Supplemental Security Income: Organizational Culture and Management
Inattention Place Program at Continued Risk (Testimony, 04/21/1998,
GAO/T-HEHS-98-146).

The Supplemental Security Income Program, which provides $25 billion
each year in cash assistance to poor, blind, and disabled persons,
remains vulnerable to fraud and abuse. More than $1 billion in
overpayments were detected in 1997. A primary reason is an agency
culture that puts more emphasis on paying an "entitled" population than
on verifying eligibility requirements. Because of this culture, the
Social Security Administration has relied heavily on applicants to
self-report important eligibility information, which it has tried to
validate with untimely and incomplete verification processes. SSA also
lacks essential collection tools to pursue overpayments once they are
identified and has not made fraud detection and prevention a priority.
Thus, annual overpayments have steadily increased, program abuses
continue, and the gap between overpayments recovered by SSA each year
and what is owed the program widens. Many of SSA's corrective measures
are still in the planning stages, and the agency still lacks a
comprehensive, long-term strategy for improving program performance.

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

 REPORTNUM:  T-HEHS-98-146
     TITLE:  Supplemental Security Income: Organizational Culture and
	     Management Inattention Place Program at Continued
	     Risk
      DATE:  04/21/1998
   SUBJECT:  Social security benefits
	     Overpayments
	     Income maintenance programs
	     Eligibility determinations
	     Data collection
	     Debt collection
	     Strategic planning
	     Program abuses
IDENTIFIER:  Supplemental Security Income Program

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GAO/T-HEHS-98-146

Cover
================================================================ COVER

Before the Subcommittee on Human Resources, Committee on Ways and
Means, House of Representatives

For Release on Delivery
Expected at 3:00 p.m.
Tuesday, April 21, 1998

SUPPLEMENTAL SECURITY INCOME -
ORGANIZATIONAL CULTURE AND
MANAGEMENT INATTENTION PLACE
PROGRAM AT CONTINUED RISK

Statement of Cynthia Fagnoni, Director
Income Security Issues
Health, Education, and Human Services Division

GAO/T-HEHS-98-146

GAO/HEHS-98-146T

(207037)

Abbreviations
=============================================================== ABBREV

  CBO - Congressional Budget Office
  CDR - Continuing Disability Reviews
  DDS - Disability Determination Services
  OCSE - Office of Child Support Enforcement
  OIG - Office of the Inspector General
  SSA - Social Security Administration
  SSI - Supplemental Security Income
  TRO - tax refund offsets

SUPPLEMENTAL SECURITY INCOME:
ORGANIZATIONAL CULTURE AND
MANAGEMENT INATTENTION PLACE
PROGRAM AT CONTINUED RISK
============================================================ Chapter 0

Mr.  Chairman and Members of the Subcommittee:

I am pleased to be here today to discuss needed changes in the Social
Security Administration's (SSA) Supplemental Security Income (SSI)
program.  SSI is the nation's largest cash assistance program for the
poor.  In 1996, the program paid about 6.5 million low-income aged,
blind, and disabled recipients $25 billion.  Since its inception, the
SSI program has grown in both size and complexity, and SSA has been
significantly challenged in its efforts to serve the diverse needs of
recipients while still protecting the financial integrity of the
program.  A major reason for the growth and changes in the SSI rolls
has been an increasing number of younger recipients with mental
impairments and limited work histories.  Rapid increases in the
number and diversity of SSI recipients; media reports highlighting
instances of program abuse; and our prior work documenting internal
control weaknesses, complex program policies, and insufficient
management attention have spurred congressional criticism of SSA's
ability to effectively manage SSI workloads.  Those factors have also
reinforced public perceptions that SSA pays too many people for too
long.

In 1997, SSI program overpayments reached $2.6 billion, including
more than $1 billion in newly detected overpayments for the year.  Of
that amount, SSA recovered only $437 million.  The SSI program's
vulnerability to fraud and abuse and the magnitude of overpayments
involved were primary factors in our decision to designate SSI a
high-risk area in 1997 and to begin a broad-based review of the
program to determine how SSA's management has influenced performance.
Today I will focus on three problem areas that we believe have
affected SSA's ability to control program expenditures and provide
effective management direction.  These include the priority SSA
places on verifying recipients' initial and continuing eligibility
for benefits, deterring and collecting SSI overpayments, and
addressing SSI program fraud and abuse--areas that we believe
currently pose the greatest near-term risk to the financial health of
the SSI program but also offer significant opportunities for
improvement.  In the next several months, we plan to issue a
comprehensive report on our findings that will elaborate on the
problem areas discussed today and will include a full discussion of
additional long-standing problems identified during our review.  Our
review was conducted at SSA headquarters and four regions, which
account for more than 50 percent of the SSI population.  It included
more than 100 in-depth interviews with SSA personnel at all levels of
the agency; an extensive review of more than 100 internal and
external studies of the SSI program dating back to its inception; and
an examination of program performance data related to SSI beneficiary
groups, overpayments, payment accuracy rates, and so forth.

In summary, the SSI program is at considerable risk of waste, fraud,
and mismanagement because of an agency culture that has tended to
view the SSI program in much the same way as SSA's title II
programs--which place emphasis on making payments to an "entitled"
population--rather than as a welfare program that requires stronger
income and asset verification policies.  Because of this culture, SSA
has often relied heavily on applicants to self-report important
eligibility information, which it has tried to validate with untimely
and incomplete verification processes.  SSA also continues to lack
essential collection tools to pursue SSI overpayments once they are
identified and has not made fraud detection and prevention an
agencywide workload priority.  Thus, annual SSI overpayments have
increased steadily, program abuses continue to occur, and the gap
between overpayments recovered by SSA each year and what is owed the
program continues to grow.  As outstanding SSI overpayment debt has
mounted, annual SSI write-offs have increased.  Since 1989, SSA has
written off more than $1.8 billion in SSI overpayments.  These
write-offs represent overpaid taxpayer dollars that SSA will probably
not recover.

More recently, SSA management has focused increasing attention on
addressing some of its long-standing SSI program problems and intends
to develop an SSI Action Plan in accordance with the Government
Performance and Results Act of 1993, which provides agencies with a
new uniform framework with which to develop their plans and monitor
progress.  However, many of SSA's initiatives are still in the
planning or early implementation stages, and SSA still lacks a
comprehensive long-term strategy for improving SSI program
performance.  Thus, our concerns about underlying SSI program
vulnerabilities remain.

   BACKGROUND
---------------------------------------------------------- Chapter 0:1

SSI provides cash benefits to low-income aged, blind, or disabled
people.  Currently, the aged SSI population is roughly 1.4 million,
and the blind and disabled population is about 5.1 million.  Those
who are applying for benefits on the basis of age must be 65 years
old or older and financially eligible for benefits; those who are
applying for disability benefits must qualify on the basis of
financial and medical criteria.  To qualify for benefits financially,
individuals may not have income greater than the current maximum
monthly SSI benefit level of $494 ($741 for a couple) or have
resources that exceed $2,000 ($3,000 for a couple).  To be qualified
as disabled, applicants must be unable to engage in any substantial
gainful activity because of an impairment expected to result in death
or last at least 12 months.

The process SSA uses to determine an applicant's financial
eligibility for SSI benefits involves an initial determination when
someone first applies and periodic reviews to determine whether the
recipient remains eligible.  SSI recipients are required to report
significant events that may affect their financial eligibility for
benefits, including changes in income, resources, marital status, or
living arrangements--such as incarceration or residence in a nursing
home.  To verify that the information provided by a recipient is
accurate, SSA generally relies on matching data from other federal
and state agencies, including Internal Revenue Service 1099
information, Department of Veterans Affairs benefits data, and
state-maintained earnings and unemployment data.  When staff find
discrepancies between income and assets claimed by a recipient and
the data from other agencies, they send notices to SSA field offices
to investigate further.

To determine a person's medical qualifications for SSI as a disabled
person, SSA must determine the individual's capacity to work as well
as his or her financial eligibility.  To determine whether an
applicant's impairment qualifies him or her for benefits, SSA uses
state Disability Determination Services (DDS) to make the initial
assessment.  Once a recipient begins receiving benefits, SSA is
required to periodically conduct Continuing Disability Reviews (CDR)
to determine whether a recipient's disabling condition has improved.

   INATTENTION TO VERIFYING
   RECIPIENTS' INITIAL AND
   CONTINUING ELIGIBILITY HAS HAD
   NEGATIVE EFFECTS
---------------------------------------------------------- Chapter 0:2

When determining SSI eligibility, SSA relies heavily on applicants'
reporting information relevant to their financial status and
disabling condition.  Although SSA has procedures in place to verify
this information, they are often untimely, incomplete, and
subservient to the primary agency goal of processing and paying
claims.  Our prior work suggests that recipients do not always report
required information when they should and may not report it at all.
In 1996, we reported that about 3,000 current and former prisoners in
13 county and local jails had been erroneously paid $5 million in SSI
benefits, mainly because recipients or their representative payees
did not report the incarceration to SSA as required, and SSA had not
arranged for localities to report such information.\1

In a report issued last year on SSI recipients admitted to nursing
homes, we found that despite legislation requiring recipients and
facilities to report such admissions, thousands of nursing home
residents continued to receive full SSI benefits.\2 These erroneous
payments occurred because recipients and nursing homes did not report
admissions and SSA lacked timely and complete automated admissions
data.  SSA has estimated that overpayments to recipients in nursing
homes may exceed $100 million annually.

To help verify that recipient financial information is correct, SSA
generally relies on computer matching with other federal and state
agencies.  In many instances, these matches allow SSA to detect
information recipients fail to report.  However, SSA's data matches
are not always the most effective means of verifying recipient
financial status, because the information is often quite old and
sometimes incomplete.  In 1996, we estimated that direct on-line
connections (as opposed to computer matching) between SSA's computers
and databases maintained by state agencies--welfare benefits,
unemployment insurance, and workers' compensation benefits--could
have prevented or quickly detected $34 million in SSI overpayments in
one 12-month period.\3 In 1998, we reported that SSA's computer
matches for earned income rely on data that are from 6 to 21 months
old, allowing overpayments to accrue for this entire period before
collection actions can begin.  We concluded that newly available
Office of Child Support Enforcement (OCSE) databases maintained by
SSA could prevent or more quickly detect about $380 million in annual
SSI overpayments caused by unreported recipient income.\4

These databases include more timely state-reported information on
newly hired employees, as well as the quarterly earnings reported for
these individuals.  However, to date, SSA has put only minimal effort
into incorporating these data into its financial verification
processes.  In the same report, we also concluded that opportunities
existed for SSA to prevent almost $270 million in overpayments by
obtaining more timely financial account information on SSI
beneficiaries.  This could be accomplished if SSA moves to obtain
access to a nationwide network that currently links all financial
institutions.  Such information would help ensure that individuals
whose bank accounts would make them ineligible for SSI do not gain
eligibility.

Our most recent field work confirmed that recipient self-reporting
and SSA's ineffectiveness at verifying this information remain a
major SSI program weakness.  Staff and managers were particularly
concerned that recipients were not reporting changes in their living
arrangements that could result in lower SSI payments.  When
determining SSI eligibility, SSA's claims processors are required to
apply a complex set of policies designed to document individuals'
living arrangements and any additional support they may be receiving
from others.  For many years, SSA's quality reviewers have deemed
this process to be highly prone to error, susceptible to
manipulation, and a major source of SSI overpayments.  In one field
office we visited, staff identified a pattern of activity involving
recipients who, shortly after becoming eligible for benefits, claim
that they have separated from their spouse and are living in separate
residences.  Staff suspected that these reported living arrangement
changes occurred as married recipients became aware that separate
living arrangements would substantially increase their monthly
benefits.  Staff also suspected that several local attorneys were
preparing "boiler plate" separation agreements for these individuals
to help them qualify for higher benefits.  However, because of a lack
of field representatives to investigate these claims, only rarely
were these cases closely reviewed or challenged.

During our review, we identified several internal and external
studies of SSI living arrangement issues conducted over many years.
Some of these studies recommended ways to simplify the process by
eliminating many complex calculations and thereby making it less
susceptible to manipulation by recipients.  Others contained
recommendations for making the SSI program less costly to taxpayers
by requiring that benefit calculations be subject to maximum family
caps or economies of scale or both when two or more recipients reside
in the same household.  In 1989, SSA's Office of the Inspector
General (OIG) reported that a more simplified process that applied an
economies-of-scale rationale to all SSI recipients living with
another person would result in fewer decisional errors and reduce
annual overpayments by almost $80 million.\5

However, the OIG concluded that such a change would require
legislative action.  Despite these studies, and the potential program
savings associated with addressing this issue, we could find no
evidence that SSA has ever acted on the recommendations or submitted
proposals for changing laws governing current living arrangement
policies.

More recently, SSA has begun to take some actions to improve the
verification aspects of the SSI program.  For example, SSA has begun
a program to identify SSI recipients in jail who should no longer
receive benefits and is expanding its use of on-line state data to
obtain more real-time applicant and recipient information.  However,
progress has been slow and SSA still does not adequately use on-line
access as an overpayment detection and prevention tool.  SSA has
opted instead to use the on-line connections it does have primarily
as a tool for helping staff with claims processing.  In regard to SSI
recipients residing in nursing homes, SSA plans to use a newly
developed Health Care Financing Administration system to more
effectively capture admissions to these and other facilities.
However, automated nursing home data already available in all state
Medicaid agencies could be used now by SSA to identify SSI recipients
living in nursing homes within 1 to 3 months of admission.  SSA's
failure to use this information while waiting for the implementation
of an alternative system has left the SSI program open to continued
abuse and millions of dollars in potential overpayments.  Finally,
SSA told us that it is continuing to study SSI living arrangement
policies and may ultimately consider proposing legislative changes to
reduce the complexity of the process and prevent overpayment of
program dollars to recipients.  Nevertheless, more than two decades
after implementation of the SSI program, this issue still has not
been addressed effectively.

--------------------
\1 Supplemental Security Income:  SSA Efforts Fall Short in
Correcting Erroneous Payments to Prisoners (GAO/HEHS-96-152, Aug.
30, 1996).

\2 Supplemental Security Income:  Timely Data Could Prevent Millions
in Overpayments to Nursing Home Residents (GAO/HEHS-97-62, June 3,
1997).

\3 Supplemental Security Income:  Administrative and Program Savings
Possible by Directly Accessing State Data (GAO/HEHS-96-163, Aug.  29,
1996).

\4 Supplemental Security Income:  Opportunities Exist for Improving
Payment Accuracy (GAO/HEHS-98-75, Mar.  27, 1998).

\5 U.S.  Department of Health and Human Services, Office of the
Inspector General, SSA Should Consider Restructuring Federal SSI
Benefits Based on Living Arrangements, A-10-89-00008 (Washington,
D.C.:  June 9, 1989).

   SSA OVERPAYMENT COLLECTIONS
   HAVE RECEIVED INADEQUATE AGENCY
   ATTENTION
---------------------------------------------------------- Chapter 0:3

In addition to problems associated with SSA's verification of
important SSI eligibility information, SSA has not placed adequate
priority on recovering overpayments, which reached $2.6 billion by
1997.  Statistics show that, on average, SSA collects only about 15
percent of all outstanding overpayments.  Thus, over time, SSA's
collection actions have been outpaced by outstanding SSI debt, which
is becoming an increasingly larger portion of all debt owed to the
agency.  Between 1989 and 1997, SSI debt carried on SSA's books more
than doubled to about $2.6 billion.  Although annual overpayment
recoveries also increased during this period, the gap between what is
owed SSA and what is actually collected each year has continued to
widen.

One reason SSI overpayment recoveries remain low is SSA's failure to
implement debt-collection tools it has had the authority to use for
many years.  For example, SSA only recently announced that it will
begin using tax refund offsets (TRO) to recover delinquent SSI debt
from former recipients, despite having the authority to do so since
1984.  The agency estimates that this initiative will result in $6
million in additional overpayment recoveries in 1998 alone.  While
the dollar amounts associated with TRO are not that large compared
with total program outlays, this initiative represents one of the few
tools available to SSA for recovering overpayments from those who
have left the program.  Sustained use of TRO may also serve a larger
purpose of deterring recipients from misreporting important
eligibility information to SSA in the future.  Waiting many years to
move forward with this important overpayment recovery tool has likely
cost the SSI program millions of dollars in SSI collections.

Another reason SSI overpayment debt has increased is that SSA does
not have and has not adequately pursued the authority to use more
aggressive debt collection tools, including the ability to
administratively intercept other federal benefit payments recipients
may receive, notify credit bureaus of an individual's indebtedness,
use private collection agencies, and charge interest on outstanding
SSI debt.  In 1995, we reported that welfare programs that used a
broad range of collection tools, such as those listed above,
experienced better rates of overpayment recovery than programs that
did not.\6 Although the agency lacks statutory authority to use these
tools to pursue SSI overpayments, in a recent testimony, SSA
management acknowledged that such tools are valuable in collecting
program overpayments.  However, SSA has not yet advocated or
sponsored any such legislative proposals for change.

To recover overpayments from current beneficiaries, SSA relies
primarily on offsetting recipients' monthly SSI benefits.  However,
the agency is prohibited under the Deficit Reduction Act of 1984 from
offsetting more than 10 percent of an overpaid recipient's total
monthly income, even if that person willfully or chronically fails to
report essential information.  In discussing the barriers to
increased overpayment collections, headquarters officials noted that
the 10-percent withholding ceiling has affected SSI collection
efforts.  However, we reported in 1996 that SSA generally agrees to
accept lower amounts than the 10-percent ceiling if a recipient
requests it rather than base such a decision on the individual's
financial situation.\7 In a review of cases involving adjusted
withholding agreements, we estimated that 42 percent of recipients
were repaying less than the 10 percent limit each month.  The
difference in potential additional collections between those repaying
at the full 10-percent level and those paying less was nearly $1
billion in one 12-month period.  Although raising the current maximum
withholding limit will likely increase SSI collections capacity, our
findings suggest that the potential exists to recover more SSI
overpayments even within the current 10-percent limit.  This will
require SSA to make more effective determinations as to who can
afford to repay at a higher level and who cannot.

Finally, SSA is not adequately using overpayment penalties as a means
of ensuring that recipients comply with reporting policies.
Overpayment penalties range from $25 to $100.  However, SSA's own
reviews have found that overpayment penalties are rarely used by
staff, even for individuals who have a history of failure to make
timely reports of earnings or living arrangement changes.  Our
analysis of data from all 10 of SSA's regions also confirmed that SSI
overpayment penalties are rarely applied.  In one 12-month period,
SSA detected about 2.3 million overpayment instances totalling $1.2
billion in erroneous payments.  However, less than $80,000 in
penalties were actually assessed and only $8,000 was collected.
These infrequent penalty assessments provide little incentive for
recipients to change their reporting habits.

--------------------
\6 Welfare Benefits:  Potential to Recover Hundreds of Millions More
in Overpayments (GAO/HEHS-95-111, June 20, 1995).

\7 SSA Overpayment Recovery (GAO/HEHS-96-104R, Apr.  30, 1996).

   SSI PROGRAM REMAINS VULNERABLE
   TO FRAUD AND ABUSE
---------------------------------------------------------- Chapter 0:4

In prior work, we identified several SSI program areas subject to
fraud and abuse.  For example, in 1995 we reported that "middlemen"
were facilitating fraudulent SSI claims by providing translation
services to non-English-speaking individuals applying for SSI.\8

These individuals often coached claimants on appearing to be mentally
disabled, used dishonest health care providers to submit false
medical evidence to SSA, and provided false information on claimants'
medical and family history.  The following year, we reported that
between 1990 and 1994, approximately 3,500 recipients admitted
transferring ownership of resources such as cars, cash, houses, land,
and other items valued at an estimated $74 million to qualify for SSI
benefits.\9 This figure represents only resource transfers recipients
actually reported to SSA.  Although these transfers are legal under
current law, using them to qualify for benefits has become an abusive
practice that raises serious questions about SSA's ability to protect
taxpayer dollars from waste and abuse.  We estimated that for the
cases above, eliminating asset transfers would have saved $14.6
million in program expenditures.  The Congressional Budget Office
(CBO) has estimated that more than $20 million in additional savings
could be realized through 2002 by implementing an asset transfer
restriction.

Although SSI represents less than 8 percent of SSA's total
expenditures, the number of fraud referrals received by OIG is
significant.  For example, between November 1996 and July 1997, SSA's
fraud Hot-Line received 12,680 allegations of fraud.  When compared
with SSA's other programs, SSI fraud referrals represented about 37
percent of all allegations.  Since becoming an independent agency in
1995, SSA has begun to take more decisive action to address SSI
program fraud and abuse.  For example, the number of OIG
investigators has nearly tripled from 76 to 227 headquarters and
field agents, and in 1997, combatting program fraud and abuse became
a key agency goal.  Last year, SSA also established National and
Regional Anti-Fraud Committees to better identify, track, and
investigate patterns of fraudulent activity.  In addition, several
OIG "pilot" investigations are under way that are aimed at detecting
fraud and abuse earlier in the SSI application process.  According to
SSA, this new emphasis on early prevention represents a major shift
away from how it has traditionally dealt with SSI fraud and abuse.
Finally, SSA recently established procedures to levy civil and
monetary penalties against recipients and others who make false
statements to obtain SSI benefits.

It is too early to tell what immediate and long-term effects SSA's
activities will have on detecting and preventing SSI fraud and abuse.
However, many years of inadequate attention to program integrity
issues have fostered a strong skepticism among both headquarters and
field staff that fraud detection and prevention is an agency
priority.  In fact, SSA's own studies show that many staff believe
OIG does not adequately review fraud referrals or provide feedback on
the status of investigations.  Others noted that constant agency
pressure to process more claims impeded the thorough verification of
recipient-reported information and the development of fraud
referrals.  Staff were also concerned that SSA has not developed
office work credit measures, rewards, and other incentives to
encourage them to devote more time to developing fraud cases--a
process that often takes many hours.  Our review of SSA's work credit
system confirmed that adequate measures of the activities and time
necessary to develop fraud referrals have not been developed.  Nor
has SSA developed a means of recording and rewarding staff for time
they spend on developing fraud cases.  As a result, many staff may be
unwilling to devote the necessary time.  It thus appears that SSA's
new anti-fraud activities and its current work credit system may be
working against each other.

--------------------
\8 Supplemental Security Income:  Disability Program Vulnerable to
Applicant Fraud When Middlemen Are Used (GAO/HEHS-95-116, Aug.  31,
1995).

\9 Supplemental Security Income:  Some Recipients Transfer Valuable
Resources to Qualify for Benefits (GAO/HEHS-96-79, Apr.  30, 1996).

   CONCLUSIONS
---------------------------------------------------------- Chapter 0:5

As overpayment debt has grown, the amounts deemed "uncollectible" and
written off each year by SSA have also increased.  Since 1989, SSI
write-offs have totalled $1.8 billion, including $562 million in 1997
alone.  When these write-offs are combined with the SSI debt
currently owed the agency, the actual amount of SSI overpayments
exceeds $4.4 billion.  This is a significant amount of taxpayer money
that will likely never be recovered.  In light of the magnitude of
SSI overpayments and outstanding debt, it is important that actions
be taken to address the long-standing problems we have discussed
today.

To a great extent, SSI program problems are attributable to an
ingrained organizational culture that has historically placed a
greater value on quickly processing and paying SSI claims than on
controlling program expenditures.  More recently, SSA has
acknowledged the need to strike a better balance between serving the
public and protecting the financial integrity of its programs.  As
noted throughout this testimony, SSA is also taking steps to address
some of the weaknesses in the SSI program.  However, reversing how
the SSI program has traditionally operated will depend heavily on
SSA's willingness to move beyond recognizing that a rebalancing of
program priorities is long overdue.  SSA management must enhance and
demonstrate its commitment to controlling program payments by seeking
out the most timely and complete automated sources for verifying
recipient eligibility information.  SSA should also aggressively
pursue SSI overpayments once they occur by using the collection tools
currently available to it and working with the Congress to obtain
legislative authority for those it does not have.  SSA should also
sustain and expand fraud-prevention initiatives that have been shown
to be effective.  Finally, SSA needs to use its office work credit
and measurement system to hold staff and managers accountable for
protecting program funds and should find better ways to reward those
who do so.

In its new annual performance plan, SSA has made a commitment to
complete a comprehensive action plan to improve the management of the
SSI program in fiscal year 1998.  This step links to SSA's strategic
goal of making its "programs the best in the business with zero
tolerance for fraud and abuse." However, such a plan has not yet been
completed, and it is still unclear whether SSA will adequately focus
on its most significant SSI program challenges.  To be effective, the
plan should include a carefully designed set of initiatives aimed at
addressing the long-standing problems affecting SSI program
performance as well as specific measures to evaluate progress and
hold the agency accountable.  If successful, SSA's actions should
serve to reduce SSI overpayments, facilitate an underlying change in
the agency's organizational culture, and ultimately improve the
financial health and public image of the SSI program.  If decisive
action is not taken, however, the SSI program will remain open to
those who believe they can manipulate the program without penalty.

-------------------------------------------------------- Chapter 0:5.1

This concludes my prepared statement.  I will be happy to respond to
any questions you or other Members of the Subcommittee may have.

RELATED GAO PRODUCTS

Supplemental Security Income:  Opportunities Exist for Improving
Payment Accuracy (GAO/HEHS-98-75, Mar.  27, 1998).

SSA's Management Challenges:  Strong Leadership Needed to Turn Plans
Into Timely, Meaningful Action (GAO/T-HEHS-98-113, Mar.  12, 1998).

Supplemental Security Income:  Timely Data Could Prevent Millions in
Overpayments to Nursing Home Residents (GAO/HEHS-97-62, June 3,
1997).

High-Risk Program:  Information on Selected High-Risk Areas
(GAO/HR-97-30, May 16, 1997).

Supplemental Security Income:  Long-standing Problems Put Program at
Risk for Fraud, Waste, and Abuse (GAO/T-HEHS-97-88, Mar.  4, 1997).

High-Risk Series:  An Overview (GAO/HR-97-1, Feb.  1997).

High-Risk Series:  Quick Reference Guide (GAO/HR-97-2, Feb.  1997).

Supplemental Security Income:  SSA Efforts Fall Short in Correcting
Erroneous Payments to Prisoners (GAO/HEHS-96-152, Aug.  30, 1996).

Supplemental Security Income:  Administrative and Program Savings
Possible by Directly Accessing State Data (GAO/HEHS-96-163, Aug.  29,
1996).

Supplemental Security Income:  Some Recipients Transfer Valuable
Resources to Qualify for Benefits (GAO/HEHS-96-79, Apr.  30, 1996).

Supplemental Security Income:  Disability Program Vulnerable to
Applicant Fraud When Middlemen Are Used (GAO/HEHS-95-116, Aug.  31,
1995).
*** End of document ***