June 18, 2010

 

CalWORKs PROGRAM GUIDE LETTER NO. 208

 

Subject

CalWORKs Whereabouts Unknown and Client Electronic Benefit Transfer (EBT) Usage

 

Effective Date

June 18, 2010

 

References

All County Letter No. 10-01.

 

Purpose

The purpose of this Program Guide Letter is to provide guidance to staff regarding:

 

·        Handling CalWORKs cases when the whereabouts of an Assistance Unit (AU)/household is unknown;

·        The roles and responsibilities of recipients regarding residency and the reporting of address changes;

·        The rules governing the use of EBT and EBT administrative data;

·        The actions to be taken when residency is in question; and

·        Rules associated with referrals to the Public Assistance Fraud Division (PAFD).

 

This clarification of “existing” policy will help reduce the potential for erroneous actions to terminate benefits to families when there are questions regarding residency or erroneous referrals for fraud investigation.  

 

Background

At times, workers question the whereabouts of an AU/household when mail addressed to the household is returned as “undeliverable” or “addressee unknown,” and/or when they learn through EBT transaction reports that an AU/household is using their EBT card in another state or county other than their stated county of residence. These situations have been generally referred to as “whereabouts unknown” scenarios.

 

Summary of Updates

CPG Section  42-400.B. Residence Intention/Change of Residence has been modified and uploaded to the online CalWORKs Program Guide:

 

CPG Section

Title

Program Updates/Changes

42-400.B

Residence Intention/Change of Residence

Added Section regarding Mail Returned as Undeliverable or Addressee Unknown

Added Whereabouts Unknown Section

 

Mail Returned as Undeliverable or Addressee Unknown

Explains worker responsibilities and actions to be taken

 

Whereabouts Unknown

“CW HHs may not be automatically discontinued for Whereabouts Unknown…”

-explains worker responsibilities and actions to be taken

 

Roles and Responsibilities Regarding Residency

Recipients of CalWORKs are required to report any address changes to their worker within ten (10) calendar days as stated in CalWORKs Program Guide (CPG) section 44-250.E. (Mandatory Mid-Quarter Reporting).  Recipients can report this change in person, verbally, or in writing to their FRC within ten calendar days of when the change becomes known to the AU.  

 

CPG Section 42-400.B states that an AU is required to immediately inform the FRC to which the AU applied for aid or the FRC paying aid if the AU plans to reside in another county, state, or country regardless of the anticipated date of return.

 

When a recipient reports being out of the state, he or she must cooperate with the Human Services Specialist (HSS) and provide them with:

·        A monthly written statement explaining the reasons for the absence from California;

·        Their intent to return to California; and

·        The anticipated date of return.

 

Whereabouts Unknown

Residence in the state, but not in the county, is a requirement for continued eligibility for aid according to CPG Section 42-400.B.  Households may not be automatically discontinued for “whereabouts unknown”, because they may still be eligible for CalWORKs if they are still California Residents.  

 

Loss of contact with the household can result in the worker being unable to request information necessary to determine continued eligibility for aid, which could ultimately result in discontinuance of the AU’s aid. In addition, if the AU has not reported an address change to the worker, the worker will not be able to properly notify the AU of changes in eligibility and/or grant amount.

 

Workers are reminded that when questions regarding an AU’s place of residence arise, they are responsible for reviewing the circumstances of the case and contacting the AU to provide them with an opportunity to clarify the discrepancies.

 

Note:  Contact with the AU must be attempted and documented before making any referral for fraud investigation or taking action against the grant.

 

Appropriate use of EBT and EBT Administrative Data

The most basic principle governing the use of the EBT system is that it be interoperable.  That is, benefits can be accessed in a state or county other than the state or county that issued the benefits and EBT card.  The AU/household should be able to access their accounts from anywhere in the country where EBT benefits are redeemed.

 

Information about EBT transactions made outside of the issuing county or state is available to workers through two methods:

 

·        Via EBT administrative terminals located in County Welfare Departments (CWDs); or

·        The “Automated Teller Machine/Point-of-Sale Out of State/Country Report” produced from the Statewide Automated Reconciliation System (SARS). 

 

Data from the EBT system is used for state and federal reporting. Information in EBT is considered confidential and subject to the same rules that govern information in CalWORKs and FSP.

 

Mail Returned as Undeliverable or Addressee Unknown

Households have a responsibility to report a Change of Address (COA) within ten calendar days.  If the AU does not report a change in address verbally, in writing, or via their QR 7 form (Eligibility/Status Report), and mail sent to the only known address returns as undeliverable or without any forwarding address, the worker must:

 

·        Attempt to reach the household to resolve the conflicting information, and

·        Send a notice of incomplete QR 7 form (if the client submits their QR 7 form without reporting a COA);

·        Document the Balderas attempt at personal contact; and

·        Discontinue the cash aid at the end of the quarter in accordance with the instructions listed below.

 

If…

Then…

Mail has been returned as “undeliverable” or “addressee unknown” and it has been determined, (after notice issuance and the documented Balderas attempt at personal contact) that the client has moved out of California

The worker can take mid-quarter action to terminate aid.

It is determined after notice issuance and the documented Balderas attempt at personal contact that the client has moved to another county

An Inter-County Transfer (ICT) should be initiated in accordance with CPG Section 40-100.P.

 

Information Generated by EBT Transaction Reports

If a worker learns of a purchase made outside of the AU’s county of residence, the worker should first review the case circumstances to determine if the AU might have reasons for making out-of-county purchases.  A case review may show that the AU lives on the border between two counties and shops across the county or state border for convenience, lower prices, etc.  The household may also be visiting friends or relatives or making routine trips outside the county.  If the worker determines it is reasonable that the household make an out-of-county purchase, no further action is required.

 

If a worker suspects a problem with a specific case or finds discrepant information, the worker must follow up with the household to gather more information before making any referral for fraud investigation. The worker should contact the household to provide them with an opportunity to confirm, refute, or clarify any identified discrepancies before making any referral for fraud investigation.

 

Examples of discrepant information might include the following situations:

 

·        The AU lives in one county but all AU purchases are made outside of the county, when not consistent with case information;

 

·        Mail delivered to the current county address returns with a forwarding address in another county/state; or

 

·        Telephone calls made to the current AU residence are always answered by an unidentified person who must always take a message and have the AU return the call at a later time, when the case does not indicate the number provided is a message number.

 

AUs Who have Moved to Another County

If the recipient responds to the worker and indicates that the AU has moved to another county, an ICT should be initiated in accordance with CPG Section 40-100.P.

 

AU Absence of 30 days or Longer

Residency in the state is an eligibility requirement.  If the worker learns that the AU has been or intends to be continuously absent from the state for 30 days or longer, the following steps should be taken to ensure that the AU intends to remain a resident of California:

 

  1. The worker must send a QR 3 form (Mid-Quarter Status Report) to the household’s last known address (which may include their temporary address) when the next aid payment is issued, asking the family to report a COA per CPG Section 44-250.E.  The QR 3 will be sent in order to determine whether the AU intends to maintain California residency CPG Section 42-400.A.  The notice shall also advise the AU that failure to respond to the inquiry will result in ineligibility and termination of aid.  It is important to note that a written response from the AU establishing intent to reside in the state of California is an acceptable form of evidence, unless the statement is inconsistent with other information known to the worker per CPG Section 42-400.B.

 

  1. In accordance with CPG Section 42-400.B if the AU establishes that he or she is no longer a resident of the state, the worker must discontinue the case with timely notice.

 

  1. If the AU does not respond to the worker’s inquiry within 30 days, it can be presumed that they do not intend to maintain California residency, and the worker must discontinue the case immediately.

 

Additionally, if the AU is unresponsive to this inquiry, the worker should initiate contact with the other state in order to inquire as to whether the AU is receiving duplicate aid in that state CPG Section 42-400.B.

 

Referrals to the Public Assistance Fraud Investigation Unit

If the AU/household refuses to provide additional necessary information or provides conflicting information to the worker after an attempt is made to clarify their residency, the worker has reasonable grounds to refer these cases to the SIU for a fraud investigation. Additionally, the above scenarios do not prevent the worker from making a fraud referral of the AU/household for any other issue when the worker has reason to suspect that potential fraud exists.  In that case, the worker may forego contacting the AU/household before the SIU referral to avoid interfering with the follow-up investigation.

 

CPG Section 20-000.C. specifies that when there are reasonable grounds to suspect that an AU/household of a public social service program has attempted or been engaged in fraudulent activity (upon receipt of a fraud allegation or observation of conditions which provide reason to suspect that fraud exists or has been attempted), a referral shall be made to the SIU for investigation within five working days in accordance with CPG Section 20-000.D.  Reasonable grounds exist when one or more criteria specified in CPG Section 20-000.A. are met, including but not limited to:

 

·  A questionable situation exists and the AU/household refuses to   cooperate in providing additional necessary information; and/or,

 

·  When staff find conflicting information or facts regarding the case that could affect eligibility or benefit amount, and any further action on his/her part could jeopardize the investigator’s ability to investigate.

 

Automation Impact

None.

 

Food Stamp Impact

Food Stamp Program will issue material specific to Food Stamp Program Regulations via FSPG Letter No. 551.

 

Forms/Imaging Impact

None.

 

Access Impact

ACCESS Customer Service Agents will assist clients reporting Changes of Address (COA), will follow up with the initiation of Inter-County Transfers (ICTs), and will remind recipients to report certain changes in their income and/or Family circumstances mid-quarter.  Irregular usage of EBT card is to be narrated in case comments and an AFTT SharePoint should be sent to the FRC Change Group for evaluation of ongoing benefits eligibility and possible overpayment.

 

Operations Impact

None.

 

Quality Assurance Impact

Quality Assurance will cite the appropriate error when the regulations listed in this material is not followed or is not followed correctly.

 

Assistant Deputy Director

Original signed June  17, 2010

 

 

 

Sylvia Melena

Assistant Deputy Director

Self sufficiency Program

Strategic Planning & Operational Support