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BETTER MANAGEMENT INFORMATION
Over $900 million paid to poor families
The quality control system was estab-
Fiscal sanctions create an adversary rela-
Because a high error rate will result in
Tear Sheet. Upon removal, the report
cover date should be noted hereon.
Several weaknesses in the system reduce its value to program managers for improving administration of the AFDC program. The overall effect of weaknesses is to limit the value of information that the system produces on errors and causes of errors. The following weaknesses were noted:
--Both State and Federal quality control reviews differ from State to State and Federal region to region. Some case reviews include extensive verification of eligibility and grant amount factors, while others rely heavily on statements by recipients. The Department of Health, and Human Servcies (HHS) 1/ has recognized the differences between quality control reviews, but has not determined how this affects the identification of incor
rect payments. (See ch. 3.) HHS regional offices do not follow consistent procedures in assessing State quality control operations, and HHS has no assessment system for its regional offices' quality control functions.
--The quality control system does not provide for reporting incorrect payments of less than $5 or those caused by changes in circumstances that occur during the payment review month or the month before it (administrative period). The system also provides for reporting only one error cause per case even if there are several. Program management is thereby denied information that could be useful for devising corrective actions for procedural or other problems causing such errors. (See p. 26.)
1/On May 4, 1980, a separate Department of Education was created. The part of the Department of Health, Education, and Welfare responsible for the activities discussed in this report became the Department of Health and Human Services.
--The data resulting from the quality control review can be valuable for error reduction purposes if it is carefully analyzed. Quality control data were not being adequately analyzed at either the State or Federal level. (See ch. 5.)
RECOMMENDATION TO THE
The House and Senate Appropriations Com-
RECOMMENDATIONS TO THE
SECRETARY OF HHS
The Secretary should:
--Assess regional quality control procedures to insure adequacy and consistency and establish guidelines for reviews of State quality control cases by HHS regional offices, including criteria for making home visits to recipients and third-party verifications.
--Increase regional monitoring and periodic assessments of State quality control operations as well as HHS monitoring of its regional quality control operations.
--Change the Federal regulations to require
--Encourage the States to perform more detailed analyses of quality control data to identify the causes of errors and provide management with better information for developing corrective actions.
-Require the Commissioner of the Social Security Administration to perform more analysis and special studies of quality control data to identify appropriate corrective actions for assisting States in their error reduction efforts.
AGENCY COMMENTS AND GAO EVALUATION
Regarding GAO's recommendation to retract the sanctions directive, HHS did not favor full retraction, while five of the six States GAO visited were in favor of such action. GAO still believes sanctions are not appropriate.
Regarding GAO's recommendations to the
GAO is not proposing that such errors be necessarily corrected, only that they be reported for management analyses and evaluation purposes. GAO also recognizes that error rates may go up if such incorrect payments are reported, but believes that not tying error rates to sanctions will allay the States' concerns in this respect.
More detailed discussions of State