Welfare Programs

Three of the federal government's main welfare programs--Aid to Families With Dependent Children, Medicaid, and Food Stamps--provided more than $92 billion in benefits in 1990. These programs rely heavily on state-run computer systems to determine participants' eligibility and the amount of assistance they should receive. The federal government estimates that during the 1980s, it gave states close to $1 billion to develop and run these systems. Yet monitoring of states' automation efforts by the Department of Health and Human Services (HHS) and the U.S. Department of Agriculture (USDA) have fallen short, allowing millions of dollars to be spent on systems that either do not work or do not meet requirements. In addition, poor coordination between HHS and USDA has sometimes resulted in contradictory directions to states. Despite explicit federal guidance, HHS and USDA have also failed to determine whether installed automated systems are working as intended and are yielding improvements. At this point, the federal government has no idea whether administrative costs and mistakes have been reduced because HHS and USDA have not measured automation's impact on welfare programs.

GAO found that: (1) Congress authorized HHS and USDA to pay most of states' costs to acquire and operate automated eligibility determination systems to help them reduce errors and process applications faster; (2) the federal government has provided more than $950 million to states to develop and operate these systems; (3) although numerous federal laws and regulations require HHS and USDA to monitor states' development of automated eligibility systems, neither agency has effectively monitored the states' systems; (4) the agencies have conducted only limited reviews of states' initial or updated system plans, have rarely conducted on-site reviews, and have not assessed key system development documents; (5) inadequate monitoring has allowed several states to develop costly integrated systems that did not work or did not meet the requirements; (6) although both HHS and USDA recognize that their monitoring needs improvement, the agencies cite their belief that they should not have a dominant oversight role and insufficient staffing as barriers to better monitoring; (7) HHS and USDA do not consider the assessment of states' operational systems a high priority, even though the agencies do not know whether state systems are providing the projected benefits; and (8) neither agency knew whether states' upgrades of automated systems produced the expected results.

Recommendations

Our recommendations from this work are listed below with a Contact for more information. Status will change from "In process" to "Open," "Closed - implemented," or "Closed - not implemented" based on our follow up work.

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