was taken at the HELP Committee hearing but the Congressman is scheduled to testify a week later at the Senate Finance Committee, which will vote on his nomination.

During the four-hour heated confirmation hearing, held in 430 Dirksen Senate Office Building, HHS nominee Price dodged questions lobbed by Democrats about the Trump Administrations position on the future of Medicare. They also zeroed in on his personal financial investments in health care companies, calling them conflicts of interest which the denied.

Price, an orthopedic surgeon and a six term congressman, considered to be one of the most vocal critics of Obamacare on Capitol Hill, is expected play a key role in the GOP’s efforts to repeal and replace the Affordable Care Act.

Rhode Island Sen. Sheldon Whitehouse, sitting on the HELP Committee, gave this take on Price after the first of two confirmation hearings: “Price hasn’t been able to win Democratic support for any of his health care legislation [in the House] and today confirmed that he and his allies have no plan that can win support from across the aisle or the millions of Americans who would be affected by tearing down the Affordable Care Act. He conceded that he should not stop Americans under twenty-six from staying on their parents’ insurance, re-open the dreaded prescription drug doughnut hole for seniors, deny coverage to those with pre-existing conditions, and reinstate lifetime limits on care. But he has no plan to make that happen.”

Adds Whitehouse, “Price also failed to reassure the Rhode Islanders I serve who rely on Medicare for their care. He has fought to voucherize the program, which would gradually unload costs onto seniors while eroding their benefits. He needed to tell the American people they could depend on him to faithfully administer Medicare and keep the sacred promise we’ve made to our seniors of a dignified retirement with access to good health care. He did not.”

“Congress must protect Social Security and Medicare, but many Republicans see the latest election results as an opportunity to hollow out these vital programs. President Trump’s pick to oversee Medicare has long championed efforts to privatize Medicare, which I strongly oppose. Cutting benefits and privatizing these programs could hurt millions of Americans and harm our economy,” said Sen. Jack Reed, noting that these programs reduce poverty and improve public health in ways that benefit all Americans.

As NCPSSM’s Richtman continues his effort to sway GOP Senators, rallying the troops at the state-level may well be the path to blocking GOP attempts to privatize Medicare. Voters in states with Republican Senators must send this message to their elected official, “don’t touch my Medicare.” Let the movement to strengthen Medicare in these states begin today.