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That list has grown from 14 programs in 1990 to 32 by 2015, when it was last updated.  These programs range from Medicare benefits to food safety oversight.

Dr. Kettl, one of the nation’s most insightful observers of government operations, stepped back to review what changes in the high-risk list mean over time.  He explored:

The federal government has developed increasingly sophisticated approaches to addressing emergencies and crises. One successful management model is the incident command system (ICS), which was initially developed in the 1970s as a command-and-control approach for fighting forest fires, but has since been adapted to other policy domains. The Department of Homeland Security adopted the ICS model—which it renamed the National Incident Management System (NIMS)—and required its use at all levels of government in emergency and crisis situations.

Today, government is in the midst of significant changes that have both near-term consequences and lasting impact. Such changes become more complex in nature and more uncertain in effect. At the same time, the demands on government continue to grow while the collective resources available to meet such demands are increasingly constrained. Government leaders, managers, and stakeholders face major challenges, including: fiscal austerity, citizen expectations, the pace of technology and innovation, and a new role for governance.

In this report, Drs. Lael Keiser and Susan Miller examine the critical role of non-governmental outreach organizations in assisting government agencies to determine benefit eligibility of citizens applying for services.  Many non-profits and other organizations help low-income applicants apply for Social Security, Medicaid, and the Supplemental Nutritional Assistance Program (SNAP, or food stamps).