History of SSA During the Johnson Administration 1963-1968



The 1965 reorganization of the Social Security Administration providedwithin each of the three program bureaus--the Bureau of Health Insurance, {1} the Bureau of Retirement and Survivors Insurance, and the Bureau of Disability Insurance--a quality appraisal function, in addition to but uniquely different from established appraisal activities. This new function paralleled the new program responsibilities in each of these bureaus in recognition of the growth and complexities of the entire social security program, and was designed to measure how well overall Social Security Administration quality objectives are met in terms of the results of the social security program.

Appraisal activities of various kinds have always existed in the Social Security Administration but were oriented in most instances toward measurement of the effectiveness of particular parts of the Social Security Administration's total processes and were performed in large part by supervisory personnel and their delegates. These have served the Social Security Administration's needs very well and continue to do so within their limitations. As the complexity of the program has increased, the capability of the manager or supervisor of a part of the process to recognize all the interfaces of his operation with others has lessened. The new appraisal function is geared to larger and stronger focal points of responsibility, yet in no way impinging on the supervisor's role in assessing the quality of the output of his unit. As a matter of fact, the overall quality evaluation is strengthened, in that appraisal complements the responsibilities of the line supervisors in helping to maintain quality of the process results.

Outlined below are basic aspects of the system used to conduct the quality appraisal activity in the Bureau of Retirement and Survivors Insurance, the office responsible for the largest of the three insurance benefit programs.

I. How the System Operates
There are four basic steps used to conduct the appraisal on an ongoing basis:

A. Systematic Sampling of Product
An end of line system for appraising awards and disallowances has been fully implemented. This is described in greater detail below. A comprehensive system for appraisal of postentitlement actions at the end of line is in the developmental stage and will replace several current studies of various parts of the postentitlement process. Implementation is expected by the end of 1968.

B. Special Studies
As dictated by experience, aspects of the process not otherwise covered are subjected to analysis on a scheduled or ad hoc basis.

C. Analysis of Deficiencies and Irregularities in Process Results
Weaknesses in quality identified in the sampling and special studies, or as a result of other information, are measured for significance and probable cause. The analysis is intended to be broad-gauged and positive. To achieve total perspective, appraisal takes into account all aspects of the RSI process, not just those subject to regularized or specific study. Further, the aim is to give management a measure of how it is doing in terms of overall results, as distinguished from an immediate measure of the quality of each step in the process which can best be supplied on a day-to-day basis by the line supervisors and management analysts. Since quality appraisal is designed to measure achievement against standards, the analysis aims to answer the broader question of "How are we doing?" as well as such questions as "When or where are we failing?"

D. Communication of Appraisal Findings
Data, study results, and other significant intelligence about quality aspects, prepared in statistical and/or narrative form, are disseminated to appropriate personnel of the Social Security Administration, primarily for management action in improvingproduct quality. A comprehensive method of presenting RSI quality data was implemented in July 1968. It provides for recurring reports to present a unified view of the entire RSI program, including claims and postadjudicative actions. There will be a continuous flow of quality information between the Bureau and the Regional Representative, RSI. In addition, there will be a monthly report indicating the quality of the RSI program from the Regional Representative, RSI, to management personnel in the payment centers and the DOO regions.

II. Staffing of Appraisal Function

The appraisal function is carried out by a central office staff and a field quality appraisal staff in the office of each of the six RSI Regional Representatives. Appraisal personnel act as staff to the Bureau Director, RSI, centrally, and to the Regional Representative, RSI, in the field. The appraisal staff provides a direct service not only for employees under the administrative supervision of the Bureau Director, RSI, or Regional Representative, RSI, but also for others who have responsibility for part of the RSI process, such as the Regional Representative, DOO, his staff and the district managers. The general responsibilities of the central office staff are the development and maintenance of appraisal systems, and analysis and dissemination of appraisal results on a national basis. The field staffs conduct appraisal studies and are responsible for analysis and dissemination of appraisal information on a regional basis.

III. End of Line Appraisal of Awards and Disallowances

The end of line appraisal of awards and disallowances, the first major RSI appraisal study, was established in September 1967. This system provides for quality review of a scientifically selected sample of 2 percent of all awards and disallowances of new claims for RSI benefits. The sample selection is made and the review conducted at the end of line, that is, after completion of all Social Security Administration processing to inform the Treasury Department of the payment due or for mailing by the Social Security Administration of the notice of decision in cases where payment is not due. The review is conducted by the field appraisal staffs.

The primary objective of the study is the measure of the extent of compliance with established policy and procedure. The system is not designed to measure the effectiveness of the policy and procedure although a by-product of the system can be a finding that a deficiency or irregularity in the process resulted from a
weakness in policy or procedure rather than from the way they were followed. Data on accuracy and processing time are gathered on the same case sample. The testing of all aspects of the process on the same set of cases permits more precise correlation of data than was possible witch previous quality studies.

Another objective is to ensure a reasonable degree of uniformity among payment centers in the application of policy and procedure. This is achieved through a method of exchange review among the field appraisal staffs. Each month approximately one-fourth of the sample cases from one region are reviewed by the appraisal staff of another region. Analysis of these data is useful in detecting indicators of basic differences among payment centers
in applying national policy and procedure.

The quality data derived from the end of line review are transmitted daily from each region by wire (the Advanced Record System). Computer tabulations of the data are done centrally. The advantages of these methods are the elimination of time-consuming manual tabulation and the ability to publish data more promptly.

Appraisal Program---Bureau of Disability Insurance

The present Bureau of Disability Insurance appraisal program also took its impetus from the 1965 reorganization of the Social Security Administration when an appraisal component was established in the Bureau's Division of Management and Appraisal. The Appraisal Branch developed an appraisal program for the entire Bureau of Disability Insurance complex of disability operations, including activities performed in the central office, the State agencies, and the district offices. Plans have been made for assessing the correctness and timeliness of disability claims determinations, as well as for the succeeding authorization or denial actions, benefit payment and other related actions. In this assessment, the efficacy of the procedures and policies governing determinations of allowance or denial are examined as well as the disability decision itself. Other plans have been developed to measure and evaluate operating experience, manpower utilization, processing time and production rates; and to evaluate organizational, managerial, operational and administrative systems. In carrying out the responsibility dealing with the status and quality of Bureau operations, the basic approach of the Appraisal Branch has been to develop a broad overall cohesive picture of Bureau operations. In essence, the expanded Bureau of Disability Insurance appraisal program encompasses every facet of the disability insurance program, administrative and operational.

One of the earliest of the Bureau of Disability Insurance's continuing"evaluation" efforts was the Medical Consultant Staff "Sample." Unlike the "on-line" work product review systems, the Medical Consultant Staffsample does not provide line management with immediate "feedback" for corrective action. Rather, the system provides information on the quality of the Bureau of Disability Insurance's and the State agencies' application of medical evaluation and development criteria, with a view to assessing the adequacy and effectiveness of the current medicalguides in the disability decision making process.

A significant feature of the Bureau of Disability Insurance's expanded appraisal program is an end-of-the-line quality review system. In this system the entire adjudicative claims process is viewed as an entity from initial filing of the claim through its final disposition. Included are the district office and State agency development and/or determination processes, the central office review-determination-authorization process, the reconsideration process, the postentitlement process, and all related benefit payment processes.

An additional feature of the Bureau of Disability Insurance's expanded appraisal program is a systematic review of a sample of cases at the State agency point of intake for the purpose of measuring district office performance, the effectiveness of operating procedures, and to identify training needs and provide feedback to district offices. Through a continuing monthly reporting system each region is kept currently informed of the number and nature of additional development requests which have been returned to district offices by the Bureau of Disability Insurance on the nondisability issues of proof of age, representative payee, etc.

Increasingly, the Appraisal Branch has also undertaken a variety of important special "ad hoc" studies and is expected to provide Bureau leadership and expertise in the more sophisticated techniques of program and managerial appraisal. Some recent examples of the ad hoc studies carried out by the Branch include: (1) an appraisal of the "pilot" multi-shift disability operations in terms of claims production rates, adjudicative quality, and a wide variety of personnel and general administrative management concerns; (2) an experimental joint medical-technical "team" evaluation of the quality of the initial State agency and Bureau of Disability review of disability decisions; (3) a series of individual Bureau of Disability Insurance work-station processing time analyses; (4) an assessment of the value of the revised disability interview report, Form SSA-401; (5) design of a system for conducting a "less-than-a-100%" review in the central office of certain initial State agency disability determinations; (6) an assessment of the direct routing of certain childhood disability cases to the payment centers, etc.

Management Information and Appraisal

In, the administrative area, in 1966, to provide for a greater emphasis and improved capability in management information and appraisal, the Management Information and Appraisal Branch was established in the Division of Administrative Appraisal and Planning, Office of Administration. This activity, as a concomitant to the reorganization of the Social Security Administration in 1965, was to be strengthened in line with actions in the Bureaus of Retirement and Survivors Insurance, Disability Insurance and Health Insurance to increase attention on improving claims processing through quality appraisal. Management information activities emphasize determining the data needed by top management to assure appraisal and control of program administration, developing the specifications for obtaining data, and developing and managing a program for exhibiting and reporting these data to top management. More emphasis is given to identifying significant shortand long-range objectives and management and operating goals so as to measure progress and overall effectiveness of administration; to identifying significant trends and indicators; to bring to management's attention the actual or potential problem, or trouble areas; and prepare "state of the organization" reports and briefings for top management.

The Evaluation and Measurement System

Another project to improve the efficiency of operations came with the establishment of an Evaluation and Measurement System on November 20, 1964.{2} It was designed to and does continuously assess the validity of the assumptions underlying claims policy.{3}

The initial impetus for planning the Evaluation and Measurement System was identified in the Commissioner's comments of November 27, 1963, on the General Accounting Office draft report, "Review of Selected Requirements for Establishing Entitlement to Insurance Benefits, Bureau of Old-Age and Survivors Insurance, Social Security Administration, Department of Health, Education, and Welfare." The Evaluation and Measurement System program proposal was prepared and submitted for comments to each of the SSA components on December 6, 1963.{4} After all components submitted comments, a memorandum "Submittal for decision", January 15, 1964, together with an analysis of the comments, were sent forward for consideration by the Commissioner.{5} After further analysis of comments, proposals for modification, and intercomponent discussions, the Commissioner held a meeting on October 29, 1964. This led to the Commissioner's decision and the announcement of November 20, 1964. The program was initiated with a pilot project of 150 cases for two months. A status report of experience in the pilot period was made to the Commissioner and the system continued as a permanent operating program, starting with a one-fourth percent and gradually moving up to a sampling rate of one-half percent of initial Old-Age and Survivors Insurance claims. The details of the concepts and measurement techniques are described in the publication "Concepts and Measurement". {6} Results of the Evaluation and Measurement System have been issued for SSA administrative use both in preliminary form and in final form, as noted in the description given in footnote {3}.

Optical Scanning

One of the most recent improvements in the area of automation which the Social Security Administration has been able to adapt to its recordkeeping operations is that of optical scanning equipment.

Within 30 days after the close of each calendar quarter, the Social Security Administration receives from employers, through the Internal Revenue Service, approximately 3.4 million tax returns and 3.1 million related continuation sheets. On these forms employers have listed the social security account number, name, and earnings for each employee to whom wages were paid during the quarter. The average number of employees reported each quarter is approximately 60 million.

These reports are prepared by 3.4 million different employers using whatever method of machinery they choose. These methods include handwriting, typewriter, posting-bookkeeping machines, Addressograph plates, punchcard tabulators, electronic printers, etc.; thus they represent a wide variety of type sizes and styles.

The Social Security Administration is now using an optical page reader which reads and automatically transfers to magnetic tape approximately 18 million of the 60 million earnings reports received each quarter.

Although the Social Security Administration began studying and talking about the possibilities of optical scanning equipment for its operations in the early 1950's, it was not until 1960 that the Social Security Administration began to search for such equipment in earnest.

In 1960, the Social Security Administration sent a statement of requirements to 33 companies and asked them to submit their proposals. At that time these were the only known companies working in the field of optical character recognition.

The Social Security Administration received and evaluated proposals from 8 of the 33 companies. Time was then spent preparing invitations for final proposals. In May 1963, invitations were sent to 71 companies. (In this short span of time many more companies had become interested in optical scanning research.) Nine final proposals were received.

Several months were spent analyzing and evaluating the proposals. Primary consideration was given to the technical requirements of the suggested system and the savings to be realized. Recommendation for award of contract was approved in June 1964. In August 1966, the Optical Page Reader became operational.

The Optical Page Reader is a highly versatile unit containing the latest advances in the fields of document handling and multifont character recognition. The recognition and interpretation of a character is performed completely by the page reader. In addition, it incorporates an electronic control system which places the page reader under control of a small computer stored program.

The electronic scanner consists of (1) a controlled cathode ray tube beam, (2) a high resolution optical system, and (3) photomultipliers. A flying spot is focused on the document by the optical system. As thespot traverses a defined area, white to black transitions are sensed by the photomultipliers and converted to an electronic image. The electronic image is then analyzed by the character recognition circuitry. This action results in the derivation of sets of measurements of the character. The set of measurements from the scanned data is conformed with a predetermined set of measurements in the reader. The result is analyzed on a decision base to determine the character.

As each character is identified, it is sent from the scanner to the computer memory. If a character cannot be identified, a special character is sent to the computer memory to take the place of the unidentified character. The reader also remembers the line containing the bad character.

The scanner reads character by character from right to left at a rate of 500 characters per second. This speed enables the system to process approximately 64,000 lines per hour.

This process--read, compare, decide, transmit--is repeated until the scanner senses the end of the line. It then returns to the start of the next line. At the same time, the line it has finished reading is moved to an output area in the computer's memory.

When the bottom of the page is reached, the sheet is ejected and a new document is fed in. As the page is being ejected, all lines containing bad characters are marked, and the information recorded in the computer storage is written on tape. {7}

Disability Case Control System Operating Methods

The Disability Case Control System is the product of 5 years' use, refinement, and improvement, in the headquarters operation of the Bureauof Disability Insurance. It was designed to speed the processing ofdisability claims and to permit prompt location of sensitive cases fromamong the 350,000 claims folders in circulation.

In 1966, BDI acquired an IBM 360/30 Data Collection System, consisting of a central processing unit and a flexible number of remote input card readers. Folder locations were recorded directly onto magnetic tape inthe central computer, through use of a control card which stayed with acase as it moved through the processing procedure.

While the magnetic type system enabled the Bureau of Disability Insurance to record folder locations practically instantly, getting information from thetape was a "next day" matter. It took the computer a couple of minutes to search through a reel of tape for a particular case, and this tied up the computer. Therefore, the retrieval of information was postponed until the night shift when new folder locations were not being fed into the computer.
This meant an overnight delay in getting folder data, printed in the form of a freeze list and broken down or segmented by locations to facilitate the next day's searching.

The Bureau of Disability Insurance's use of magnetic tape as the best means for storing folder control information was short-lived, for early in 1967 a new type of equipment was installed that reduced the time it took to get information on folder location from the overnight delay of the magnetic-tape system, down to what in effect is--nothing.

The "nothing" that this equipment takes to do its job is measured in millionths of a second, termed microseconds. Engineers refer to this equipment's speed of operation in terms of "real time," which is the actual amount of time it takes from query to response.

Where the magnetic tape system could record data in terms of real time, the new system can not only do this, but of equal importance, can find and retrieve information previously stored, upon request, also in real time. This ability to answer queries on folder locations instantly is known as the "answerback" technique.

The great speed with which the system operates means that mistakes which stop the process, even for a few minutes, are much more costly than ever before. This underscores the great reliance that the Case Control System places on the accurate work performance of nontechnical personnel. The design of the system, in fact, has been primarily influenced by the human factor and has given first consideration to the personnel who will work with it.

As a result of the successful operation of the Disability Case Control System, the Social Security Administration has had similar systems installed in the payment centers located in Birmingham, New York, Philadelphia, Chicago, San Francisco, and Kansas City.

Now plans are being developed to expand the Case Control Systems to control and report on not just the claims folders, but also the processing of the individual claims and the post-entitlement actions contained in the folders. {8}

Tape Reporting of Earnings by Employers

Since 1956 when the Social Security Administration first received quarterly FICA (Federal insurance contributions Act) earnings reportson magnetic tape, there has been a large increase in the number ofcompanies reporting on tape. The volume of wage items reported ontape has also increased steadily from 18,000 in 1956 to about 10million in the first quarter of this year. The 10 million wage itemrpresent 538 parent organizations.

Reporting on tape benefits the Social Security Administration and the employer. These reports can be introduced directly into the Social Security Administration's electronic report processing system, thus saving the government the time and cost required for manual card punching and verifying. These savings in cost are approximately
$12,000 per million items. Also, because the reports are submitted directly to the SSA on magnetic tape, the earnings information is available for posting at an earlier date. Consequently, a person's account is kept more current for claims and earnings request purposes. This also avoids having to make corrections of errors made manually.

Employers may also find certain advantages and economies in such a system. For example, there is no further need to convert from tape to paper. As a result, there is no need to handle bulk paper. Thus savings in time and money are realized. The employers also receive the tapes, after processing, along with a detailed list or microfilm (at the employer's choice).

In late 1960 the Social Security Administration began actively to enlist participation of about 300 companies employing 10,000 or more people quarterly in the tape-reporting plan. The use of computers was not widespread until this time. The Social Security Administration notified these employers that a tape-reporting plan was available to those companies meeting certain requirements. The specifications included the type of computer tape the Social Security Administration could accept, the paper forms needed along with the tapes, and the format and content of the tape record required.

Early in 1962 the Social Security Administration re-contacted the companies that had indicated an interest in the plan but were not ready at the earlier date to undertake the project.

The Social Security Administration's last major contact with employers was through the district offices. In August 1962 the Social Security Administration began contacting those employers with 5,000 to 10,000 employees per quarter.

The campaign is still going on, but on a different note. The Social Security Administration sends press releases on a regular basis to newspapers through the district offices and to over 100 national business journals. In addition, data are released at meetings of equipment users. Of course, through correspondence and, upon request, personal visits, the Social Security Administration maintains direct contact with the employers using computer equipment.

A most important change has occurred since 1960. Then, only magnetic tape prepared on the same manufacturer's equipment as used by the Administration was acceptable. A study was then made of the different types of tape available on the market. On the basis of findings the Social Security Administration determined that other types of tapes as well as tapes exactly like those used by the Social Security Administration were compatible with its equipment, and therefore, acceptable.

Today the Social Security Administration can accept magnetic tape reports prepared on a number of computers. However, all of these do not produce compatible tapes. But arrangements have been made with other government agencies to convert certain incompatible tapes to the Social, Security Administration's machine language for processing. {9}

Footnotes (Footnote numbers not same as in the printed version)

{1} The BHT phase was covered in the Medicare section.

{2} Commissioner's Bulletin, Number 18, November 20, 1964

{3} Office of Research and Statistics, Work Plan, Fiscal Years 1969-1970

{4} See Below memorandum dated December 6, 1963, on Evaluation and Measurement Program Proposal

{5} Memorandum to Mr. Ball dated January 15, 1964, on Evaluation and Measurement System -- Submittal for Decision

{6} Evaluation and Measurement System, Concepts and Measurement, Series 2, Number 1.

{7} Data Processing in the Social Security Administration--A series of lectures given by Mr. J. L. Fay in Mexico City, pages 54 and 56

{8} Social Security Administration, Bureau of Disability Insurance, TheDisability Case Control System.

{9} Data Processing in the Social Security Administration-A series of lectures given by Mr. J. L. Fay in Mexico City, Pages 54 and 56