County of San Diego Health and Human Services Agency HHSA Cash Assistance Program for Immigrants CAPI Program Guide Waiver Determinations Number Page 991093 1 of 3 Revision Date September 1 2019 Background This section provides information on how to complete a waiver determination for overpayment recovery in CAPI Purpose This section is updated for the sunset review No Program rules have changed Policy An overpaid recipient may request a waiver of overpayment recovery at any time after receiving an overpayment notice Suspend overpayment recovery while deciding on the waiver request Waive recovery if the overpaid recipient is without fault in connection with causing or accepting the overpayment and recovery or grant reduction would o Defeat the purpose of CAPI o Be against equity and good conscience o Impede the effective or efficient administration of CAPI because of the small amount involved Note Approve waivers up to 1000 Supervisors approve all waivers over 1000 and all denials 1 Determine Without Fault To determine if a recipient is without fault consider all available evidence and pertinent circumstances surrounding the overpayment such as if the recipient Understood the cause of the overpayment at the time it occurred Understood the reporting requirements Agreed to report events affecting payments Was aware of events that should have been reported Attempted to comply with the reporting requirements Had the ability and opportunity to comply with the reporting requirements Understood the obligation to return payments that were not due The extent of efforts made to instruct the recipient about reporting responsibilities and program eligibility rules in hisher native language In considering these factors also consider the recipients Age Comprehension Limitations physical mental educational linguistic including any lack of facility with the English language 2 Without Fault Situations Presume without fault for any overpayment that occurred prior to the workers receiving the recipients report If incorrect payments continue establish fault if the recipient accepts payments heshe knew were incorrect County of San Diego Health and Human Services Agency HHSA Cash Assistance Program for Immigrants CAPI Program Guide Waiver Determinations Number Page 991093 2 of 3 Find without fault in the following situations The recipient failed to report a change because of misinformation from an official source such as a state or county employee When the sole cause of the overpayment was excess resources of 50 or less Waive recovery of the overpayment unless the recipient willfully and knowingly failed to report the value of resources accurately and timely See the example in Desk Aid 991093A Note There is willful and knowing failure to report when the evidence clearly shows the recipient was fully aware of the eligibility requirements and the excess resources and chose to conceal them When the sole cause of the overpayment was excess resources of over 50 unless the recipient willfully and knowingly failed to report the excess resources accurately and timely To allow a determination of without fault in this situation follow the steps in the table below Step Action 1 Subtract the applicable resource limit from the greatest countable resource amount during the overpayment period 2 Recover the lesser of the difference or the overpayment 3 Waive recovery of any amount in excess of the difference as being against equity and good conscience 3 With Fault Although findings depend on all the circumstances of a case a recipient will be found to be at fault in connection with an overpayment when the incorrect payment resulted when the recipient Failed to furnish information the recipient knew or should have known was material Made an incorrect statement which heshe knew or should have known was incorrect Did not return a payment which heshe know or could have been expected to know was incorrect Received and negotiated duplicate payments for the same period Had similar overpayments in the past 4 Defeat the Purpose of CAPI This provision applies to any overpaid recipient who Is still receiving CAPI or SSISSP Does not have earned income in excess of 65 per month The provision does not apply if the overpaid individual has in hisher possession any of the incorrectly paid funds For Defeat the Purpose to apply in any other case for example when the recipient is no longer receiving CAPI or SSISSP determine if The recipient needs substantially all current income to meet current and necessary living expenses Recovery would reduce the total resources below 3000 for a recipient with no dependents or 5000 for a recipient with one dependent allow an additional 600 for each additional dependent County of San Diego Health and Human Services Agency HHSA Cash Assistance Program for Immigrants CAPI Program Guide Waiver Determinations Number Page 991093 3 of 3 5 Against Equity and Good Conscience Adjustment or recovery is against equity and good conscience if the recipient Changed hisher position for the worse Relinquished a valuable right because of reliance upon a notice that payment would be made or because of the incorrect payment itself Example 1 A recipient fails to take advantage of a private organization or charity relying instead on the award of CAPI benefits 2 It was subsequently found that the CAPI benefits were improperly paid 3 Recovery would be against equity and good conscience if the recipient were also found to be with fault 6 Impede Effective or Efficient Administration Attempts to recover minor overpayments would impede effective or efficient administration of CAPI due to the small amount involved Therefore Waive total overpayment amounts from 01 to 30 without further action Presume the individual is without fault Procedure Follow the actions in the policies above and Processing Guide 991092A to collect on a CAPI overpayment Program Impacts None References ACL 9882 and 0073 ACIN 3309 Sunset Date This policy will be reviewed for continuance on or by 09302022 Approval for Release Rick Wanne Director Eligibility Operations