THE INSPECTOR GENERAL
SOCIAL SECURITY ADMINISTRATION
CLAIMED BY THE
NEW JERSEY DEPARTMENT
DIVISION OF DISABILITY
By conducting independent and objective audits, evaluations and investigations, we inspire public confidence in the integrity and security of SSA's programs and operations and protect them against fraud, waste and abuse. We provide timely, useful and reliable information and advice to Administration officials, Congress and the public.
The Inspector General Act created independent audit and investigative units, called the Office of Inspector General (OIG). The mission of the OIG, as spelled out in the Act, is to:
Conduct and supervise independent and objective audits and investigations
relating to agency programs and operations.
Promote economy, effectiveness, and efficiency within the agency.
Prevent and detect fraud, waste, and abuse in agency programs and operations.
Review and make recommendations regarding existing and proposed legislation and regulations relating to agency programs and operations.
Keep the agency head and the Congress fully and currently informed of problems in agency programs and operations.
To ensure objectivity, the IG Act empowers the IG with:
Independence to determine what reviews to perform.
Access to all information necessary for the reviews.
Authority to publish findings and recommendations based on the reviews.
We strive for continual improvement in SSA's programs, operations and management by proactively seeking new ways to prevent and deter fraud, waste and abuse. We commit to integrity and excellence by supporting an environment that provides a valuable public service while encouraging employee development and retention and fostering diversity and innovation.
Date: August 3, 2007
To: Beatrice M. Disman
Regional Commissioner New York
From: Inspector General
Subject: Administrative Costs Claimed by the New Jersey Department of Labor, Division of Disability Determination Services (A-02-06-16043)
For our audit of Fiscal Years (FY) 2003 and 2004 administrative costs claimed
by the New Jersey Department of Labor, Division of Disability Determination
Services (NJDDS), our objectives were to:
evaluate NJDDS' internal controls over the accounting and reporting of administrative costs;
determine whether costs claimed by NJDDS were allowable and funds were properly drawn; and
assess limited areas of the general security controls environment.
Disability determinations under the Social Security Administration's (SSA) Disability Insurance and Supplemental Security Income programs are performed by Disability Determination Services (DDS) in each State or other responsible jurisdiction, according to Federal regulations. Each DDS is responsible for determining claimants' disabilities and ensuring adequate evidence is available to support its determinations. To make proper disability determinations, each DDS is authorized to purchase consultative medical examinations and medical evidence of record from the claimants' physicians or other treating sources. SSA pays the DDS for 100 percent of allowable expenditures using a State Agency Report of Obligations for SSA Disability Programs (Form SSA-4513). For additional background information, see Appendix B.
RESULTS OF REVIEW
Our tests of the costs NJDDS claimed on Forms SSA-4513 provided reasonable assurances the DDS had accurately reported administrative costs, except for $6,353 in costs that required adjustments and $38,945 in costs that were not fully supported. Additionally, we concluded that controls over NJDDS' computer inventory and physical security could be improved. Lastly, we found NJDDS improperly transferred approximately $5.8 million by using 1 FY's funds to pay another FY's expenditures.
RECONCILIATION OF NJDDS' COSTS
We reconciled NJDDS' Personnel Service, Medical, Indirect, and All Other Nonpersonnel Costs to the final Form SSA-4513 for FYs 2003 and 2004. The total costs claimed for the 2 FYs totaled $86,061,767. Our review found $6,353 of Other Nonpersonnel Costs needed to be adjusted.
All Other Nonpersonnel Costs
We found $6,353 of Other Nonpersonnel Costs required adjustment.
Three individuals who were not NJDDS employees received a total of $3,342 for tuition refunds ($795 and $752 for FY 2003 and $1,076 and $719 for FY 2004).
Two mailgram expenses totaling $3,011 were recorded in FY 2004 but were incurred in FY 2005. The two transactions should be recorded as FY 2005 expenses.
During our close-out meeting, the New Jersey Department of Labor (NJDoL) reported it had taken actions in response to our findings concerning tuition refunds incorrectly charged to NJDDS but paid to non-DDS employees and mailgram expenses incorrectly charged to FY 2004.
Medical Consultants Costs
We found NJDDS was missing timesheets for 16 of 50 part-time Medical Consultants.
We contacted the New Jersey Department of Labor (NJDoL) Personnel Office staff
about the missing timesheets, and they informed us they were unable to locate
the supporting documentation. They also informed us the 16 Medical Consultants
worked at the same location and should have signed the same timesheet. Therefore,
the 16 Medical Consultants represented 1 timesheet that should have been retained
for at least 6 years but was not. Without the timesheet to support the $38,945
in payroll costs for the 16 Medical Consultants for the period April 3 through
April 16, 2004, we were not able to fully ensure the reasonableness of these
We reconciled SSA records to NJDDS' inventory of computer equipment and found three desktop computers and eight computer monitors did not have the required SSA tags. According to SSA instructions, "The State is responsible for maintenance and inventory of all equipment acquired whether purchased through SSA or the State."
PHYSICAL SECURITY CONTROLS
We reviewed physical security controls at the three NJDDS regional office locations. We found controls over the identification of computer and utility rooms could be improved at all three locations. SSA guidance states sensitive rooms should not have signs visible to the public. We found that sensitive rooms were identified with signs at all three locations. Also, the three locations did not test their disaster recovery plans to ensure continuity of operations, as required. Finally, the three sites did not have completed security action plans, and the plans were not tested as required.
We also identified issues specific to individual regional offices.
At one location, we observed the entrances to the computer room were not locked at all times and were at-risk of unauthorized access to sensitive SSA information and systems. Also, the room did not have an uninterruptible power source and therefore was at-risk for loss of service if the power supply failed. Further, the room did not have its own sprinkler system zone and was vulnerable to water damage if there was a fire in another part of the building.
At another regional office, we were informed by an NJDDS official that medical records and folders were not secured overnight in locked cabinets or in locked rooms. We were also informed that the office was cleaned after hours. As a result, cleaning personnel had unrestricted access to documents that contained confidential medical information. According to POMS, SSA requires that all claimant records and files be maintained in a locked drawer, cabinet or room when there is no authorized individual on location.
Personnel from NJDDS' parent agency, NJDoL, stated they drew funds from 1 FY's Automated Standard Application for Payments (ASAP) account to pay for another FY's expenditures. The transfers, totaling $5,797,572, consisted of cash draws between FY 2002 through 2005 ASAP accounts. See Appendix D for the specific transfers.
The improper transfer of funds between ASAP accounts and the use of 1 FY's funds to pay another FY's expenditures violates Federal law, which states,
The balance of an appropriation or fund limited for obligation to a definite period is available only for payment of expenses properly incurred during the period of availability or to complete contracts properly made within that period of availability and obligated consistent with section 1501 of this title.
The ASAP system allows recipients of Federal funds to transfer cash between accounts. The feature had not been disabled in Region II at the time of our audit. SSA's Office of Finance staff informed us that each regional office decides whether to disable the ASAP system for each DDS. This ASAP feature allows the Regional Office Project Officer to monitor the draw down of funds between FYs.
PAYMENT OF MEDICAL COSTS
NJDDS reimbursed all medical costs by mailing individual checks to medical providers. For FYs 2003 and 2004, NJDDS made at least 300,000 medical payments by check. We considered the mailing of individual checks to medical providers not the most cost beneficial method of payment. We deemed payments made through electronic funds transfer rather than by check to be more cost beneficial. An alternative payment method is to use batch processing to save processing costs.
CONCLUSION AND RECOMMENDATIONS
To address the conditions noted in this report, we recommend SSA staff work with the NJDDS to:
1. Verify the adjustment of $3,342 of disallowed costs representing tuition refunds for employees who did not work for the NJDDS.
2. Verify the adjustment of $3,011 of Nonpersonnel Service Costs representing mailgram expenses incurred in FY 2005 but charged to FY 2004.
3. Ensure the retention policies for time and attendance records are followed.
4. Review the reasonableness of the Medical Consultant charges totaling $38,945 claimed on FY 2004 Form SSA-4513 representing payroll costs for 16 part-time Medical Consultants where supporting documentation was missing.
5. Properly account for all computer equipment.
6. Strengthen physical security for those areas noted in the report.
7. Consider coordinating with the New Jersey Department of the Treasury to use alternative payment methods to medical vendors to save processing costs.
We also recommend:
8. Responsible SSA Headquarters' components, the Regional Office's Center for Disability and NJDDS personnel work together to determine the appropriateness of the movement of ASAP funds between FYs.
SSA AND STATE AGENCY COMMENTS
SSA's New York Regional Commissioner and NJDoL agreed with all our recommendations. Please see Appendices E and F for the full text of SSA's and NJDoL's comments.
Patrick P. O'Carroll, Jr.
APPENDIX A - Acronyms
APPENDIX B - Background, Scope, and Methodology
APPENDIX C - Schedule of Total Costs Reported on Forms SSA-4513-State Agency Reports of Obligations for SSA Disability Programs
APPENDIX D - Transfer of Funds Between Fiscal Years
APPENDIX E - Agency Comments
APPENDIX F - State Agency Comments
APPENDIX G - OIG Contacts and Staff Acknowledgments
ASAP Automated Standard Application for Payments
C.F.R. Code of Federal Regulations
DDS Disability Determination Services
Form SSA-4513 State Agency Report of Obligations for SSA Disability Programs
FY Fiscal Year
NJDDS New Jersey Department of Labor, Division of Disability Determination Services
NJDoL New Jersey Department of Labor and Workforce Development
OIG Office of the Inspector General
POMS Program Operations Manual System
Pub. L. No. Public Law Number
SSA Social Security Administration
U.S.C. United States Code
Background, Scope, and Methodology
The Disability Insurance (DI) program, established under Title II of the Social Security Act, provides benefits to wage earners and their families in the event the wage earner becomes disabled. The Supplemental Security Income (SSI) program, established under Title XVI of the Act, provides benefits to financially needy individuals who are aged, blind, and/or disabled.
The Social Security Administration (SSA) is responsible for implementing policies for the development of disability claims under the Disability Insurance and Supplemental Security Income programs. Disability determinations under both programs are performed by disability determination services (DDS) in each State, Puerto Rico and the District of Columbia in accordance with Federal regulations. In carrying out its obligation, each DDS is responsible for determining claimants' disabilities and ensuring adequate evidence is available to support its determinations. To assist in making proper disability determinations, each DDS is authorized to purchase medical examinations, x-rays, and laboratory tests on a consultative basis to supplement evidence obtained from the claimants' physicians or other treating sources.
SSA reimburses the DDS for 100 percent of allowable expenditures up to its approved funding authorization. The DDS withdraws funds through the United States Department of the Treasury's Automated Standard Application for Payments system to pay for program expenditures. Funds drawn down must comply with Federal regulations and intergovernmental agreements entered into by the United States Department of the Treasury and States under the Cash Management Improvement Act of 1990. An advance or reimbursement for costs under the program must comply with Office of Management and Budget Circular A-87, Cost Principles for State, Local, and Indian Tribal Governments. At the end of each quarter of the Fiscal Year (FY), each DDS submits a State Agency Report of Obligations for SSA Disability Programs (Form SSA-4513) to account for program disbursements and unliquidated obligations.
To accomplish our objectives, we reviewed the administrative costs New Jersey Department of Labor, Division of Disability Determination Services (NJDDS), reported on its Forms SSA-4513 for FYs 2003 and 2004. For the periods reviewed, we obtained evidence to evaluate recorded financial transactions and determine whether they were allowable under Office of Management and Budget Circular A-87, and as appropriate, as defined by SSA's Program Operations Manual System (POMS).
Reviewed applicable Federal laws, regulations and pertinent parts of POMS DI 39500, DDS Fiscal and Administrative Management, and other instructions pertaining to administrative costs incurred by NJDDS and draw down of SSA funds.
Interviewed staff at NJDDS and the SSA Regional Office.
Evaluated and tested internal controls regarding accounting and financial reporting and cash management activities.
Verified the reconciliation of official State accounting records to the administrative costs reported by NJDDS on Forms SSA-4513 for FYs 2003 and 2004.
Examined the administrative expenditures (personnel, medical service, and all other non-personnel costs) incurred and claimed by NJDDS for FYs 2003 and 2004 on Forms SSA-4513.
Examined the indirect costs claimed by NJDDS for FYs 2003 and 2004 and the corresponding Indirect Cost Rate Agreements.
Compared the amount of SSA funds drawn to support program operations to the allowable expenditures reported on Forms SSA-4513.
Reviewed the State of New Jersey Single Audit report issued in 2003.
Conducted limited general control testing-which encompassed reviewing the physical access security within the DDS.
Reviewed the transfer of funds between FYs 2002 to 2005 Automated Standard Application for Payments accounts.
Researched alternative methods of payment for medical costs.
The electronic data used in our audit were sufficiently reliable to achieve our audit objectives. We assessed the reliability of the electronic data by reconciling them with the costs claimed on the Forms SSA-4513. We also conducted detailed audit testing on selected data elements in the electronic data files.
We performed our audit at the NJDDS in Newark, New Brunswick and Trenton, New Jersey and the Office of Audit in New York, New York, from September 2005 through January 2007. We conducted our audit in accordance with generally accepted government auditing standards.
Our sampling methodology encompassed the four general areas of costs as reported on Forms SSA-4513: (1) Personnel, (2) Medical, (3) Indirect, and (4) All Other Non personnel costs. We obtained computerized data from NJDDS for FYs 2003 and 2004 for use in statistical sampling. Also, we reviewed general security controls the DDS had in place.
We sampled 50 employee salary items from 1 randomly selected pay period in
FY 2004. We tested regular and overtime payroll and hours for each employee selected. We verified that approved time records were maintained and supported the hours worked. We tested payroll records to ensure NJDDS correctly paid employees and adequately documented these payments.
We also sampled 50 Medical Consultant costs from 1 randomly selected pay period in FY 2004. We determined whether sampled costs were reimbursed properly and ensured the selected Medical Consultants were licensed.
We sampled 100 medical evidence of records and consultative examination records
(50 items from FYs 2003 and 2004) using a proportional random sample. We determined whether sampled costs were properly reimbursed.
We reviewed the indirect cost base and computations used to determine those costs for reimbursement purposes. Our objective was to ensure SSA reimbursed NJDDS in compliance with the approved Indirect Cost Rate Agreement. We analyzed the approved rate used, ensuring the indirect cost rate changed when the Indirect Cost Rate Agreement was modified. We reviewed the documentation and traced the base amounts to Forms SSA-4513 for the indirect cost computation components. We determined whether the approved rate used was a provisional, predetermined, fixed or final rate.
All Other Non-Personnel Costs
We stratified all other non-personnel costs into nine categories: (1) Occupancy,
(2) Contracted Costs, (3) Electronic Data Processing Maintenance, (4) Equipment
Purchases and Rental, (5) Communications, (6) Applicant Travel, (7) DDS Travel,
(8) Supplies, and (9) Miscellaneous. We selected a stratified random sample
of 50 items from each FY based on the percentage of costs in each category
(excluding the rent portion of Occupancy) to total costs. For those cost categories where we found costs that required adjustment, we expanded our review to include more transactions. We also performed a 100 percent review of the rent portion of Occupancy expenditures.
General Security Controls
We conducted limited general security control testing. Specifically we reviewed
the following eight areas relating to general security controls: (1) Perimeter
Security, (2) Intrusion Detection, (3) Key Management, (4) Internal Office Security,
(5) Equipment Rooms, (6) Security Plan, (7) Continuity of Operations, and (8)
Other Security Issues. We determined whether the general security controls NJDDS
had in place were satisfactory.
Schedule of Total Costs Reported on Forms SSA-4513-State Agency Reports of Obligations for Social Security Administration Disability Programs
New Jersey Disability Determination Services
FISCAL YEARS (FY) 2003 and 2004 COMBINED
REPORTING ITEMS DISBURSEMENTS UNLIQUIDATED OBLIGATIONS TOTAL OBLIGATIONS
Personnel 52,621,731 0 52,621,731
Medical 17,271,017 0 17,271,017
Indirect 7,064,342 0 7,064,342
All Other 9,104,677 0 9,104,677
TOTAL 86,061,767 0 86,061,767
REPORTING ITEMS DISBURSEMENTS UNLIQUIDATED OBLIGATIONS TOTAL OBLIGATIONS
Personnel 25,642,879 0 25,642,879
Medical 8,404,409 0 8,404,409
Indirect 3,877,092 0 3,877,092
All Other 4,550,894 0 4,550,894
TOTAL 42,475,274 0 42,475,274
REPORTING ITEMS DISBURSEMENTS UNLIQUIDATED OBLIGATIONS TOTAL OBLIGATIONS
Personnel 26,978,852 0 26,978,852
Medical 8,866,608 0 8,866,608
Indirect 3,187,250 0 3,187,250
All Other 4,553,783 0 4,553,783
TOTAL 43,586,493 0 43,586,493
Transfer of Funds Between Fiscal Years
No. FY Funds were Authorized FY Funds were Expended
New Jersey Department of Labor
Explanation for Transfer
1. 2002 2003 Transfer to reconcile administrative costs. $2,992,727.59
2. 2002 2003 Transfer made for medical cost adjustment. $216,319.89
3. 2003 2002 Transfer made for payroll purposes. $1,331,789.00
4. 2003 2002 Transfer made for payroll purposes. $532,715.60
5. 2003 2004 Transfer made for medical cost adjustment. $294,239.92
6. 2004 2003 Transfer made to reconcile FY 2003 amounts. $26,916.46
7. 2004 2005 Transfer made for medical cost adjustment. $134,288.00
8. 2005 2004 No explanation. $268,576.00
Date: July 9, 2007
To: Inspector General
From: Regional Commissioner New York
Subject: Administrative Costs Claimed by the New Jersey Department of Labor, Division of Disability Determination Services (A-02-06-16043) -- REPLY
I appreciate the opportunity to review the attached draft report. I am pleased that the auditors found that the New Jersey (NJ) Division of Disability Determination Services (DDS) reported administrative costs of $86,061,767 with virtually 100% accuracy over the two year period that this review covered.
I concur with the recommendations outlined in the draft report. They will assist us in further improving the DDS' adherence to SSA policies concerning equipment inventory requirements, physical security controls, and retention of time and attendance records and will also help reduce case processing costs.
Should your staff have any questions regarding this reply, they may contact Gene Purk in the Center for Disability, at 212 264-7283.
Beatrice M. Disman
State Agency Comments
N.J. Department of Labor and Workforce Development
Social Security Administration
Office of Inspector General
Review of Administrative Costs Claimed by New Jersey
Division of Disability Determination Services
FFY 2003 and 2004
Conclusion and Recommendations No. 1
Verify the adjustment of $3,342 of disallowed costs representing tuition refunds for employees who did not work for the NJDDS.
DDS has been reimbursed $3,342 for tuition refunds of employees that do not work for DDS. This correction was made as follows:
1. Document EM 45450009511 for $718.56 that reimbursed DDS from Employment
Security on 5/15/06.
2. Document EM 45450009510 for $1,547.15 that reimbursed DDS from Employment Security on 5/15/06.
3. Document AV 45355000441 for $1,076.50 that reimbursed DDS from Vocational Rehabilitation on 5/19/06.
Documentation has been provided to the Office of Inspector General (OIG).
Conclusion and Recommendations No. 2
Verify the adjustment of $3,011 of Nonpersonnel Service Costs representing mailgram expenses incurred in FY 2005 but charged to FY 2004.
With regard to the $3,011 for NPS mailgram expense that should be a FY 2005 expense. This correction was made as follows:
1. Document EM 45150000465 for $3,011.22 that reimbursed FY 2004 from FY 2005 on 5/16/06.
Documentation has been provided to the OIG.
Conclusion and Recommendations No. 3
Ensure the retention policies for time and attendance records are followed.
The New Jersey Department of Labor and Workforce Development has instituted the e-CATS payroll system (Electronic Cost Accounting Timesheet System). Effective April 1, 2006, all time and attendance records are now kept electronically with appropriate back-up and retention systems in place.
Conclusion and Recommendations No. 4
Review the reasonableness of the Medical Consultant charges totaling $38,945 claimed on FY 2003 Form SSA-4513 representing payroll costs for 16 part-time Medical Consultants where supporting documentation was missing.
DDS has reviewed these charges and believe them to be reasonable. The 16 part-time Medical Consultants at $38,945 represent one payroll timesheet that we are unable to find. This problem has been corrected with the e-CATS which is discussed above.
Conclusion and Recommendation No. 5
Properly account for all computer equipment.
The three (3) desktops and eight (8) monitors were all tagged with SSA control numbers. The workstation replacements which occurred in March and April of 2007 all have SSA control numbers. DDS currently maintains a database for all computer equipment and updates this database on a regular basis.
Conclusion and Recommendation No. 6
Strengthen physical security for those areas noted in the report.
All computer rooms remain locked at all times, and all computer rooms have
an uninterrupted power supply. All computer rooms are key-padded. In the event
of a power outage, keys are available but are kept in a secure location.
NJDDS has a fully electronic case management system, therefore a majority of the claims are electronic and the paper cases are secure in the file cabinets at the close of business.
All signs identifying the computer rooms have been removed.
Conclusion and Recommendation No. 7
Consider coordinating with the New Jersey Department of the Treasury to use alternative payment methods to medical vendors to save processing costs.
DDS is working with Versa, Division of Accounting, and the Department of Treasury to institute a better payment method to medical providers. We are working on a system which will batch the expenditures for MER and CE on a two week basis. Before the checks are issued a letter will be sent out to the vendor detailing what payments are in the check that the vendor will receive.
OIG Contacts and Staff Acknowledgments
Tim Nee, Director, (212) 264-5295
Vicki Abril, Audit Manager, (212) 264-0504
In addition to those named above:
Stephen L. Liebman, Senior Auditor
Robert Blake, Senior Auditor
Abraham Pierre, Auditor
For additional copies of this report, please visit our web site at http://ww.ssa.gov/oig
or contact the Office of the Inspector General's Public Affairs Specialist at
(410) 965-3218. Refer to Common Identification Number A-02-06-16043.
Overview of the Office of the Inspector General
The Office of the Inspector General (OIG) is comprised of our Office of Investigations (OI), Office of Audit (OA), Office of the Chief Counsel to the Inspector General (OCCIG), and Office of Resource Management (ORM). To ensure compliance with policies and procedures, internal controls, and professional standards, we also have a comprehensive Professional Responsibility and Quality Assurance program.
Office of Audit
OA conducts and/or supervises financial and performance audits of the Social Security Administration's (SSA) programs and operations and makes recommendations to ensure program objectives are achieved effectively and efficiently. Financial audits assess whether SSA's financial statements fairly present SSA's financial position, results of operations, and cash flow. Performance audits review the economy, efficiency, and effectiveness of SSA's programs and operations. OA also conducts short-term management and program evaluations and projects on issues of concern to SSA, Congress, and the general public.
Office of Investigations
OI conducts and coordinates investigative activity related to fraud, waste, abuse, and mismanagement in SSA programs and operations. This includes wrongdoing by applicants, beneficiaries, contractors, third parties, or SSA employees performing their official duties. This office serves as OIG liaison to the Department of Justice on all matters relating to the investigations of SSA programs and personnel. OI also conducts joint investigations with other Federal, State, and local law enforcement agencies.
Office of the Chief Counsel to the Inspector General
OCCIG provides independent legal advice and counsel to the IG on various matters, including statutes, regulations, legislation, and policy directives. OCCIG also advises the IG on investigative procedures and techniques, as well as on legal implications and conclusions to be drawn from audit and investigative material. Finally, OCCIG administers the Civil Monetary Penalty program.
Office of Resource Management
ORM supports OIG by providing information resource management and systems security. ORM also coordinates OIG's budget, procurement, telecommunications, facilities, and human resources. In addition, ORM is the focal point for OIG's strategic planning function and the development and implementation of performance measures required by the Government Performance and Results Act of 1993.