Improving the Social Security Representative Payee Program Serving Beneficiaries and Minimizing Misuse (2007) / Chapter Skim
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6 Program Policies and Practices
6 Program Policies and Practices
Pages 81-115
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From page 81... ...
A SySTEMS PERSPECTIvE The Representative Payee Program involves a complex interactive system of people, policies, and procedures. As such, the performance of the program is best viewed as the outcome of many interactions among Social Security Administration (SSA)
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From page 82... ...
The Representative Payee Program is dynamic, and it is influenced by a complicated environment of policies and interactions between the beneficiaries and their representative payees. The amount of the Social Security benefit and the circumstances of the beneficiaries (e.g., health status, living situation, availability of additional beneficiary income or resources)
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From page 83... ...
PROGRAM POLICIES AND PRACTICES FACTORS: THE PAYEE PROCESS Federal Law and Determine Need for a Payee Regulations ↓ SSA Policies POMS Select a Payee RPS ↓ Train and Field Offices Support the SSA Staff Payee Beneficiary and Payee ↓ Characteristics Monitor the Payee Environment State Policies Organizations ↓ State Courts Conclude Payee Tenure FIGURE 6-1 Systemic View of the SSA Representative Payee Process.
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From page 84... ...
In this section we discuss the effectiveness of this flexible system of protocols to evaluate the need for a representative payee, particularly the extent to which payees are appointed for beneficiaries who are able to manage their own payments and the types of conditions that lead SSA to determine there is a need for a payee. Accuracy of Need Determinations In the committee's field office site visits, some staff said that some beneficiaries with payees do not need them.
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From page 85... ...
of payees would like to talk to SSA about their beneficiaries' managing their own funds. Although the prevalence of what may be erroneous payee assignment is relatively low, there was broad interest among field office staff in establishing a more effective relationship between the Disability Determination Service offices and the SSA field offices.
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From page 86... ...
SELECTION Recruitment Selecting appropriate payees is a critical factor in meeting beneficiaries' needs to manage their SSA payments. The committee's site visits to SSA field offices indicated that current definitions and policies in the POMS adequately describe desirable characteristics of a payee.
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From page 87... ...
PROGRAM POLICIES AND PRACTICES BOX 6-1 Criteria for Identifying Payee Candidates as Reported by SSA Field Staff Is financially capable Understands that the primary job is to see that the money is spent for the beneficiary's needs Can manage his or her money Has enough financial savvy to know how to keep beneficiary funds separate from own funds Knows how to manage money Has a close relationship with beneficiary Has frequent contact with the beneficiary Is most likely a family member (e.g., parent, spouse, other) Shows concern for the beneficiary Possesses an in-depth knowledge of the beneficiary Knows the beneficiary -- at least first and last name, perhaps also date of birth Lives with the beneficiary Lives very close to the beneficiary Can check in on the beneficiary once a day Knows what is going on with the beneficiary Has no or very few risk factors for potential to misuse funds Should not be a felon -- but if it happened twenty years ago, it is probably okay now Is gainfully employed or has his or her own sources of income Has no criminal record Is not a fugitive felon Is not owed money by the beneficiary Has a stable employment record Has a high school or equivalency diploma Has had no encounter with law enforcement Has no record of alcohol or drug abuse The meeting between an SSA staff person and a payee candidate affords an important opportunity for the staff person to interact with the payee candidate and observe physical and nonverbal cues (e.g., nervousness, cognitive ability, coherence, physical condition, potential drug or alcohol use, sincerity)
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From page 88... ...
. To handle the more difficult cases of finding appropriate payees, SSA field offices are required by the Social Security Act (Section 205(j)
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From page 89... ...
The lack of resources for ensuring the development and maintenance of payee volunteer pools severely hampers the program in some offices. RECOMMENDATION 6.1 To help mitigate shortages of payees, the Social Security Administration should create a program to identify, train, certify, and maintain a pool of voluntary, temporary payees that are available on an as-needed basis.
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From page 90... ...
For such situations, the staff suggested the development of a pool of trained, willing payees that could be tapped as needed for emergency or other temporary situations. Some field office staff said that they believe that at-risk beneficiaries are better served by fee-for-service payees who are professionals and may be better acquainted with the payee system and rules.
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From page 91... ...
The process of determining suitability involves • completion of an application by the candidate; • verification of candidate's identity; • assessment of the candidate's exclusion factors (see below) ; and • in most but not all cases, a personal interview with an SSA field office staff person.
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From page 92... ...
The POMS also identifies individuals that generally should be avoided as payees, yet are ultimately eligible to serve as representative payees: • convicted felons other than those convicted of violations of felonies involving fraudulent action in relation to a benefits applications and misuse of Social Security numbers under the Social Security Act (defined in the Act) ; • applicants found guilty of fraud related to the Representative Payee Program; • applicants with a prior history of misuse; • people who have been imprisoned for more than 1 year; and • creditors of the beneficiary.
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From page 93... ...
The estimated 5-year bankruptcy rate for active payees, 6.4 percent (0.8) , appears to be higher than the national rate.2 The rate of changing residences for the representative payees is similar to the rate in the general U.S.
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From page 94... ...
RECOMMENDATION 6.3 The Social Security Administration should screen potential payees (including organizational payees) for suitability on the basis of specified factors associated with misuse, particularly credit history and criminal background.
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From page 95... ...
Individual payees who are administrators of care organizations or who serve several beneficiaries in some other organized capacity should be treated differently from payees who truly serve beneficiaries as individuals. Such groups are in need of monitoring similar to that provided to organizational payees, and SSA should consider a new category that properly classifies organized care providers.
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From page 96... ...
. The issue is whether the exception to the Privacy Act, which permits disclosure of records maintained by an agency "pursuant to the order of a court of competent jurisdiction," applies to orders of state courts seeking access to records about individuals appearing before such courts in guardianship proceedings and who have served or are serving as representative payees.
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From page 97... ...
To qualify as a fee-for-service payee, an organization must • be a state or local government agency, or • be a community-based, nonprofit social service agency, that is bonded and licensed by each state in which it serves as a represen tative payee (if available) , and • regularly provide payee services to at least five beneficiaries and demonstrate that it is not a creditor of the beneficiary.
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From page 98... ...
This causes potential conflicts, violations of Social Security Administration rules, inefficiencies and inaccuracy in reporting, delays in payee selection, and duplication of effort. CONCLuSION There is a lack of communication between the Social Security Administration and state courts with regard to beneficiaries who might have both a guardian and a representative payee.
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From page 99... ...
RECOMMENDATION 6.8 The Social Security Administration, in consultation with the states, should eliminate inconsistencies between state and federal practices regarding the calculation of payee fees and financial oversight. The committee suggests that SSA consider several changes in policies regarding payees who are in dual roles: 1.
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From page 100... ...
RECOMMENDATION 6.9 The Social Security Administration should provide comprehensive and formal training for representative payees.
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From page 101... ...
online guidance for payees to complete the annual accounting form. MONITORING AND ACCOuNTABILITy If the Representative Payee Program is to be effective, performance of payees needs to be monitored, and problems should be addressed expeditiously.
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From page 102... ...
. Although failure to submit the form can be an indicator of improper use or misuse, SSA told the committee that resources are inadequate for fully pursuing and investigating payees who fail to submit annual accounting forms (Appendix B)
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From page 103... ...
Another issue associated with the annual accounting form is perceived paperwork burden on payees. Some field office staff expressed concern about the burden placed on payees.
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From page 104... ...
) that requires the Commis sioner of the Social Security Administration to establish and implement statistically valid procedures for reviewing the annual accounting forms creates a concomitant obligation to provide information for under standing and monitoring the performance of representative payees.
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From page 105... ...
Review of Ad Hoc Complaints A second monitoring strategy in the program is the review of ad hoc complaints of potential misuse by field office staff. Typically, misuse complaints are lodged against a payee by the beneficiary or nonpayee relatives or friends of the beneficiary.
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From page 106... ...
RECOMMENDATION 6.1 The Social Security Administration should establish mandatory protocols for payee replacement when misuse is suspected.7 When misuse or suspected misuse is the reason for a change of payee, staff should provide full documentation. The use of phrases such as "more suitable payee found" should not be allowed as formal documentation.
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From page 107... ...
The RPS is thus a critical part of the system to administer the payee program, and it is heavily used by SSA offices to document payee relationships and evaluate potential payees for service. However, our attempts to use the RPS as a research tool and information from field office staff during our site visits indicate that the system could be greatly improved to more effectively facilitate SSA's mission, both for monitoring individual payees and for agency-level studies of the program.
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From page 108... ...
Ideally, the RPS should also be updated with information on the annual accounting forms to establish which payees submit annual accounting forms and which do not. This is a critical
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From page 109... ...
easy access and use by all field office staff; 8. streamlined linkage to annual accounting form data; and 9.
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From page 110... ...
RECOMMENDATION 6.16 The Social Security Administration should implement a process that regularly updates information in the Representative Payee System, both by field office staff and through the annual accounting form. The Social Security Administration should also implement a quality control program that periodically checks the integrity of the information in the Representative Payee System.
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From page 111... ...
RECOMMENDATION 6.17 The Social Security Administration should revise the current regulations that require a final accounting whenever a payee is terminated to ensure, so far as practicable, that all funds are accounted for.
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From page 112... ...
to show what has been filed with the state court or the court's acceptance of the filing. There is currently no "deemed status" between SSA and state courts that would lead SSA to accept the reports filed with a court in lieu of the SSA annual accounting form.
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From page 113... ...
CONCLuSION State court guardianship and conservatorship programs operate totally independently from the Social Security Administration Representative Payee Program even though the program requires any beneficiary who has a guardian or conservator to also have a payee appointed by the Social Security Administration. There is no coordina tion between the Social Security Administration and state courts for the training of guardians, conservators, and payees or regarding filing annual reports.
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From page 114... ...
An aggregation of all state laws, regulations, policies, and practices that may affect the use of beneficiaries' funds would enable the development and sharing of best practices between the states and SSA. RECOMMENDATION 6.19 The Social Security Administration should begin an outreach program with state agencies to compile the
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From page 115... ...
We also note, however, that local management plays a vital role in how the program operates, and we observed significant differences in how local offices were managed. The variations were significant: different practices, different attention to the rules, different interpretation of policies, and most importantly, different allocation of resources to the payee program.
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