January 11, 2011

CalWORKs PROGRAM GUIDE

Special Notice

11-01

 

Subject

calworks efforts to reduce erroneous payments

 

Reference

All County Notice (ACIN) No. I-74-10, Information Memorandum TANF-ACF-IM-2010-02.

 

Purpose

The purpose of this Special Notice is to remind Family Resource Center Managers of the importance of payment accuracy and to consider implementing measures to reduce erroneous payments.

 

Background

The federal Administration for Children and Families (ACF) issued an Information Memorandum (TANF-ACF-IM-2010-02) providing guidance to states on best practices for the reduction of improper payments. ACF strongly encourages states to stress the importance of payment accuracy and to seriously consider measures to reduce erroneous payments.

 

Office of the Inspector General Review Findings

A federal Office of the Inspector General (OIG) review conducted in 2007 in 30 counties identified several improper payments in our state.

 

The causes of the improper payments included the following:

   Recipients did not fully disclose information during:

o   Application,

o   Redetermination, or

o   Did not notify the county of changes in their financial situation or other changes affecting eligibility;

   Not all information provided to support the application was verified; or

   The appropriate documentation to support eligibility and payment determinations was not available or maintained in the case file.

Efforts on the Reduction of Erroneous Payments

The California Department of Social Services (CDSS) reiterates and strongly encourages counties to maintain and implement processes and procedures to ensure that:

   Payments are made to eligible families,

   The payment levels are accurate,

   Recipients report accurately and timely, and

   All actions are adequately verified and documented in the case files to support eligibility and payment determinations.

 

All these efforts will contribute to the continued reduction of erroneous payments.

 

Required FRC Managers Actions

Required actions that can reduce erroneous payments include but are not limited to the following:

   Conducting local office quality control or supervisory reviews at both the initial intake and redetermination stage.

   Providing periodic reminders to staff through training, written reminders or other means, of the need to accurately verify and document eligibility information and to maintain the appropriate documentation in all case files.

   Developing and maintain a reminder system and establish deadlines for critical follow-up actions on cases such as responding to reports of non-cooperation with child support, Income Eligibility Verification System (IEVS) alerts, redeterminations of eligibility, or failure to fulfill work requirements.

   Ensure staff follow established process for the collection of CalWORKs overpayments from the appropriate recipient results in timely and accurate collection of erroneous aid payments.

   Ensure staff remind recipients periodically of their responsibility to accurately report income, resources, and other family circumstances under quarterly reporting requirements.

   Conducting training on investigative interviewing techniques for intake workers and case managers.

   Performing periodic reviews of case records paying particular attention to documentation that includes a current application and facts supporting income, household composition, participation in work activities, and cooperation with child support enforcement.

   Establishing and monitor internal procedures to ensure that CalWORKs payments are adjusted on a timely basis when changes to family circumstances affect case eligibility or the amount of payment.

Recommended Actions

Cont.

   Ensure staff review Electronic Benefits Transfer (EBT) usage when unable to contact the client (telephone out of service, whereabouts unknown, mail returned), when appointments are missed and/or homeless mail is not being picked up, to see if the EBT usage is Out of County/State usage; and determining whether the case continues to be eligible for aid or should be discontinued and/or be referred for a fraud investigation.

 

Cal-
Fresh Program Impact

Staff shall follow the processes and procedures described in this special notice, adhering to the Cal-Fresh regulations to ensure payment accuracy.

Medi-Cal Program Impact

Staff shall follow the processes and procedures described in this special notice, adhering to the Medi-Cal regulations to ensure benefits accuracy.

 

Child Care Program Impact

Child Care Case Managers (CCM) and CalWORKs Human Services Specialists (HSS) shall work collaboratively to prevent overpayments by communicating any information that may affect eligibility of the CalWORKs cash grant or CalWORKs child care subsidies.

 

They shall contact each other within 24 hours of receiving any change of information that affects eligibility or to verify and resolve any inconsistent information. For changes to report please refer to CPG 20-000K Child Care Program Integrity.

 

Automation Impact

No Automation impact.

 

ACCESS Impact

No ACCESS impact.

 

Forms Impact

No forms impact.

 

Imaging Impact

No imaging impact.

 

Operational Impact

No Operational impact.

 

QC / QA Impact

The best practices described in this Special Notice are intended to contribute to the continued reduction of erroneous payments.

 

For appropriate application to specific case circumstances, the HSS shall refer to the CalWORKs Program Guide for complete regulations.

 

Quality Assurance will cite the appropriate error when the appropriate CalWORKs regulations have not been followed.

 

Manager Approval

SYLVIA MELENA, Assistant Deputy Director

Self-Sufficiency Programs

Strategic Planning & Operational Support

 

Manager Contact

CalWORKs Program.

 

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