Attachment A-13. Service Provider Focus Group Letter and Consent

Attachment A-14. Invitation and Consent to Participate in Focus Groups with Service Providers

[Date]
Dear [Respondent Name]:
You are invited to participate in the Beyond Benefits Study, a national study paid for by the Social
Security Administration (SSA). This study will collect information about the service, medical and
employment needs of working-age adults who get disability payments now or stopped receiving
disability payments due to medical improvement. By participating in this study, you will help SSA
understand the policies and programs that may help people who stop receiving disability payments.
SSA hired Westat, a national research company, to conduct the study. Westat is inviting you to
participate in a focus group with service providers like you who work with those who have exited or
are likely to exit SSA disability programs due to medical improvement. The focus group will be
virtual (video conference using Microsoft Teams) at a time convenient to the participants during
[TIME FRAME]; it should last 90 minutes or less. We will ask questions about the challenges and
facilitators of service provision to those exiting disability programs, as well as about your experiences
in this field broadly. You will have the opportunity to share your thoughts about how services for
those exiting disability programs could be improved. We will mail you a $40 Visa gift card to offset
any costs such as childcare that you may have incurred as a result of your participation.
Participation in this study is voluntary. As described in the Study Consent, we will safeguard the
information you provide and will use it for limited purposes, consistent with applicable Federal law,
regulations, and directives. Your name or other identifying information will not be included in any
published reports.
If you are interested in participating in this focus group, please respond to this letter by calling 1855-516-3665 and study staff will reach out to you to begin the process of scheduling the focus
group. For questions about your rights and welfare as a research participant, call the Westat Human
Subjects Protections office at 1-888-920-7631. Leave a message only with your first name, the name
of the research study (Beyond Benefits Study) and a phone number beginning with the area code.
I hope you will agree to participate in this very important focus group.
Sincerely,

[INSERT SIGNATURE OF SSA SIGNATORY]

Attachment A-14. Invitation and Consent to Participate in Focus Groups with Service Providers

BEYOND BENEFITS STUDY
SOCIAL SECURITY ADMINISTRATION

Consent to Participate in a Focus Group
What is the purpose of the study?
The Social Security Administration (SSA) is conducting the Beyond Benefits Study to collect
information about the service, medical and employment needs of working-age adults who
currently receive disability-related payments or stopped receiving disability-related payments
from SSA due to medical improvement. SSA hired Westat, a national research company, to carry
out the Beyond Benefits Study. The purpose of the research is to help SSA identify ways to help
people who may be leaving or have left disability benefit programs. Some people who leave SSA
disability programs return to work, so we are also very interested in your thoughts about what
services and supports help—or don’t help—when people focus on their employment goals.
What are we asking of you?
We seek your consent for your voluntary participation in a focus group lasting 90 minutes, or
less with a few other service providers on your experience providing services to this population.
We will schedule it at a time that works for you and the other participants and conduct it via
Microsoft Teams video conference 1. We will ask for your permission to send text message
reminders about the study. Depending on your texting plan, you may incur a charge for these
texts. If you agree, you will be able to opt-out of receiving these reminders at any time by
replying “STOP” to the text or by calling the Help Desk at Westat. 2 A member of the research
team will facilitate the focus group and ask questions about your experience providing
employment services to this population, funding challenges, and challenges and facilitators for
improving vocational outcomes for these groups.
0F

1F

We ask for your permission to record the focus group, so we accurately capture what you tell us.
If at any point you do not wish to be audio-recorded, you will need to drop off from the focus
group. The recording will be used to develop the report and will be destroyed once the study is
completed.
What benefits will you get for participating?
You will not benefit directly from participation. By participating in this study, you will contribute
to SSA’s understanding of policies and programs that might be helpful to people who leave
disability programs. After completing the focus group, we will mail you a $40 Visa gift card.
What is the study doing to minimize your risks?

1

Privacy Notice : Microsoft Teams is a nongovernment application that may have different privacy policies from those of the Social Security
Administration (SSA). This application is not under SSA’s control and may not follow SSA’s privacy, security, or accessibility policies
located on their official website at https://www.ssa.gov/privacy. Once you access this application, you are subject to Microsoft’s policies. As
such, by using this application, you may be providing non-government third parties access to your personally identifiable information (PII).
Westat is taking precautions to protect your privacy and PII, such as by using secure equipment in a private location. To minimize any risk
of access by unauthorized third parties, we recommend that you use a reliable, secured, and private internet connection and ensure no one
enters the room with you during the meeting. General information about SSA programs may be found at http://www.ssa.gov/.

2

Each text message sent by the study will also include these opt-out instructions.

Attachment A-14. Invitation and Consent to Participate in Focus Groups with Service Providers

There is a small risk of disclosure of your personal information. The participants in the focus
group may recognize each other. There is also the chance that some focus group members might
share what they hear in the focus group with others outside the group. The researcher leading
the focus group will instruct all participants that everything discussed in the focus group should
be kept private.
How will we protect your privacy?
We will summarize the information from these focus groups to SSA. We may use anonymous
quotes from you or other participants in these summarizes but no names or other personal
information will be linked to those quotes or any responses. We will follow Federal law and
regulations to protect your privacy. SSA and Westat will protect your personal information
collected during the study, consistent with applicable Federal law, regulations, and directives.
The information we collect is used for research in limited ways. For example, we use your
thoughts and comments about employment support needed, combined with thoughts and
comments about employment support from other people interviewed, to help understand
employment support needs. Your name or other identifying information will not be included in
any published reports.
Privacy Act Statement Collection and Use of Personal Information. Section 1110(a) of the
Social Security Act, as amended, allows us to collect this information, which we will use to help
the Social Security Administration (SSA) identify ways to help people who may be leaving or
have left disability programs. Providing us this information is voluntary; not providing all or part
of the information will not affect your SSA benefit. As law permits, we may use and share the
information you submit, including with other Federal agencies, contractors, student volunteers,
and others, as outlined in the routine uses within System of Records Notice (SORN) 60-0218,
available at www.ssa.gov/privacy. The information you submit may also be used in computer
matching programs to establish or verify eligibility for Federal benefit programs and to recoup
debts under these programs.
Who you can contact if you have questions?
For questions about the study, call the study’s toll-free number at 1-855-516-3665. For questions
about your rights and welfare as a research participant, call the Westat Human Subjects
Protections office at 1-888-920-7631. Leave a message only with your first name, the name of
the research study (Beyond Benefits Study) and a phone number beginning with the area code;
please do not leave any other personal information in the message.