63-702     District Staff Responsibilities in Fraud

Prevention and Detection

 

Table of Contents

 

 

Section

Family Resource Center (FRC) Managers

702.1

Supervisor

702.2

Worker

702.3

Annual Training

702.4

 x

 

63-702.1
Family Resource Center (FRC) Managers

FRC Managers are responsible for:

·         Ensuring that maximum time is given for an accurate evaluation of eligibility determinations; and

·         Supporting staff in meeting the Agency’s fraud prevention and detection goals;

·         Emphasizing to staff the importance of referring cases with inconsistent information for fraud investigation;

·         Modifying operational systems and procedures, as necessary, to improve accuracy, accountability, efficiency and effectiveness of service delivery; and

·         Ensure all subordinates comply with Fraud Prevention Training requirement.

 

63-702.2
Supervisor

Supervisors are responsible for:

·         Ensuring that fraud prevention activities are recognized/ implemented to deter/prevent fraud and abuse of social services programs;

·         Ensuring that staff attend mandated fraud prevention training

·         Supporting fraud prevention by monitoring the resolution of conflicting or inconsistent information identified during supervisor case reviews

·         Encouraging fraud referrals and ensuring appropriate problem resolution associated with the District Attorney’s Public Assistance Fraud Division (PAFD) Investigation staff takes place;

·         Monitoring, reviewing and controlling timely fraud referrals and response/follow-ups on fraud prevention investigation findings in their unit.

 

63-702.3
Worker

The Worker is responsible for:

·         Ensuring that clients understand their responsibility to provide accurate information and report any changes within ten days that may affect their eligibility and/or grant amount.  The worker must review these responsibilities, as well as the penalties for failing to meet them, with the client at each application and recertification;

·         Documenting in the case record that the client has been advised of their rights, and responsibilities to report changes and that the client understood his/her reporting responsibilities;

·         Gathering information and obtaining verifications mandated by the program to ensure accuracy;

·         Determining whether the information/verification provided is inconsistent, incorrect or questionable;

·         Attempting to resolve any conflicting, inconsistent, or incomplete information/verification with the client to the fullest extent possible including collateral contacts when necessary;

·         Documenting in the case record all contacts, responses from the client, and any additional information received as a result of the contacts;

·         Using automated information systems for fraud prevention purposes;

·         Requesting that the Public Assistance Fraud Division (PAFD) Investigator interview the applicant if the worker suspects fraud;

·         Responding to PAFD investigator on FRTS regarding case action being taken;

·         Completing the required verification process before issuing aid payments or allowing aid payments to continue; and

·         Authorizing accurate aid payments for eligible clients.

63-702.4
Annual Fraud Training

Annual periodic refresher and special training in the prevention and detection of fraud is required to be provided to all Eligibility Workers and front-line supervisors.  A minimum of four hours of refresher training shall be provided each year.  New employees shall receive a minimum of eight hours of such training during the first four months of their employment. All training should be developed in collaboration with the county’s Special Investigative Unit SIU, and specifically address when to make a referral for investigation.

MPP 20-005.2