Major Management Challenges and Program Risks: Social Security
Administration (Letter Report, 01/01/2001, GAO/GAO-01-261).

This report, part of GAO's high risk series, discusses the major
management challenges and program risks facing the Social Security
Administration (SSA). The challenges facing the SSA include (1) the need
to play a more active role in research, evaluation, and policy
development, (2) improving SSA's disability determination process, (3)
sustaining management and oversight of long-standing, high-risk
Supplemental Security Income issues, (4) addressing future service
delivery issues, and (5) strengthening controls to protect SSA
information.

--------------------------- Indexing Terms -----------------------------

 REPORTNUM:  GAO-01-261
     TITLE:  Major Management Challenges and Program Risks: Social
	     Security Administration
      DATE:  01/01/2001
   SUBJECT:  Risk management
	     Accountability
	     Eligibility determinations
	     Social security benefits
	     Internal controls
	     Computer security
	     Program graduation
	     Disability benefits
	     Income maintenance programs
IDENTIFIER:  High Risk Series 2001
	     GAO High Risk Program
	     Supplemental Security Income Program
	     Social Security Disability Insurance Program
	     Old Age Survivors and Disability Insurance Programs

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GAO-01-261

Performance and Accountability Series

January 2001 Major Management Challenges and Program Risks

Social Security Administration

GAO- 01- 261

Letter 3 Overview 6 Major

13 Performance and Accountability Challenges

Related GAO 37

Products Performance

39 and Accountability Series

Lett er

January 2001 The President of the Senate The Speaker of the House of
Representatives

This report addresses the major performance and accountability challenges
facing the Social Security Administration (SSA) as it seeks to
“promote the

economic security of the nation's people through compassionate and vigilant
leadership in shaping and managing America's social security
programs.” It includes a summary of actions that SSA has taken and

that are under way to address these challenges. It also outlines further
actions that GAO believes are needed. This analysis should help the new
Congress and administration carry out their responsibilities and improve
government for the benefit of the American people.

This report is part of a special series, first issued in January 1999,
entitled the Performance and Accountability Series: Major Management
Challenges

and Program Risks. In that series, GAO advised the Congress that it planned
to reassess the methodologies and criteria used to determine which federal
government operations and functions should be highlighted and which should
be designated as “high risk.” GAO completed the assessment,
considered comments provided on a publicly available exposure draft, and
published its guidance document, Determining Performance and Accountability
Challenges and High Risks (GAO- 01- 159SP), in

November 2000. This 2001 Performance and Accountability Series contains
separate reports on 21 agenciescovering each cabinet department, most major
independent

agencies, and the U. S. Postal Service. The series also includes a
governmentwide perspective on performance and management challenges across
the federal government. As a companion volume to this series, GAO is issuing
an update on those government operations

and programs that its work identified as “high risk” because of
either their greater vulnerabilities to waste, fraud, abuse, and
mismanagement or major challenges associated with their economy, efficiency,
or effectiveness.

David M. Walker Comptroller General of the United States

Overview The Social Security Administration (SSA) oversees three major
programs that provide benefits to more than 50 million recipients: the Old
Age and Survivors Insurance (OASI) program, the Disability Insurance (DI)
program, and the Supplemental Security Income (SSI) program. SSA's fiscal
year 1999 expenditures of more than $400 billion constituted over one- fifth
of all federal disbursements. This amount is expected to grow over the
coming years as the baby- boom generation ages and the life expectancy of
Americans continues to lengthen. Even with its considerable workload, SSA is
considered a leader in federal service delivery. Additionally, the

agency produces timely and accurate financial statements and is a leader
among government agencies for its accountability reporting. However,
substantial

challenges continue to face SSA as it administers its programs now and in
the future. The most critical overarching issue facing SSA is the long- term
solvency of the social security system. At issue is how to make SSA's
programs fiscally sustainable after the large

number of Americans born in the baby boom generation become eligible for
retirement. Without actions taken to reform the social security system, the
nation will face continuing difficulties financing social security benefits
in the long term.

In addition to the solvency issue, SSA faces the following major performance
and accountability challenges that will further affect its ability to
administer critical programs.

Play an active research, evaluation, and policy development role

? Improve SSA's disability determination process and return people to work

? Sustain management and oversight of long- standing, high- risk
Supplemental Security Income (SSI) issues

? Better position SSA for future service delivery challenges

? Further strengthen controls to protect SSA information

Research and As the nation's expert on social security issues, SSA is
Evaluation

uniquely positioned to assess the programmatic impacts of economic and
demographic trends and to identify areas where policy changes are needed to
ensure that recipients' needs are met efficiently and cost effectively.
However, in numerous reports and testimonies, we have shown that SSA has not
always been sufficiently active in using its research, evaluation, and
policy development components to identify areas where legislative or other
changes are needed and to assist policymakers in developing options for
change. Thus, SSA has missed

several opportunities to provide information to the Congress and others to
use to address crucial policy issues. For example, we reported that SSA was
not sufficiently contributing to the solvency and sustainability debate or
developing policy options to address long- standing problems with the SSI
program. Over the last 2 years, however, SSA has taken action to

strengthen its research and policy development role, identify emerging
issues, and develop options for change. For example, SSA has significantly
increased the level of staff and resources available to support research
activities and has several analyses planned or underway to address key trust
fund solvency, disability program, and SSI program integrity issues.
However, many of SSA's actions are still in the early stages. Thus, their
effect on SSA program policy is unclear at this time. Determining

SSA's disability determination process is fragmented and Disability and
complex. As a result, making timely and accurate Focusing on Work

disability determinations is one of SSA's most challenging service delivery
issues. These ongoing weaknesses result in beneficiaries often waiting more
than 1 year for final disability decisions. Moreover, SSA's disability
programs are expected to grow significantly over the next 10 years. By 2010,
SSA expects applications for DI benefits to increase by as much as 54
percent over 1999 levels.

In 1994, SSA embarked on a massive effort to redesign and streamline the
agency's disability determination process. The initial redesign plans were
overly ambitious, and results were disappointing. Since then, SSA has twice
revised and scaled back its initial redesign plan in accordance with our
recommendation to emphasize those initiatives offering the greatest
potential for improvement, such as efforts to increase the consistency of
decisions.

In addition to continued inefficiencies in the determination process, very
few beneficiaries return to work because SSA's disability programs focus on
applicants' and beneficiaries' inability to work rather than their potential
or capacity to work. In 1996, we reported that if only an additional 1
percent of the 6.3 million DI beneficiaries left the rolls and returned to

work, lifetime cash benefits would be reduced by nearly $3 billion. SSA has
begun to place greater priority on returning beneficiaries to work.
Moreover, the recently passed Ticket to Work and Work Incentives Improvement
Act of 1999, which expanded access to vocational services, is expected to
enhance work incentives for people with disabilities. This effort represents
a positive step toward helping people with disabilities return to work.
However, much remains to be done. We have recommended that SSA still needs
to move forward in developing a comprehensive return- towork

strategy that integrates, as appropriate, earlier intervention, better
identification of work capacities, and essential return- to- work services
for applicants and beneficiaries. Such a strategy could require improvements
to staff skill levels and areas of expertise, as well as changes to the
disability determination process. An improved return- to- work strategy
would

benefit recipients who want to work and the American taxpayers that support
the DI program. SSI Program

Problems we identified with the SSI program, including Vulnerabilities
substantial overpayments and SSA's inability to recover outstanding debt,
have spurred congressional criticism of the program. In 1997, we designated
SSI a high- risk program because of the program's insufficient management
oversight and susceptibility to fraud, waste, and abuse. We found that, to a
great extent, SSA's

problems stem from an organizational culture that places a greater priority
on processing and paying SSI claims than on controlling expenditures and
from a management approach characterized by a reluctance to fulfill its role
in SSI policy development. Thus, SSA has often paid insufficient attention
to verifying recipient financial eligibility, deterring fraud and abuse, and
identifying options for addressing underlying policy weaknesses that impede
program integrity. Since SSI was designated high- risk, SSA has taken
numerous actions to improve program integrity.

For example, SSA has stepped up its efforts to better verify recipient
financial eligibility for SSI via enhanced computer matching and other
means. The agency also sought and obtained new legislation last year that
strengthened its ability to obtain applicant income and resource information
from financial institutions, access state databases for essential
eligibility information, and use credit bureaus, private collection
agencies, interest

levies, and other tools to recover delinquent debt. SSA's initiatives have
the potential to significantly improve SSI management and financial
integrity. However, additional actions are needed, including

revising SSA's work credit and measurement system, which has historically
rewarded staff for claims processed rather than for fully verifying
applicant

eligibility and preventing overpayments. Until further progress is made in
these and other areas, the SSI program will remain at high risk of waste,
fraud, abuse, and mismanagement. Serving the Public Among federal agencies,
SSA has long been considered one of the leaders in service delivery. Even
though SSA considers service delivery one of its top priorities, the agency
faces significant challenges that could hamper its ability to provide high-
level service delivery over the

next decade and beyond. SSA expects to experience a significant increase in
the demand for services as the baby boom generation ages. In addition, the
imminent retirement of a large portion of SSA's own workforce over the next
decade and changing customer expectations for the types of services
delivered will further strain agency operations. SSA's data show that by
2009, more than one- half of its 63, 000 employees will be eligible for
retirement. By 2010, more than 80 percent of its upper level managers and
senior executives will be eligible to retire. Consistent with our
recommendations to cope with pending staff retirements, SSA has begun
initiatives, such as succession planning and sponsoring

leadership development programs, to prepare its workforce for the future.
SSA's human capital problems can be seen as a part of a broader pattern of
human capital shortcomings that have eroded mission capabilities across the
federal government. See our High Risk Series: An Update (GAO- 01- 263, Jan.
2001) for a

discussion of human capital as a governmentwide highrisk area.

In addition to addressing its human capital challenges, SSA has also pursued
a number of information technology initiatives to modernize and enhance
automation capabilities; however, these efforts have met with mixed success.
SSA also recently completed an ambitious “2010 Vision” document,
which describes how SSA envisions the agency functioning in the year 2010.

While we have not yet fully evaluated the new vision, it represents a
positive step toward the agency's acknowledging and preparing for future
service delivery challenges. However, the 2010 Vision document does not map
out the steps needed to achieve this vision. We have consistently
recommended that SSA develop a more detailed service delivery plan to
translate its vision into action. Such a plan should specifically discuss
how future human capital and information technology investments will be
tailored to support new ways of doing business. In the absence of such a
plan, scarce budget resources may be spent on initiatives and activities
that do not adequately support SSA's future work environment and may
ultimately result in a

degradation of service to the public. Internal Control

In prior work, we have reported that SSA must address Weaknesses

weaknesses in its information systems' internal controls to ensure that
automated agency data are both reliable and credible. In particular, we
reported that internal control weaknesses have exposed SSA and its computer
systems to external and internal intrusion, thus subjecting automated data
to potential unauthorized

access and modification. SSA has made notable progress in addressing
information systems internal controls and its ability to respond to a
disruption in business as a result of a disaster or long- term crisis. For
instance, SSA has strengthened physical security agencywide and

successfully tested its critical workloads during fiscal year 2000. However,
SSA must continue to focus on internal control issues. A recent audit by an
independent accounting firm identified continuing deficiencies in SSA's
information systems internal controls in regard to access and other areas.
The audit acknowledged SSA's progress in resolving a number of internal
control weaknesses but emphasized the importance of continuing corrective
actions.

Major Performance and Accountability Challenges

The mission of SSA, established as an independent agency in 1995, is to
“promote the economic security of the nation's people through
compassionate and vigilant leadership in shaping and managing America's
social security programs.” With its independence, SSA gained a new
measure of control over its resources and the authority to address the
various performance and management challenges it faces in its OASI, DI, and
SSI programs.

The OASI and DI programs together are commonly known as “social
security.” They are financed through payroll taxes and provide
benefits to retired and disabled workers and their dependents and survivors.
In fiscal year 1999, SSA administered the earnings records of 140 million
individuals who contributed to the social security system. In addition,
about 44 million individuals received more than $380 billion in OASI and DI
benefits. SSI is financed from general tax revenues and provides cash
assistance to needy, aged, blind, or disabled recipients with limited or no
work histories. In fiscal year 1999, 6. 6 million recipients were paid more
than $28 billion in SSI benefits. Combined, SSA's programs

provide essential financial support and touch the lives of nearly every
American family. SSA is considered a front- runner in several important
federal management areas, including service delivery and financial
reporting. Indeed, in the area of service delivery, in fiscal year 1999, 87
percent of the public rated the agency's service as “good” or
“very good.” Additionally, for the past 7 years, the agency has
received unqualified opinions on its financial statements. Moreover, SSA has
been a leader in producing accountability reports. Recent reports were
issued several months before the statutory March 1

deadline. In addition, SSA was one of only two federal agencies to receive
the Association of Government Accountants “Certificate of Excellence
in Accountability Reporting” award for its fiscal year 1999
accountability

report. However, SSA faces several challenges that will affect its ability
to administer its programs.

The most critical issue facing SSA is ensuring the longterm solvency of the
social security system as the large number of Americans born during the baby
boom era become eligible for retirement. Many analysts agree that the social
security system as designed and administered will be unable to meet its
current commitments to future generations of beneficiaries. Specifically,
according to OASDI trustees' estimates, total benefits paid out by SSA

will gradually exceed OASDI revenues collected, and by 2037, the trust funds
are expected to be depleted. At that time, annual tax revenues will be
sufficient to cover only about 72 percent of benefit obligations. To address
this situation, there are various reform proposals currently under
consideration by the Administration and the Congress. Any actions taken to
restore the solvency of the social security system need to address the
sustainability of the system, to ensure that the program balances income
adequacy and individual equity, and to

consider how readily changes could be implemented, administered, and
explained to the public. In addition to the solvency issue, SSA faces
additional performance and accountability challenges that we have documented
in numerous reports, testimonies, and management reviews of SSA over several
years. These include the need for SSA to (1) better use its research,
evaluation, and policy components to address crucial program
vulnerabilities; (2) improve its disability determination and return- to-
work processes; (3) further

strengthen the integrity of the SSI program; (4) serve more recipients in an
environment of changing customer expectations and fewer staff; and (5)
maintain a sound

information technology infrastructure to support its operations. SSA's
success in addressing these challenges will require sustained management
attention and proactive leadership in identifying strategies for change.

Program In prior work, we have noted that addressing the major Challenges
Require management and performance challenges facing SSA

SSA to Play an would require the agency to strengthen its research and
Active Research,

policy development activities. Accordingly, we reported Evaluation, and that
SSA should (1) identify areas where legislative or Policy

other changes are needed to address program Development Role weaknesses and
(2) assist policymakers in exploring and developing options for change.

As the nation's expert on social security issues, SSA is uniquely positioned
to assess the programmatic impacts of economic and demographic trends and to
identify areas where policy changes are needed to ensure that recipients'
needs are met efficiently and cost effectively. However, SSA has not always
been sufficiently active in this regard. In monitoring SSA's 1995 transition
from a component of the Department of Health and Human

Services to an independent agency, we reported that SSA had not always
played a leadership role in analyzing and suggesting policy options for its
programs. In 1997, SSA's advisory board issued a report that concluded that
the agency should take a leadership role in the initiation of major policy
changes, rather than continue its pattern of reacting to short- term crises.
The board also noted that SSA often had an overly cautious attitude toward

initiating analysis of controversial policy issues. In prior work, we have
also reported that SSA had not undertaken the range of research, evaluation,
and policy analysis needed to inform policymakers and the public about long-
term trust fund financing issues. Thus, SSA was not sufficiently
contributing to the national debate surrounding the most critical
overarching issue facing its programs. In addition to the solvency debate,
we identified other areas that called for enhanced research and policy
analysis, such as the need for SSA to develop better data on its disability
beneficiary population and the extent to which its disability programs are
meeting program objectives, conduct analyses of workload and

retirement trends to prepare for future work environment demands, and
develop options for addressing long- standing SSI polices that have
contributed to increased overpayments and program abuse. SSA has
acknowledged the need to play a more active research and policy development
role. In the last few years, SSA has initiated several reorganizations of
its

policy component to strengthen its capacity. These reorganizations are
expected to enhance SSA's policy capability by linking policy development
and analysis to a strong research and evaluation base. According to agency
officials, over the last 2 years SSA has significantly increased staff
resources and almost doubledfrom $17 million to more than $30 millionthe
amount of funds available to support research by universities and other
entities outside the

agency. According to SSA officials, the newly restructured and enhanced
policy component has several completed, ongoing, and planned initiatives.
For example, the agency recently completed a study of various reform
proposals aimed at women and the possible effects of increasing the early
retirement age. Additionally, in November 2000, SSA issued a report on the
SSI program, including discussion of the status of the program,
opportunities to simplify administration of the program,

and plans for improving payment accuracy and program integrity. SSA is
strengthening its capacity to use different projection models to analyze the
implications of proposed program changes. In 1998, SSA also submitted to the
Congress its first major SSI legislative proposal aimed at improving program
integrity. Finally, SSA's policy component has also taken steps to make more
SSA program data and its published reports available via the Internet to a
wider range of stakeholders and interested parties.

Reflecting its commitment to this issue, SSA has made conducting effective
research, program evaluation, and policy development a key strategic goal.
Accordingly, SSA's current strategic plan and fiscal year 2001 performance
plan include objectives and strategies for completing additional analyses
and providing more timely information to decisionmakers. SSA plans to
conduct ongoing research and provide the Congress and others with
comprehensive analyses of the impacts of various social security reform
proposals. Over the next several years, SSA intends to promote disability
program changes by gathering additional data on the characteristics of
disability beneficiaries and the factors that may facilitate more effective
return- to- work strategies.

SSA's actions to restructure its policy component and the analyses it plans
to conduct should enhance its ability to conduct timely research, provide
information to decisionmakers, and develop options for legislative change.
However, many of SSA's initiatives are still in the planning stages or have
not yet been completed. Thus, their effect on SSA program policy is unclear
at this time. If sustained, SSA's stepped- up research and policy
development activities should allow it to play a more active role in
critical policy debates, such as those aimed at ensuring the long- term
solvency of social security trust funds. If properly targeted, SSA's actions
in other areas should also allow it to identify emerging issues

more effectively and to develop sound policy solutions before major program
crises occur. SSA intends to measure the success of its efforts by the
extent to which

its customers- including the Congress and the Office of Management and
Budget- believe its research is timely and of high quality. In time, these
measures should provide a clearer picture of whether SSA's approach is
effective or whether additional actions are needed in research, evaluation,
and policy development.

Key Contact Barbara D. Bovbjerg, Director Education, Workforce, and

Income Security Issues (202) 512- 7215 bovbjergb@ gao. gov Additional
Progress

Our prior work has shown that SSA's disability Is Needed to determination
process is time- consuming, complex, and

Improve SSA's expensive. Individuals who are initially denied benefits
Disability by SSA and appeal their claim often wait a long time for
Determination

a final agency decision. SSA's past efforts to redesign the Process and to
claims process have not achieved the intended result, Return People to and
SSA is still trying to improve the process. Because Work

SSA's DI and SSI programs are expected to grow significantly over the next
decade, making accurate and timely disability determinations remains one of
SSA's most challenging service areas. Additionally, SSA has not developed,
as we have recommended, a comprehensive return- to- work strategy that
focuses on identifying and enhancing beneficiaries work capacities;

consequently, few people have left the rolls to return to work. Improvements
to the SSA's complex disability claims process has been Disability plagued
by a number of long- standing weaknesses that Determination have resulted in
lengthy waiting periods for claimants Process Have Been seeking disability
benefits. For example, claimants who Limited

are dissatisfied with the initial determination and file an appeal
frequently wait more than 1 year for a final decision. We have reported that
these long waits are due, in part, to complex and fragmented decisionmaking
processes that are laden with many layers of reviews and multiple hand- offs
from one person to another. The cost of administering the DI and SSI
programs reflects the demanding nature of the process. In fiscal year 1999,
SSA spent almost $4. 1 billion or 59 percent of its administrative budget on
these programs,

even though beneficiaries of these programs comprise less than 20 percent of
the agency's total number of beneficiaries. In addition to its difficulties
in processing claims, SSA has also experienced trouble ensuring that
decisions about a claimant's eligibility for disability benefits are
accurate and consistent across various program components. For example, our
work shows that in fiscal year 2000, about 40 percent of applicants whose
cases were denied at the initial level appealed this decision, and about
two- thirds were awarded benefits. This

happens in part because decisionmakers at the initial level use a different
approach to evaluate claims and make decisions than those at the appellate
level. The

inconsistency of decisions at these two levels has raised questions about
the fairness, integrity, and cost of SSA's disability programs. Since 1994,
SSA has taken a number of steps to try to address these problems; until
recently, it has met with limited success. First, in an effort to improve
the claims process, SSA embarked on a massive effort to redesign the way it
made disability decisions. Among other

things, SSA planned to develop an automated and simpler claims intake and
appeal process, a simplified method for making disability decisions, more
consistent guidance and training for decisionmakers at all levels of the
process, and an improved process for reviewing the quality of eligibility
decisions. We concluded in a 1996 report, however, that 2 years into the
plan SSA had yet to

achieve significant results. The agency's slow progress was due in part to
the overly ambitious nature of the redesign plan, the complexity of the
redesign initiatives, and inconsistent stakeholder support and cooperation.
In our 1996 report, we recommended that the agency focus on those few
initiatives considered most crucial

and rethink its approach to testing. In 1997, the agency scaled back its
plan, but progress continued to be slow, in part because even the scaled-
back plan proved too

large and cumbersome to keep on track. By 1998, SSA was behind on its near-
term initiatives, and its proposed process changes initially showed
disappointing and inconclusive results as tested. Only one of its large
tests, which combined a number of proposed process changes, began to show
promise. Moreover, as originally envisioned, SSA's plan to redesign its
disability determination process was heavily dependent upon successful
technological improvements. The agency spent most of the last decade

designing and developing a new computer software application to automate the
disability claims process. However, SSA experienced performance problems and
delays in developing this software and, after approximately 7 years and more
than $71 million reportedly spent, decided to discontinue the initiative.

In 1999, we again made a number of recommendations designed to improve SSA's
prospects for success as the agency continues its efforts to improve the
claims process. We again recommended that the agency focus

its resources on those initiatives offering the greatest potential for
improvement, such as efforts to increase the consistency of decisions,
improve quality assurance, and enhance computer support systems. In March
1999, SSA issued a new disability plan that is consistent with some of our
recommendations. According to SSA

officials, the revised redesign plan, even in its scaled back form,
represents the most significant changes to the disability process since the
1950s. The revised plan focuses on even fewer initiatives and builds on
those areas where the agency showed some promise. For example, it emphasizes
initiatives to improve the quality and consistency of decisions. SSA plans
to continue training efforts to improve the consistency of decisions, which
agency officials believe have resulted in 90, 000 eligible individuals
receiving benefits 500 days sooner during the years 1997 through 1999. In
addition, SSA has begun broader field- testing of a number of its more

promising initiatives and process changes in an integrated fashion and is
pursuing a new automation strategy to support the processing of disability
claims. Until recently, SSA's proposed changes primarily affected the
initial decision- making level in the process, leaving problems largely
unresolved at the hearing level, where appeals are decided. However,
beginning in January 2000, the agency initiated plans to overhaul operations
at its hearing offices in an effort to increase efficiency and significantly
reduce processing times at that level. Beginning at 37 of its 140 hearings
offices, SSA implemented significant changes in organizational structure to
hold teams accountable for improved workflow. The agency also plans to
improve automation of data collection and management information. In
addition, SSA has developed and begun implementing an action plan to improve
operations at the Appeals

Council, the final level of administrative review for appealed cases.
However, much is left to be done on this and all of SSA's disability-
related improvement projects, and the effectiveness of these efforts remains
to be seen. It is vital that SSA address its claims process problems now,
before the agency experiences another surge in workload when the baby
boomers reach their disabilityprone

years. SSA Lacks a

The number of working age beneficiaries of the DI and Comprehensive

SSI programs has increased by 65 percent over the past Strategy to Return 10
years (see fig. 1). We have reported that, as the the Disabled to Work

beneficiary population has grown, numerous technological and medical
advances, combined with changes in society and the nature of work, have
increased the potential for some people with disabilities to return to, or
remain in, the labor force. Also, legislative changes have focused on
returning disabled beneficiaries to work. The Americans With Disability

Act supports the premise that people with disabilities can work and have the
right to work, and the Ticket to

Work and Work Incentives Improvement Act of 1999 increased beneficiaries'
access to vocational services. Indeed, many beneficiaries with disabilities
indicate they want to work, and many can work in today's labor market if
they receive needed support. In 1996, we recommended that SSA place a
greater priority on helping disabled beneficiaries work, and SSA has taken

a number of actions to improve its return- to- work practices. But even with
these actions, SSA has achieved poor results in this arena, where less than
1 in 500 DI beneficiaries and few SSI beneficiaries leave the rolls to
return to work.

Figure 1: Increase in Disability Beneficiaries, 19891999

SSI and DI Recipients (in Millions)

8 6 4 2 0

1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 Note: Includes DI
disabled workers aged 18- 64. Also includes blind

and disabled SSI recipients aged 18- 64 with a federal SSI payment or a
federally administered state supplementation.

Source: GAO analysis of data from SSA's Annual Statistical Supplement to the
Social Security Bulletin, multiple years.

Even in light of the new Ticket to Work Act, SSA will continue to face
difficulties in returning some of its beneficiaries to work, in part due to
statutory and policy weaknesses in the design of the DI program. As we have
reported in the past, these weaknesses include an eitheror

disability decision- making process that characterizes individuals as either
unable to work or having the

capacity to work. This either- or process produces a strong incentive for
applicants to establish their inability to work to qualify for benefits.
Moreover, return- to- work services are offered only after a lengthy
determination

process. Because many applicants are unemployed at the time of application
and remain unemployed during the eligibility determination process, it is
likely that their skills, work habits, and motivation to work deteriorate
during this wait. Thus, individuals who have successfully established their
disability may have little reason or desire to attempt rehabilitation and
competitive work. Unlike some private sector disability insurers and foreign
social insurance systems, SSA does not incorporate into its initial or
continuing eligibility assessment process an evaluation of what is needed
for an individual to return to work. Instead, an individual who might have
been able to stay in the workforce or return to work with assistance- and
thus stay off the long- term disability benefit rolls- has little choice but
to prove his or her inability to work to obtain assistance through DI or
SSI.

Moreover, SSA has not traditionally reported on its progress in returning
people with disabilities to work. In its fiscal year 1999 performance
report, SSA's return- towork

performance measures were focused on activities, such as SSA's progress in
developing tools to help beneficiaries achieve self- sufficiency, rather
than on the outcome of whether individuals were being returned to work. SSA
recognized that its performance measures did

not track long- term achievement of self- sufficiency and that it needed to
establish better measures. The agency has taken some preliminary steps in
that direction with its fiscal year 2001 performance plan, which tracks the
percentage increase in beneficiaries who begin a trial work period or who
participate in a program that permits them to work and to continue receiving
benefits

under certain conditions.

In addition, SSA has recently stepped up its return- towork efforts. For
example, it has (1) established an Office of Employment Support Programs to
promote employment of disabled beneficiaries, (2) raised the

limit on the amount a DI beneficiary can earn from work and still receive
benefits to encourage people with disabilities to work, (3) funded 12 state
partnership

agreements that are intended to help the states develop services to increase
beneficiary employment, and (4) begun a demonstration project to determine
whether providing access to the right medical treatment for some
beneficiaries will enable them to work. While these efforts represent
positive steps in trying to return people with disabilities to work, much
remains to be done. As we have recommended previously, SSA should develop a
comprehensive return- to- work

strategy that integrates, as appropriate, earlier intervention, including
earlier and more effective identification of work capacities and expansion
of such capacities by providing necessary return- to- work assistance for
applicants and beneficiaries. Adopting a comprehensive return- to- work
strategy will require fundamental changes to the underlying philosophy and
direction of the DI and SSI programs, including the determination of
disability. Policymakers will need to carefully weigh the implications of
such changes.

Key Contacts Barbara D. Bovbjerg, Director Education, Workforce, and

Income Security Issues (202) 512- 7215 bovbjergb@ gao. gov Joel C.
Willemssen, Managing Director

Information Technology (202) 512- 6408 willemssenj@ gao. gov

Long- Standing, In prior work, we have reported on SSI program abuses High-
Risk SSI and mismanagement, increases in overpayments, and Issues Require

SSA's difficulties in recovering outstanding SSI debt. Sustained

These issues have spurred congressional criticism of Management and

SSA's ability to manage its workloads effectively. In Oversight February
1997, we designated SSI a high- risk program because of its susceptibility
to fraud, waste, abuse, and mismanagement. We found that, to a great extent,
SSA's inability to address its most significant problems with the SSI
program is attributable to two underlying causes:

(1) an organizational culture that places greater priority on processing and
paying claims than on controlling program expenditures and (2) a management
approach characterized by SSA's reluctance to fulfill its policy development
and planning role in advance of major program crises. In regard to SSA's
organizational culture, our prior work confirmed that there has been a
tendency among staff and managers to view the SSI program in much the same
way as SSA's OASI and DI programs- where emphasis is

placed on quickly processing claims for individuals with an earned right to
benefits- rather than as a welfare program, where additional income and
asset verifications are necessary. As a result, SSA has often relied heavily
on recipient self- reporting of their financial circumstances, with
insufficient agency verification. SSA's culture has also contributed to the
low priority placed on recovering overpayments once they are identified.
This has been evidenced by SSA's past reluctance to use available
overpayment recovery

tools and to pursue additional tools aggressively when warranted, including
tax refund offsets, credit bureau reporting, collection agencies, and
interest levies on outstanding debt. In fiscal year 1999, outstanding SSI
debt and newly detected overpayments for the year totaled more than $3. 8
billion. SSI write- offs- overpayments waived or deemed uncollectable by
SSA- also totaled about $466 million for the year. We

have reported that write- offs represent overpaid program dollars that SSA
will likely never recover. In regard to SSA's management approach, our work
also shows that SSA's actions have been historically reactive in nature,
resulting in missed opportunities to address

critical policy issues before they reach crisis levels. However, in response
to our high- risk designation and report recommendations, SSA has taken
steps in coordination with the Congress to improve the financial integrity
and management of SSI. For example, in 1998, SSA submitted its first major
SSI legislative proposal,

which included numerous overpayment deterrence and recovery provisions. Many
of these provisions were incorporated into the Foster Care Independence Act,

which was signed into law last year. The Act, which directly addresses
several of our prior recommendations, provides SSA with additional tools for
obtaining applicant income and resource information from financial
institutions, accessing state databases for essential eligibility
information, imposing a period of ineligibility for applicants who transfer
assets to qualify for SSI benefits, and using credit bureaus, private
collection agencies, interest levies, and

other means to recover delinquent debt. SSA also produced its first SSI
management report in 1998, which discussed its intent to take aggressive
action to control program overpayments and

outstanding debt. And, according to SSA officials, the agency is currently
doing this in part through enhanced computer matching and other means. This
includes more frequent (monthly) data matches to identify ineligible SSI
recipients residing in nursing homes and

stepping up efforts to obtain online access to SSI recipient employment and
income information. In fiscal year 1999, SSA also sought and obtained
additional budget resources to substantially increase the number of SSI
financial redeterminations conducted. These reviews focus on income and
resource factors affecting

eligibility and payment amounts. Through this effort, SSA calculated that it
collected and prevented nearly $600 million in overpayments above fiscal
year 1998 levels. SSA's Office of Inspector General (OIG) has also

significantly increased the level of resources and staff dedicated to
investigating program fraud and abuse. Finally, SSA has begun using tax
refund offsets for delinquent SSI debtors and has recovered about $84
million in additional collections over the last 2 fiscal years. This
increased emphasis on program integrity is further evident in SSA's planning
and performance measurement activities. SSA's current strategic and

annual performance plans include several goals and performance measures
targeted specifically at achieving SSA's goal of improving SSI program
integrity and addressing fraud and abuse.

SSA's initiatives have the potential to significantly improve SSI management
and financial integrity. However, many problems facing the program are
attributable to more than 20 years of inattention to payment controls and
will take time to correct. SSI overpayments and outstanding debt owed to the
program remain at high levels. Further, our recent work shows that SSI
continues to be vulnerable to abuse, especially from individuals feigning
disabilities with the help of suspicious medical providers and middlemen.
Last year, the OIG reported that, since 1998, SSI representative payees 1
have defrauded the program of nearly $8 million in benefit payments. This
was

attributable primarily to SSA's failure to screen and monitor these
individuals sufficiently. SSA's OIG also recently reported that, due to
weaknesses in SSA's verification processes, thousands of fugitive felons
incorrectly received $76 million in SSI benefits over the 1 SSA appoints
representative payees to SSI recipients whom it has determined incapable of
managing their own benefits.

last several years, despite a law prohibiting such payments. We believe that
sustained and additional actions are needed to improve SSI program
integrity. In accordance with our prior recommendations, SSA should move
forward in fully implementing the debt collection tools

currently available to it, continue to develop additional ways to improve
program management and integrity, and seek legislative changes as
appropriate. SSA should also consider ways to revise its work credit and
measurement system, which has historically rewarded staff for cases
processed, rather than thoroughly verifying applicant eligibility or
preventing overpayments. Any revised system should include specific goals
and performance measures to hold staff

and managers accountable for ensuring program integrity. If properly
implemented and managed, such measures should ultimately facilitate a change
in SSA's organizational culture and provide much- needed

incentives for staff to devote time to verifying recipient information,
preventing fraud and abuse, and controlling program overpayments. Until
additional progress is made, the SSI program will remain at high risk for
waste, fraud, abuse, and mismanagement. Key Contact Barbara D. Bovbjerg,
Director

Education, Workforce, and Income Security Issues (202) 512- 7215 bovbjergb@
gao. gov SSA Needs to

Among federal agencies, SSA has long been considered Better Position one of
the leaders in service delivery. Indeed, for fiscal Itself for Future year
1999, SSA reported that 87 percent of the public Service Delivery rated its
services as “good” or “very good.” SSA Challenges
considers service delivery one of its top priorities, and

its current performance report includes specific goals and strategies to
provide accurate, timely, and useful service to the public. Our work shows,
however, that the

agency is not without weaknesses in its current service delivery system. For
example, although 800- number answers given to customers concerning their
benefit payments were largely correct during fiscal year 1999, 20 percent of
nonpayment- related answers were inaccurate. Also, in 1999, the Social
Security Advisory Board reported that many persons who visited one of SSA's
field offices encountered crowded waiting areas

and long waiting times for service. More importantly, however, SSA faces
significant future challenges that could hamper its ability to provide
highlevel service delivery, including a projected increase in the demand for
services. Demand for services will grow rapidly as the baby boom generation
ages and enters the disability- prone years (see fig. 2). By 2010, SSA
expects applications for DI to increase by as much as 54 percent over 1999
levels. Determining eligibility for disability benefits is a complex process
that spans a number of offices and can take over a year to complete. As

discussed in the section on disability, SSA already has trouble managing its
disability determination workload; adding additional cases without
rectifying case

processing issues will result in greater service delivery problems for SSA.
By 2010, SSA also expects that applications for retirement benefits will
increase by 20 percent over 1999 levels.

Figure 2: Predicted Increases in OASI, DI, and SSI Applications Number of
Claims

8000 7500

Total Applications Predicted

7000 6500 6000

Total SSI

5500 5000 4500

Total DI

4000 3500 3000 2500

Total OASI

2000 1999

2000 2001

2002 2003

2004 2005

2006 2007

2008 2009

2010

Fiscal Year

Note: SSA's Office of the Chief Actuary does not have estimates of
applications for OASI and DI beyond 2010. Also, these estimates reflect some
double- counting of those individuals who apply for both DI and SSI, a group
that is expected to grow from about 480,000 in fiscal year 1999 to 640,000
in fiscal year 2010.

Source: Data provided by SSA's Office of the Chief Actuary.

Other challenges facing SSA's ability to provide highquality service
delivery, center on its workforce. First, SSA's workforce is aging, and
beginning in 2001, SSA is predicting a retirement wave that will peak in
2009 when more than one- half of SSA's 63, 000 employees will be eligible
for retirement. The percentage is higher for employees in SSA's supervisor
or manager ranks. In

particular, more than 80 percent of SSA's upper- level managers and
executives (GS- 14, GS- 15, and SES level) will be eligible to retire by
2010. Secondly, SSA will need to increase staff skills to deal with changing
customer expectations and needs. SSA's already- limited information systems
staff will be increasingly challenged to develop and implement new
technologies, including more electronic (for example, Internet) applications
to serve the public in a more convenient, cost- effective, and secure
manner. At the same time, some aspects of SSA's customer service workload
will likely become more time- consuming and labor intensive.

This is primarily due to the growing proportion of SSA's non- English
speaking customers and the rising number of disability cases involving
mental impairments. Both situations result in more complex cases that
require diverse staff skills. SSA has a number of initiatives underway to
try to prepare for its future challenges. In 1998, it began working on an
effort to systematically monitor and

measure the needs, expectations, priorities, and satisfaction of customer
groups, major stakeholders, and its workforce. Additionally, as we
recommended in 1993, and as required by law, SSA recently developed a
workforce transition plan to spell out steps needed so that its workforce
will be able to handle future service delivery challenges. In addition,
recognizing that it will shortly be facing the prospect of increasing
retirements,

SSA conducted a study that predicts staff retirements and attrition by year,
from 1999 to 2020, by major job position and agency component. This
initiative went beyond identifying the dates that its employees first became
eligible to retire by also factoring in 10 years of historical retirement
data to make more realistic projections. SSA is also beginning to take steps
to fill its expected leadership gap. We have long stressed the importance of
succession planning and formal programs to develop and train managers at all
levels at SSA. As early as 1993, we recommended that SSA make

succession planning a permanent aspect of its human resource planning and
evaluate the adequacy of its investments in management training and
development. SSA recently created three new leadership development programs
to help prepare selected staff to assume mid- and top- level leadership
positions at the agency. Thus far, the agency's workforce approach shows
promise in that many of its steps are consistent with principles of human
capital management.

To cope with its growing workloads, SSA plans to rely extensively on
information technology to help it achieve processing efficiencies and
improved customer service. To this end, the agency has devoted considerable
time and effort to identifying strategies to meet its goal of providing
world- class service. For example, SSA has

recently begun to offer retirees the option of applying for benefits online.
SSA has also pursued a number of initiatives over the past decade aimed at
establishing the technological infrastructure needed to enhance its claims-
processing capabilities and the overall administration of its programs. For
example, SSA implemented the Intelligent Workstation/ Local Area Network to
provide the automation infrastructure to support its redesigned work
processes and improve the

availability and timeliness of information, and it is pursuing other
initiatives to achieve electronic disability processing. However, SSA has
experienced mixed success in carrying out its information technology
initiatives, and we found that it has not been able to clearly demonstrate
the benefits resulting from some of its most significant investments.
Because many of SSA's

information technology initiatives are still in various stages of
development, evidence of how they will improve the agency's processing
capabilities and service to the public remains to be seen.

More recently, SSA has taken additional steps to better plan for its future
service delivery challenges. In 2000, SSA completed an ambitious “2010
Vision” document

that articulates how it envisions the agency functioning in the year 2010.
For example, SSA anticipates offering services either inperson, over the
telephone, or via the Internet, where telephonic and electronic access

services are equipped with sophisticated voice recognition and language
translation features and where work is accomplished through a paperless
process. In the “Vision” document, SSA also states that it will
rely heavily on technology and a workforce with diverse and updated skills
to accomplish its mission. While we have not yet fully evaluated this new
vision, it represents a positive agency step toward acknowledging and
preparing for future service delivery challenges. However, to be useful in
making information technology and workforce decisions, we have stressed that
this

document should be followed by a more detailed service delivery plan that
spells out who will provide what type of services in the future and where
these services will be made available. SSA has not yet developed such a
blueprint for how it will achieve its vision. The combination of the
expected increase in demand for services, imminent retirement of a large
part of its workforce, changing customer expectations, and questionable
success in technology investment is a

potentially crippling force to SSA's service delivery. SSA has begun taking
concrete steps to address these challenges; however, without a service
delivery plan, SSA cannot ensure that its investments in its workforce and
technology are consistent with and fully support its future approach to
service delivery.

Key Contacts Barbara D. Bovbjerg, Director Education, Workforce, and

Income Security Issues (202) 512- 7215 bovbjergb@ gao. gov

Joel C. Willemssen, Managing Director Information Technology (202) 512- 6408
willemssenj@ gao. gov SSA Needs to

With the retirement of the baby- boom generation and Further Strengthen
individuals living longer in retirement, SSA will soon be Controls to
Protect

serving greater numbers of individuals with fewer staff. Its Information

To handle these workload demands, SSA is counting on the effective use of
technology and automated financial and performance data to guide and
evaluate the impact of its efforts. In prior work, we have reported that SSA
must address weaknesses in its information systems' internal controls to
ensure that automated agency data are both reliable and credible. In
particular, we reported

that internal control weaknesses have exposed the agency and its computer
systems to external and internal intrusion, thus subjecting automated data
to potential unauthorized access and modification. SSA has made notable
progress in addressing information systems internal control weaknesses and
in strengthening its ability to respond effectively to a disruption in
business as a result of a disaster or longterm

crisis. For instance, SSA has issued a security policy, strengthened
physical security agencywide, and successfully tested its critical workloads
during FY 2000. It is important for SSA to continue to address

weaknesses in its information systems' internal controls. A recent audit by
an independent public accounting firm noted continuing weaknesses in several
components of SSA's overall information protection internal control

structure. The general areas where exposures occurred included (1) controls
designed to limit or detect access to computer programs, data, and other
computing resources at nonheadquarters sites; (2) policies and rules
governing the operation of devices that control external access to the SSA
network; and (3) the

technical configuration of a contractor- controlled area of SSA's network. 2
Until corrected, a weakened or incomplete information protection control
structure will continue to impair SSA's ability to mitigate the risk of
unauthorized access, modification, or disclosure of sensitive SSA
information.

The audit acknowledged SSA's progress in resolving these issues, and it
emphasized the importance of continuing corrective action. The need for a
strong entitywide security framework to address threats to the security and
integrity of SSA operations will grow as the agency moves ahead with plans
to increase its dependency on the Internet and Web- based applications to
serve the American public. The audit recommended that SSA accelerate and
build on its progress to enhance

information protection. Key Contact Robert F. Dacey, Director

Information Security Issues (202) 5123317 daceyr@ gao. gov 2 SSA corrected
the last item prior to issuance of the audit report.

Related GAO Products Research and

Observations on the Social Security Administration's Policy Fiscal Year 1999
Performance Report and Fiscal Year Development

2001 Performance Plan (GAO/ HEHS- 00- 126R, June 30, 2000).

SSA's Management Challenges: Strong Leadership Needed to Turn Plans Into
Timely, Meaningful Action (GAO/ T- HEHS- 98- 113, Mar. 12, 1998). Social
Security Administration: Effective Leadership Needed to Meet Daunting
Challenges (GAO/ T- OCG- 96- 7, July 25, 1996).

Social Security Administration: Leadership Challenges Accompany Transition
to an Independent Agency (GAO/ HEHS- 95- 59, Feb. 15, 1995). Social Security

SSA Disability: Other Programs May Provide Lessons for Disability

Improving Return- to- Work Efforts (GAO/ T- HEHS- 00- 151, Programs

July 13, 2000). Social Security Disability: SSA Has Had Mixed Success in
Efforts to Improve Caseload Management (GAO/ T- HEHS- 00- 22, Oct. 21,
1999).

SSA Disability Redesign: Actions Needed to Enhance Future Progress (GAO/
HEHS- 99- 25, Mar. 12, 1999). SSA Disability: Return- to- Work Strategies
From Other Systems May Improve Federal Programs (GAO/ T- HEHS- 96- 133, July
11, 1996).

Supplemental Supplemental Security Income: Additional Action Security Income

Needed to Reduce Program Vulnerability to Fraud and Program

Abuse (GAO/ HEHS- 99- 151, Sept. 15, 1999).

Supplemental Security Income: Long- Standing Issues Require More Active
Management and Program Oversight (GAO/ T- HEHS- 99- 51, Feb. 3, 1999).
Supplemental Security Income: Action Needed on LongStanding Problems
Affecting Program Integrity (GAO/ HEHS- 98- 158, Sept. 14, 1998).

Supplemental Security Income: Long- Standing Problems Put Program at Risk
for Fraud, Waste, and Abuse (GAO/ T- HEHS- 97- 88, Mar. 4, 1997). Service
Delivery to SSA Customer Service: Broad Service Delivery Plan the Public

Needed to Address Future Challenges (GAO/ T- HEHS/ AIMD- 00- 75, Feb. 10,
2000). Information

Information Security: Software Change Controls at the Technology

Social Security Administration (GAO/ AIMD- 00- 198R, June 30, 2000).

Social Security Administration: Update on Year 2000 and Other Key
information Technology Initiatives (GAO/ T- AIMD- 99- 259, July 29, 1999).

Social Security Administration: Technology Performance Challenges Threaten
Progress of Modernization (GAO/ AIMD- 98- 39, June 19, 1998).

Social Security Administration: Software Development Process Improvements
Started, but Work Remains (GAO/ AIMD- 98- 39, Jan. 28, 1998). Social
Security Administration: Risks Associated With Information Technology
Investment Continue (GAO/ AIMD- 94- 143, Sept. 19. 1994).

Performance and Accountability Series

Major Management Challenges and Program Risks: A Governmentwide Perspective
(GAO- 01- 241)

Major Management Challenges and Program Risks: Department of Agriculture
(GAO- 01- 242)

Major Management Challenges and Program Risks: Department of Commerce (GAO-
01- 243)

Major Management Challenges and Program Risks: Department of Defense (GAO-
01- 244)

Major Management Challenges and Program Risks: Department of Education (GAO-
01- 245)

Major Management Challenges and Program Risks: Department of Energy (GAO-
01- 246)

Major Management Challenges and Program Risks: Department of Health and
Human Services (GAO- 01- 247)

Major Management Challenges and Program Risks: Department of Housing and
Urban Development (GAO- 01- 248)

Major Management Challenges and Program Risks: Department of the Interior
(GAO- 01- 249)

Major Management Challenges and Program Risks: Department of Justice (GAO-
01- 250)

Major Management Challenges and Program Risks: Department of Labor (GAO- 01-
251)

Major Management Challenges and Program Risks: Department of State (GAO- 01-
252)

Major Management Challenges and Program Risks: Department of Transportation
(GAO- 01- 253)

Major Management Challenges and Program Risks: Department of the Treasury
(GAO- 01- 254)

Major Management Challenges and Program Risks: Department of Veterans
Affairs (GAO- 01- 255)

Major Management Challenges and Program Risks: Agency for International
Development (GAO- 01- 256)

Major Management Challenges and Program Risks: Environmental Protection
Agency (GAO- 01- 257)

Major Management Challenges and Program Risks: National Aeronautics and
Space Administration (GAO- 01- 258)

Major Management Challenges and Program Risks: Nuclear Regulatory Commission
(GAO- 01- 259)

Major Management Challenges and Program Risks: Small Business Administration
(GAO- 01- 260)

Major Management Challenges and Program Risks: Social Security
Administration (GAO- 01- 261)

Major Management Challenges and Program Risks: U. S. Postal Service (GAO-
01- 262)

High- Risk Series: An Update (GAO- 01- 263)

GAO United States General Accounting Office

Page 1 GAO- 01- 261 SSA Challenges

Contents

Page 2 GAO- 01- 261 SSA Challenges

Comptroller General of the United States

Page 3 GAO- 01- 261 SSA Challenges United States General Accounting Office

Washington, D. C. 20548

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Challenges

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Challenges

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Challenges

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Challenges

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Challenges

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Challenges

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Challenges

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Challenges

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Challenges

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Challenges

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Challenges

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Challenges

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Challenges

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Challenges

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Challenges

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Challenges

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Challenges

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Challenges

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Challenges

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Challenges

Major Performance and Accountability Challenges Page 34 GAO- 01- 261 SSA
Challenges

Major Performance and Accountability Challenges Page 35 GAO- 01- 261 SSA
Challenges

Major Performance and Accountability Challenges Page 36 GAO- 01- 261 SSA
Challenges

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Related GAO Products Page 38 GAO- 01- 261 SSA Challenges

Page 39 GAO- 01- 261 SSA Challenges

Performance and Accountability Series

Page 40 GAO- 01- 261 SSA Challenges

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