TN 31 (08-09)
GN 00605.500 Representative Payee Onsite Review Program
A. Introduction to the representative payee onsite review program
A plan for the development of the onsite review program to periodically evaluate the fiduciary performance of State mental institutions serving as representative payees for SSA beneficiaries was approved by the Commissioner of the Social Security Administration (SSA) in January 1969.
The Social Security Disability Benefits Reform Act of 1984 requires that SSA review each State mental institution serving as representative payee for title II or title XVI beneficiaries at least once every 3 years. If there are indications of unsatisfactory performance, more frequent reviews are necessary. For the purpose of calculating the frequency of these reviews, the review interval ends on December 31st of the third year, depending on the type of payee, following the last site review. For example, if SSA conducts a site review of a State mental institution payee in July 2012, SSA must conduct the next site review before the end of December 2015.
The term “beneficiary” is used generically in this subchapter to refer to both title II beneficiaries and title XVI recipients. Title II or title XVI (Supplemental Security Income (SSI)) is specified when an instruction applies to only one type of benefit.
B. Policy for the onsite review program
The objectives of the onsite review program are to:
Establish and maintain cooperative relationships between SSA and the State mental health systems to improve understanding and resolve problems related to the institutions’ role as representative payee;
Ensure that the State institution’s performance as payee conforms with SSA policies and procedures in areas such as the use of benefits and prompt reporting of significant events; and
Ensure that any problems identified in current and prior reviews have been corrected.
C. Policy for the review period
The term “review period” usually refers to the 1-year period just prior to the scheduled review. In some States, however, it refers to a somewhat earlier time frame which that is required because of State bookkeeping practices.
The onsite review program evaluates the representative payee performance of the State institutions not only for beneficiaries who are physically residing in the institutions, but also for beneficiaries who are residing outside of an institution but whose benefits are still being handled by the institution.
D. Regional office (RO) responsibilities
Determine whether a qualified State organization should be added to or deleted from the onsite review program;
Maintain a current listing of State institutional facilities by making systematic inputs to the Representative Payee System (RPS) to add or delete the onsite indicator;
Prepare a schedule for the triennial review of the State mental institutions located in the region;
NOTE: While ROs have overall responsibility for completing the triennial onsite reviews, ROs may delegate responsibility for conducting the reviews to local field office (FO) staff or to regional cadres.
Prepare letters to the State and institution notifying them of upcoming review;
Determine staff needed to manage and complete the reviews;
Approve travel arrangements;
Train reviewers and monitor review activities in the field;
Prepare draft and final reports;
Issue reports to States;
Present and discuss report findings with State/institution officials; and
Follow up on SSA’s recommendations to verify that the institution has taken all necessary corrective actions.
E. Central office responsibilities
Develop and issue program policies, objectives, and national standards; and
Monitor and evaluate regional onsite review activities.
F. Reporting jurisdictions
Most State mental institutions report to a single State office, such as the State Commissioner for Mental Health. Some States require that different types of State mental facilities (e.g., psychiatric hospitals and schools/developmental centers) report to different State offices. In those States, separate reports must be issued.
Individual institutions are designated as the representative payee in most States. In some States, there is a central collection site which handles this responsibility. The central collection site disburses the beneficiary funds to the individual State mental institutions.
G. Separate reporting jurisdictions within State
The following States have separate reporting jurisdictions for hospitals and developmental centers; therefore, more than one onsite report is prepared:
H. State payee designations
1. Central collection States
There are two States that collect all benefits at a central point and disburse personal funds for the beneficiaries to the institutions. These States are:
2. State is payee
There are three additional States where the State rather than the institution is designated as the payee. However, in these States, the checks are addressed to the institutions. They are: