Supporting Statement--0633

Supporting Statement for SSA-637 and SSA-639

Site Review Questionnaire for Volume and Fee-for-Service Payees,

and Beneficiary Interview Form

20 CFR 404.2035, 404.2065, 416.665, 416.701, 416.708

OMB No. 0960-0633

1. Justification

1. Section 205(j)(1)(A) and Section 1631(a)(2) of the Social Security Act (the Act) provide for the payment of Social Security and Supplemental Security Income (SSI) benefits to a relative, another person, or an organization when the best interest of the beneficiary will be served. 20 CFR 404.2065 and 416.665 of the Code of Federal Regulations provide for representative payees to keep records on the use of benefit payments and to submit a written report accounting for these benefits. These regulations also specify that SSA may verify, in certain situations, how a representative payee used the funds. 20 CFR 404.2035, 416.701 and 416.708 discuss the responsibilities of representative payees. In March 2004, Congress passed Public Law (P.L.) 108-203. Section 102(b) of P.L. 108-203 amended sections 205(j)(6)(A) and 1631(a)(2)(G)(i) of the Act to require SSA to conduct periodic onsite (site) reviews of representative payees who meet the criteria described in sections 205(j)(6)(A)(i), 205(j)(6)(A)(ii), 205(j)(6)(A)(iii), 1631(a)(2)(G)(i)(I), 1631(a)(2)(G)(i)(II) , and 1631(a)(2)(G)(i)(III) of the Act.

2. In Fiscal Year 2000, the representative payment program came under close scrutiny from the news media and the Congress, largely due to several well-publicized instances of misuse of beneficiaries’ funds by organizational payees. The Senate Special Committee on Aging and the House Ways and Means Committee held hearings on the representative payment program, including initiatives by the Social Security Administration (SSA) designed to improve the representative payee monitoring process. Because of continued Congressional interest and SSA’s commitment to protecting beneficiaries from loss of benefits, SSA initiated triennial site reviews for fee-for-service payees and certain volume payees (i.e., organizations serving 100 or more beneficiaries and individuals serving 20 or more beneficiaries). Due to passage of P.L. 108-203 in March 2004, SSA initiated triennial site reviews for organizations serving 50 or more beneficiaries and individuals serving 15 or more beneficiaries. The reviews include a face-to-face meeting with the payee (and appropriate staff), examination/verification of a sample of beneficiary records and supporting documentation, and usually include beneficiary (if competent adult) or custodian (if different from payee) interviews.

The information on the questionnaires is obtained from the payee during the opening meeting where the payee provides an overview of how the organization operates and carries out its representative payee responsibilities, and at the time the financial records are reviewed. If necessary, the review team asks the questions directly to gather the required information. The information gathered through the site reviews ensures payees are carrying out their responsibilities in accordance with representative payment policies and procedures, and enables SSA to identify poor payee performance, uncover misuse and initiate corrective action. SSA is required to report the number of the reviews and the results to Congress. Respondents are representative payees serving multiple Title II and/or Title XVI beneficiaries.

3. Improved information technology which would reduce the burden is not available. Since these forms are for use by SSA employees for an activity intended to deter and detect representative payee fraud, the Agency has no plans to make these forms available to the public on the internet, as it may cause misuse of the forms.

4. Some of the information collection (e.g, questions on direct deposit of benefits) may be duplicative of information contained in SSA's Representative Payee System (RPS). However, we need to collect current information, whereas the RPS system may not have the most recent information.

5. The collection of information could impact small businesses serving as representative payees. However, there is no significant economic impact on a substantial number of small businesses or other small entities. Also, the review team, not the payee, completes the Site Review Questionnaire for Volume and Fee-for-Service Payees and the Beneficiary Interview Form, based on interviews and observations of the representative payees and beneficiaries.

6. There are no technical or legal obstacles that prevent burden reduction. However, there is continued congressional interest in the site review program. SSA must now provide Senator Charles Grassley with both quarterly status reports and an annual report on our progress in increasing the oversight of organizational payees and improving the monitoring process, including the number of site reviews conducted, relevant findings and corrective actions. We cannot discontinue our collection of the information, or collect it less frequently, due to Congressional interest and SSA’s responsibility to protect vulnerable beneficiaries.

7. There are no special circumstances that would cause this information collection to be conducted in a manner inconsistent with 5 CFR 1320.5.

8. The first Federal Register Notice was published on January 17, 2007 at 72 FR 2081 and SSA has received no public comments. The second Notice was published on March 23, 2007 at 72 FR 13851, and there have been no outside consultations with members of the public.

The burden hours listed in the First Federal Register Notice is one hour lower than the number of burden hours listed in the Second Federal Register Notice and below in #12 due to a difference in rounding between SSA’s calculations and the calculations made by the ROCIS system. The Second Federal Register Notice reflects that change.

The burden chart in #12 below, as well as the burden chart in ROCIS, has been changed to include new management information which we received after the publication of the Second Federal Register Notice. This new information has updated our burden estimates.

9. SSA provides no payment or gifts to the respondents.

10. The information provided on these forms is protected and held confidential in accordance with 42 U.S.C. 1306, 20 CFR 401 and 402, 5 U.S.C. 552 (Freedom of Information Act), 5 U.S.C. 552a (Privacy Act of 1974) and OMB Circular No. A-130.

11. The information collection does not contain any questions of a sensitive nature.

11. We estimate that we will use the Site Review Questionnaire for Volume and Fee for Service Payees for an estimated 1,747 representative payees annually. This number equals approximately one-third of the payees who are subject to site reviews under sections 205(j)(6)(A) and 1631(a)(2)(G)(i) of the Act plus a subset of other organizational and individual payees who we will review at random. The average burden time to gather the information for the questionnaire is estimated to be 2 hours.

After reviewing the beneficiaries’ records, the review team contacts and interviews a sample of beneficiaries (or their custodians) to ensure the payee is meeting their basic needs for food, housing, clothing, etc. The interview allows SSA to determine if the beneficiary has any unmet needs, is experiencing any problems with the payee, and to confirm receipt of any large or unusual purchases. We estimate 5 beneficiaries are interviewed during each site review and 3 beneficiaries interviewed for each random review for a total of 7741 beneficiaries annually. The average burden time to gather the information on the interview form is estimated to be 10 minutes. The following chart gives a breakout of the burden for each form.

Form Number	No. of Respondents	Frequency	Time per Response	Total Hours
SSA-637	1747	1	2 hours	3494
SSA-639	7741	1	10 minutes	1290
Totals	9488			4784

The total burden is reflected as burden hours, and no separate cost burden has been calculated.

13. There is no known cost burden to the respondents.

13. The estimated annual cost to the Agency to produce the questionnaires and beneficiary interview form is approximately $109,016.60. This estimate is a projection of the costs for printing and distributing the collection instrument and for collecting the information.

13. The number of payees who meet the criteria for site reviews under P.L. 108-203 has increased each year. In addition, we are eliminating form SSA-638 which was used as the interview guide for those payees who qualified as fee for service payees. The revised SSA-637 will now be used to interview these payees instead (see addendum). In addition, SSA also reviews a number of payees randomly. The number of payees chosen for random review is derived from a formula tied to the number of payees subject to site reviews. Previously, the burden hours for random reviews were reported in the burden hours for form SSA-624 (0960-0069). To simplify procedures for our field offices and ensure that payees are interviewed thoroughly, we are replacing the SSA-624 with the SSA-637. The SSA-624 has other uses so while the form is being eliminated for random reviews, it will not become obsolete. The SSA-624 was also used to document the beneficiary interviews conducted with random reviews. Due to the expansion of the SSA-637 in order to incorporate those questions previously asked on the SSA-638 and SSA-624, we have adjusted the time per response to two hours to accommodate the increase in questions which the respondents will answer. The SSA-639 will now be used to conduct the beneficiary interview portion of the random review (see addendum). The burden hours for the SSA-624 will be adjusted accordingly after approval of these changes.

13. The results of the information collection will not be published.

13. OMB has granted SSA an exemption from the requirement that the expiration date for OMB approval be printed on its program forms. SSA produces millions of public-use forms, many of which have a life cycle longer than that of an OMB approval. SSA does not periodically revise and reprint its public-use forms (e.g., on an annual basis). This exemption was granted so that otherwise useable editions of forms would not be taken out of circulation because the expiration date had been reached. In addition, government waste has been avoided because stocks of forms will not have to be destroyed and reprinted.

13. SSA is not requesting an exception to the certification requirements at 5 CFR 1320.9 and related provisions at 5 CFR 1320.8(b)(3). Please note, however, that statistical survey methodology is not used for this information collection.

2. Collections of Information Employing Statistical Methods

Statistical methods are not used for this information collection.

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