In accordance with the Paperwork Reduction Act of 1995, collection of this information has been approved by the Office of Management and Budget (OMB) under OMB Control Number 0970-0290, expiration date 10-31-2008.  Submission of this information, however, is voluntary.  The public reporting burden for this collection of information is estimated to average 24 hours per response, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information.  An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.

Please enter the following information for the individual(s) completing this questionnaire and attachments, so we may contact them to clarify information, if necessary.

Date :   December 30, 2005                                                                                                                  

Name:  Gary Grayson                                                                                                                           

Title:     Bureau Chief, Fraud Bureau                                                                                                     

State Agency:   California Department of Social Services                                                                       

(Area Code) Phone Number: (916) 263-5738                                                                                         

E-mail Address: Gary.Grayson@dss.ca.gov                                                                                           

Please return the completed questionnaire and attachments in the enclosed business reply envelope.  Alternatively, you may fax your completed questionnaire and brief attachments to the attention of Dennis Poe at 202-205-5887, or preferably email an electronic copy of the questionnaire and any attachments to him at dspoe@acf.hhs.gov.

If you have any questions or comments regarding your submissions, please contact Dennis Poe at 202-401-4053, or at dspoe@acf.hhs.gov.

Please return the questionnaire and attachments by December 30, 2005.

1.       How does the TANF Lead Agency define improper payments?

            An overpayment is any amount of any aid payment an Assistance Unit received to which it was    not eligible.  (CCR 44-350.15)

            An underpayment occurs when the applicant or recipient receives less than the amount to which   he/she is entitled in a given month or months.  (CCR 44-340.12)

 

2.       Provide a description (electronic copy, if available) of the organizational structure of the agency in your State that handles improper payments in the TANF program.  If available, please submit an organizational chart, or provide the web site address where it can be found.

            See Attached.

 

3.       Please check all of the topics or activities listed below for which your State has policies or regulations in place for the program. (Please check all that apply.)

þ   Steps involved in identifying a potential improper payment

þ   Steps involved in verifying an improper payment

þ   Establishing claims for improper payments

þ   Collecting improper payments, including, for example, the authority to reduce payments to recover overpayments

þ   Distribution of recovered improper payments

þ   Sources of funding for addressing improper payments

q   Other (please specify : )                                                                                              

 

4.       Has your State performed an assessment or analysis to determine whether the program is at risk of improper payments?

þ   Yes. 

For which of the following uses of program funds did your state perform an assessment or analysis to determine whether the program is at risk of improper payments? (Please check all that apply.)

þ a.  Monthly cash assistance payments

q b.  “Nonassistance” benefits or services, for example, one-time cash payments designed to
divert a family from welfare or payments for car repairs or rental assistance

q c.  Other types of benefits and services for families not receiving cash assistance

q d.  Payments to service providers

q e.  Other (Please specify:) ________________________________________________________
___________________________________________________________________________

q No.

 

5.       Please describe your process for identifying and handling improper payments.

            IEVS reviews and other state and federal matches that ID payments.  Counties handle collection activities for improper payments.

 

6.       Which methods, if any, did your state use to identify a total amount of improper payments for the program? (Please check all that apply.)

Calculation based on:

q Findings from the state's Single Audit

q Other audit findings from state auditors

q Findings from other state or local auditors, including legislative review entities (Please specify :) ______________________________________________________________________________

þ Findings from state or local fraud units (Please specify :) The Fraud Bureau conducts 8-10 IEVS reviews annually and local counties report monthly (482 report) improper payments identified.

q Reviews of service providers and/or contractors

q Reviews of sampled cases, although not statistically representative of all program payments

þ Statistically representative sample of payments

q Other (Please specify :) ____________________________________________________________________

 

7.       Does your State calculate an improper payments (including fraudulent payments) rate, that is, a measure of the percentage of total payments that are determined to be improper? (Please check one response and provide the appropriate data.)

þ Yes.  Please describe the methodology used to arrive at the error rate.

q No 

q Information not available.

      Information is collected from monthly 482 reports.  Counties report total payments and total improper payments identified.  The Fraud Bureau compiles data and determines statewide error rate.   TANF payments due to fraud are calculated by dividing the percentage of IPV cases from the FNS 209(Food Stamps) into our total collections.  Counties submit TANF overpayments and collections on a Quarterly basis.

 

8.       Please rank the following sources of improper payments (1 to 7) for the program in your State over the past two fiscal years, beginning with one (1) indicating the primary source of improper payments.  Error is defined as an inadvertent mistake whereas fraud is defined as a willful misrepresentation. (Please rank each source below.)  Gary, are you sure client error is first?  Is this based on recent annual data?  Also, I don't think you can say much beyond client and Agency error because we don't collect data on the others to rank.  This should be stated under other.

___ Client error

___ Provider error

___ Agency error

___ Client fraud

___ Provider fraud

___ Agency fraud

_X_ Other (Please specify).  We do not collect TANF data to distinguish between the types of errors and fraud.

 

9.       Of all improper payments in your State, what proportion of those payments would you estimate are overpayments, and what proportion would you estimate are underpayments?  An overpayment is defined as a payment larger than what should have been made/received or any payment that is received when none should have been received.  An underpayment is defined as a payment smaller than what should have been made/received or no payment was received when there should have been one.

            TANF underpayments are not tracked.

Overpayments                                 % 

Underpayments                               %

10.   To what extent, if any, have the following factors contributed to improper payments in your State over the past two fiscal years?  (Please check one answer in each row

 

            *Information not collected in this manner

 

11.   Please describe your top 3 priorities for preventing and reducing improper payments (e.g., training/meetings for providers on rules and responsibilities; training for agency staff on correct implementation of rules and responsibilities; clear communication with parents on rules and responsibilities; use of information technology.)

Our priority is to work with counties to focus attention on their early fraud prevention and detection programs with emphasis on sharing best practices; CDSS will be conducting more state oversight in this area through county reviews. CDSS will continue to provide technical assistance to counties in reducing improper payments through onsite visits, training and regional meetings.  Additionally, the CDSS is testing the cost-effectiveness of the National Database for New Hires to assist in identifying improper  payments.

12.   For each activity listed below, indicate whether or not your State performs it to verify the accuracy of information needed to determine eligibility for and/or proper amount of a program payment.  If yes, indicate when in the process the step or activity is performed and how often it is performed.

 

13.   Data sharing is a method used to obtain and disclose information about individuals from within your agency, from other agencies and/or from independent, third party sources, including federal and State agencies or private companies.  These activities can be conducted before an initial payment is made to an individual or provider (pre-payment) and also after payment is made (post-payment) to verify eligibility and payment accuracy.   For each source listed below:

Indicate whether or not your agency or State utilizes this data source to better ensure accurate payments under the program.  If your State utilizes the source, indicate when in the process the source is used (before the payment is issued or at some point after the payment is issued), and/or indicate how often that source is used. (Please check all appropriate responses for each row.)

 

14.   For the most recently completed fiscal years, how much in program improper payments has your agency, or another agency within your State, recovered? (Please indicate your responses in the space provided below.)

Most recently completed fiscal year  04/05        (Specify ending month/ year) 7/1/04 – 6/30/05

þ   Includes fraudulent improper payments $86,085,305

Next most recently completed fiscal year                     (Specify ending month/ year)                 

q      Includes fraudulent improper payments

q      Not tracked

 

15.   What penalties does your program mandate for clients, agencies, or providers, who commit an error leading to improper payments?

A.     Agency: 

Agency caused overpayments are collected by offsetting the TANF Grant by 5%.

B.     Clients/Parents:

Client caused overpayments are collected by offsetting the TANF Grant amount by 10%.

C.     Providers:

None 

D.     County/Local Agency:   

None.  Closed TANF cases with outstanding overpayments are referred to TAX (State) INTERCEPT.

 

16.   How does the TANF Lead Agency define “fraud”?

Definition of fraud:

California Code of Regulations 20-003: http://www.dss.cahwnet.gov/getinfo/pdf/2cfcman.pdf

Welfare and Institutions Code Section 10980:
http://www.leginfo.ca.gov/cgi-bin/waisgate?WAISdocID=19006912628+0+0+0&WAISaction=retrieve

 

17.   Does your agency maintain data on fraudulent payments in the program as a subset of your improper payments data? (Please check one response.)

þYes

If yes, please list the methods you use for finding occurrences of fraud and indicate whether you would rate each method as very effective, somewhat effective, somewhat ineffective, or very ineffective. 

The methods used for finding occurrences of fraud vary within each county that investigates fraud.  However, some examples include IEVS matches, identifying forged documents, and home visits.

q      No 

Does any other entity in your State maintain this information, such as a State fraud unit or Inspector General? If yes, please provide us with a contact name and phone number:

 

18.   What steps, if any, beyond improper payments prevention, does your State take to specifically prevent fraud?

Each county maintains a Special Investigative Unit (SIU) to investigate potential fraud.  In addition, most counties have processes in place for Early Fraud Detection, including home visits, trigger referrals, and training eligibility workers.  Furthermore, CDSS conducts regular IEVS reviews to ensure county compliance and also conducts county technical assistance visits.

 

19.   Is your agency required to report, or to have information available, on improper payments to the State legislature, the Governor, or any other higher-level agencies? (Please check one response.)

q      Yes ® Please provide a copy of the report(s), and indicate who received them.

þNo

 

20.   Describe any other information that may be relevant to improper payments in the program that you wish to share with us.

In California, the administration of the TANF program is delegated to local counties with oversight by the State.  Each county develops their own processes for identifying potential fraud and handling cases.

 

21.   Please submit copies of pertinent sections of manuals and other State-issued guidance that you would like to make available, or provide the web site address where they can be found.

None