The government reform expert and acclaimed author of The Solution Revolution presents a roadmap for navigating the digital government era. In October 2013, HealthCare.gov went live—and promptly crashed. Poor website design was getting in the way of government operations, and the need for digital excellence in public institutions was suddenly crystal clear. Hundreds of the tech industry’s best and brightest dedicated themselves to redesigning the government’s industrial-era frameworks as fully digital systems. But to take Washington into the 21st century, we have to start by imagining a new kind of government. Imagine prison systems that use digital technology to return nonviolent offenders promptly and securely into society. Imagine a veteran’s health care system built around delivering a personalized customer experience for every Vet. We now have the digital tools—such as cloud computing, mobile devices, and analytics—to stage a real transformation. Delivering on Digital provides the handbook to make it happen. A leading authority on government reform, William D. Eggers knows how we can use tech-savvy teams, strong leadership, and innovative practices to reduce the risks and truly achieve a digitally transformed government.

More than 7 million recipients of Social Security benefits have a representative payee-a person or an organization-to receive or manage their benefits. These payees manage Old Age, Survivors and Disability Insurance funds for retirees, surviving spouses, children, and the disabled, and they manage Supplemental Security Income payments to disabled, blind, or elderly people with limited income and resources. More than half of the beneficiaries with a representative payee are minor children; the rest are adults, often elderly, whose mental or physical incapacity prevents them from acting on their own behalf, and people who have been deemed incapable under state guardianship laws. The funds are managed through the Representative Payee Program of the Social Security Administration (SSA). The funds total almost $4 billion a month, and there are more than 5.3 million representative payees. In 2004 Congress required the commissioner of the SSA to conduct a one-time survey to determine how payments to individual and organizational representative payees are being managed and used on behalf of the beneficiaries.1 To carry out this work, the SSA requested a study by the National Academies, which appointed the Committee on Social Security Representative Payees. This report is the result of that study. Improving the Social Security Representative Payee Program: Serving Beneficiaries and Minimizing Misuse (1) assesses the extent to which representative payees are not performing their duties in accordance with SSA standards for representative payee conduct, (2) explains whether the representative payment policies are practical and appropriate, (3) identifies the types of representative payees that have the highest risk of misuse of benefits, and (4) finds ways to reduce the risk of misuse of benefits and ways to better protect beneficiaries.

The United States Social Security Administration (SSA) administers two disability programs: Social Security Disability Insurance (SSDI), for disabled individuals, and their dependent family members, who have worked and contributed to the Social Security trust funds, and Supplemental Security Income (SSSI), which is a means-tested program based on income and financial assets for adults aged 65 years or older and disabled adults and children. Both programs require that claimants have a disability and meet specific medical criteria in order to qualify for benefits. SSA establishes the presence of a medically-determined impairment in individuals with mental disorders other than intellectual disability through the use of standard diagnostic criteria, which include symptoms and signs. These impairments are established largely on reports of signs and symptoms of impairment and functional limitation. Psychological Testing in the Service of Disability Determination considers the use of psychological tests in evaluating disability claims submitted to the SSA. This report critically reviews selected psychological tests, including symptom validity tests, that could contribute to SSA disability determinations. The report discusses the possible uses of such tests and their contribution to disability determinations. Psychological Testing in the Service of Disability Determination discusses testing norms, qualifications for administration of tests, administration of tests, and reporting results. The recommendations of this report will help SSA improve the consistency and accuracy of disability determination in certain cases.

Millions of Americans experience some degree of hearing loss. The Social Security Administration (SSA) operates programs that provide cash disability benefits to people with permanent impairments like hearing loss, if they can show that their impairments meet stringent SSA criteria and their earnings are below an SSA threshold. The National Research Council convened an expert committee at the request of the SSA to study the issues related to disability determination for people with hearing loss. This volume is the product of that study. Hearing Loss: Determining Eligibility for Social Security Benefits reviews current knowledge about hearing loss and its measurement and treatment, and provides an evaluation of the strengths and weaknesses of the current processes and criteria. It recommends changes to strengthen the disability determination process and ensure its reliability and fairness. The book addresses criteria for selection of pure tone and speech tests, guidelines for test administration, testing of hearing in noise, special issues related to testing children, and the difficulty of predicting work capacity from clinical hearing test results. It should be useful to audiologists, otolaryngologists, disability advocates, and others who are concerned with people who have hearing loss.

Children living in poverty are more likely to have mental health problems, and their conditions are more likely to be severe. Of the approximately 1.3 million children who were recipients of Supplemental Security Income (SSI) disability benefits in 2013, about 50% were disabled primarily due to a mental disorder. An increase in the number of children who are recipients of SSI benefits due to mental disorders has been observed through several decades of the program beginning in 1985 and continuing through 2010. Nevertheless, less than 1% of children in the United States are recipients of SSI disability benefits for a mental disorder. At the request of the Social Security Administration, Mental Disorders and Disability Among Low-Income Children compares national trends in the number of children with mental disorders with the trends in the number of children receiving benefits from the SSI program, and describes the possible factors that may contribute to any differences between the two groups. This report provides an overview of the current status of the diagnosis and treatment of mental disorders, and the levels of impairment in the U.S. population under age 18. The report focuses on 6 mental disorders, chosen due to their prevalence and the severity of disability attributed to those disorders within the SSI disability program: attention-deficit/hyperactivity disorder, oppositional defiant disorder/conduct disorder, autism spectrum disorder, intellectual disability, learning disabilities, and mood disorders. While this report is not a comprehensive discussion of these disorders, Mental Disorders and Disability Among Low-Income Children provides the best currently available information regarding demographics, diagnosis, treatment, and expectations for the disorder time course - both the natural course and under treatment.

The Other Welfare offers the first comprehensive history of Supplemental Security Income (SSI), from its origins as part of President Nixon's daring social reform efforts to its pivotal role in the politics of the Clinton administration. Enacted into law in 1972, Supplemental Security Income (SSI) marked the culmination of liberal social and economic policies that began during the New Deal. The new program provided cash benefits to needy elderly, blind, and disabled individuals. Because of the complex character of SSI-marking both the high tide of the Great Society and the beginning of the retrenchment of the welfare state-it provides the perfect subject for assessing the development of the American state in the late twentieth century. SSI was launched with the hope of freeing welfare programs from social and political stigma; it instead became a source of controversy almost from its very start. Intended as a program that paid uniform benefits across the nation, it ended up replicating many of the state-by-state differences that characterized the American welfare state. Begun as a program intended to provide income for the elderly, SSI evolved into a program that served people with disabilities, becoming a primary source of financial aid for the de-institutionalized mentally ill and a principal support for children with disabilities. Written by a leading historian of America's welfare state and the former chief historian of the Social Security Administration, The Other Welfare illuminates the course of modern social policy. Using documents previously unavailable to researchers, the authors delve into SSI's transformation from the idealistic intentions of its founders to the realities of its performance in America's highly splintered political system. In telling this important and overlooked history, this book alters the conventional wisdom about the development of American social welfare policy.