5
Concluding Comments

The committee and SSA agree on the very important role that DES will play in SSA's long-term disability research in understanding the growth of the disability programs. The survey, if well designed, could also help SSA to develop and evaluate its disability decision redesign and address future policy questions. The committee, however, has strong reservations about the current plan for the DES. It generally believes that a more focused effort should be devoted to preparing a single, larger national survey with one large sample and one protocol, instead of two half samples threatened by mixed measurement methods and other nonequivalencies. The committee understands that SSA has started to address some of the issues that were discussed previously during committee meetings and that are addressed in this report. The committee, however, continues to be concerned about the adequacy of the technical advisory structure for the survey, and SSA's ability to get the necessary definitional and feasibility research done in time to mount the survey. It therefore urges SSA to establish a formal technical advisory body for the purpose of oversight of the planning and conduct of the survey.

As previously stated, the committee intends to comment further on the DES in subsequent reports. In its final report, the committee also intends to address issues surrounding the long-term analysis of and future directions in needed disability decision research. This report addresses only the general features of the survey design and some data collection and related issues described in SSA's draft scope of work. These decisions are critical to the conduct of a cost-effective, statistically sound DES. The committee is issuing this brief report at this time because it recognizes the agency's need to make immediate decisions about these topics in order to issue an RFP and award a contract for the DES in a timely manner.

The text of the committee's recommendations follows, keyed to the chapter in which they appear in the body of the report.



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OCR for page 28
5 Concluding Comments The committee and SSA agree on the very important role that DES will play in SSA's long-term disability research in understanding the growth of the disability programs. The survey, if well designed, could also help SSA to develop and evaluate its disability decision redesign and address future policy questions. The committee, however, has strong reservations about the current plan for the DES. It generally believes that a more focused effort should be devoted to preparing a single, larger national survey with one large sample and one protocol, instead of two half samples threatened by mixed measurement methods and other nonequivalencies. The committee understands that SSA has started to address some of the issues that were discussed previously during committee meetings and that are addressed in this report. The committee, however, continues to be concerned about the adequacy of the technical advisory structure for the survey, and SSA's ability to get the necessary definitional and feasibility research done in time to mount the survey. It therefore urges SSA to establish a formal technical advisory body for the purpose of oversight of the planning and conduct of the survey. As previously stated, the committee intends to comment further on the DES in subsequent reports. In its final report, the committee also intends to address issues surrounding the long-term analysis of and future directions in needed disability decision research. This report addresses only the general features of the survey design and some data collection and related issues described in SSA's draft scope of work. These decisions are critical to the conduct of a cost-effective, statistically sound DES. The committee is issuing this brief report at this time because it recognizes the agency's need to make immediate decisions about these topics in order to issue an RFP and award a contract for the DES in a timely manner. The text of the committee's recommendations follows, keyed to the chapter in which they appear in the body of the report.

OCR for page 28
RECOMMENDATIONS RECOMMENDATION 3-1. The committee strongly endorses the conduct by the Social Security Administration of a well-designed, carefully pretested, and statistically sound Disability Evaluation Study. RECOMMENDATION 3-2. The committee recommends that the current stage 1 and pilot study be merged, expanded, and extended into a research, development, and testing phase of the survey with application to samples of the type that are more traditionally used in methods testing. Only when the development and refinement of the functional assessment instruments, survey operations, and other issues are tested and resolved should a national sample survey be launched using a single protocol. RECOMMENDATION 3-3. The committee recommends that the national survey should be conducted with one sample large enough to estimate the sizes of the population at risk with acceptable levels of statistical precision. RECOMMENDATION 3-4. The committee recommends that the Social Security Administration use relevant data from the national Health Interview Survey Disability Supplement, National Health and Nutrition Examination Survey, Survey of Income and Program Participation, and other relevant surveys to assist in developing the sample design, survey operation, and questionnaire content for the Disability Evaluation Study. RECOMMENDATION 4-5. The committee recommends that the Disability Evaluation Study be based on a design offering full coverage of the U.S. household population of adults. If resources are lacking to mount an area probability sample using face-to-face interview, the Social Security Administration should use a multiple frame design of a statistically optimum mix of general population followed by face-to-face interviews of the eligible population. RECOMMENDATION 4-6. The committee recommends that once the options for using different combinations of team composition and origin, examination setting, and other dimensions are sufficiently set for assessments, a formal field experiment should be performed during the research, development, and testing phase of the survey to determine the validity and reproducibility of these options as well as the most cost-effective approach to meeting the objectives of the survey. RECOMMENDATION 4-7. The committee recommends that the Social Security Administration require in the scope of work a rigorously designed experiment in the field testing and development phase of the survey to identify mechanisms for enhancing participation in the Disability Evaluation Study, to guide decisions on the use of home examination for those unable to travel to an examination site, to establish the validity of the measures obtained, and to assess the quality of the medical evidence of record. RECOMMENDATION 4-8. The committee recommends that the Social Security Administration enhance the safeguards of matched data according to accepted practices by employing procedures used in recent federal surveys and that it take into consideration the effect of such procedures on response rates.