63285 CountyInitiated MidPeriod Actions
Table of Contents
Section
CountyInitiated MidPeriod Actions 2851
Decrease of Benefits MidPeriod Due to Late SAR 7 2852
Case Correction Due to County Error 2853
Recoupment of Claims 2854
PA Grant Changes MidPeriod 2855
Third PartyKnown to County Information 2856
Action on Third PartyKnown to County Information 2857
Data and Income Eligibility Verification System IEVS Matches 2858
632851 CountyInitiated MidPeriod Reports
The changes in eligibility status listed below are considered CountyInitiated These changes may occur at any time during the semiannual period Take action at the end of the month in which you can send timely and adequate notice even if it results in a decrease in benefits CountyInitiated action include but are not limited to
A Sanctions or financial penalties
B Failure of a member of the household to comply with a Quality Control Review
C Discontinuances due to the termination of a CalWORKs InterCounty Transfer
D Benefits are applied for and approved for a household member in another household or for the household
E CalWORKs is approved midperiod
F Change from state funded California Food Assistance Program CFAP to federally funded Supplemental Nutrition Assistance Program SNAP which shall be seamless to the client
G Cost of Living adjustments COLAs for CalFresh CalWORKs General Assistance and for those COLAs administered by the Social Security Administration
H Adjustments due to erroneous or incomplete SAR 7 or midperiod reports of information or lack of action by the County on
632852 Decrease of Benefits MidPeriod Due to Late SAR 7
the SAR 7 or midperiod recipient reports refer to 632852 and 3
I The threemonth limit for an ABAWD ends or an ABAWD who is not exempt and doesnt reside in an area with an ABAWD waiver who has regained eligibility and subsequently stops meeting the work requirements
J The County discovers Transitional CalFresh recipients have moved outofstate and are receiving public benefits TANF andor SNAP in another state ACIN I4110 and
K A member of the household receives SSISSP benefits
ACL 1225
Submission of a late SAR 7 may require that benefits be reduced for the second month of the SAR period
Establish an Inadvertent Household Error IHE overissuance claim when a recipient submits a late SAR 7 after the 11th of the SAR 7 submit month which results in the household receiving more benefits than entitled because you are unable to decrease benefits due to the 10day notice requirement
If the SAR 7 is Then establish
Received timely by the 11th An Administrative Error AE
of the Submit Month but overissuance if the household
was not processed or was receives more benefits than entitled
processed incorrectly by the to when there is not sufficient time to
County provide a 10day notice to decrease benefits effective the first month of the SAR period Decrease benefits effective the second month of the SAR period
Submitted late after the 11th of the Submit Month but before NOA cutoff and the SAR 7 was not processed by the county until after the NOA cutoff An IHE overissuance if the household receives more benefits than entitled to when you dont have sufficient time to provide a 10day notice to decrease benefits effective the first month of the SAR period Decrease benefits effective the second month of the SAR period
Submitted after NOA cutoff but by the Extended Filing Date
NOTE Timely notice is only required for adverse actions during the certification period A 10day notice is not required to reduce benefits at recertification
632853 When you discover that a household is receiving an erroneous Case Correction allotment correct the error midperiod even if benefits are decreased Due to County
midperiod
Error
You must correct an erroneous payment as soon as it is discovered whether it is a client IHE or administrativecaused AE error
Example
Scenario A CalFresh household correctly reports income of 400 a month on their May 2013 SAR 7 Two months later in July 2013 the worker realizes that the income was incorrectly entered as 40 a month
Outcome Take action immediately to correct the error Recalculate the allotment and decrease benefits for August 2013 with timely notice and Establish an AE overissuance for June and July 2013 Begin recoupment of the claim after the certification month effective January 2014 Refer to 632854 below
632854 Recoupment ofClaims
Refer to 63287 Overissuances and Underissuances
Recouping an overissuance claim is not a CountyInitiated MidPeriod Action Therefore you may only initiate benefit adjustmentreduction to begin recouping a claim at the beginning of a semiannual period after the SAR 7 or recertification submit month unless the recoupment does not result in a decrease of benefits
For example if recoupment of one claim is completed midperiod you may begin recoupment on a second claim in the following month if the recoupment amount of the second claim is equal to or less than the first
Refer to 6328710 Claim Recoupment by Allotment Reduction
632855 Public Assistance PAGrant ChangesMidPeriod
The receipt of Public Assistance PA benefits is considered KnowntoCounty information
When a joint CalWORKs and CalFresh application is received and CalWORKs is granted after CalFresh has been approved the new CalWORKs grant will be budgeted effective the month after CalWORKs is approved No timely notice is required because the CalFresh approval notice CF 3771 informed the
632856 Third PartyKnown to CountyInformation
household that benefits could be lowered after granting CalWORKs
When a PA Grant is recalculated midperiod budget the new PA Grant amount in the CalFresh budget effective the first of the month for which timely notice can be provided to the household
When a PA Grant application is approved midperiod the receipt of PA grant will result in a CountyInitiated midperiod action Budget the PA grant effective the first of the month for which timely notice can be provided to the household
Example 1
Scenario A CalFresh household with a December recertification month applies and is approved for CalWORKs on March 10th
Outcome The CalWORKs grant will be used in the CalFresh budget effective April
Example 2
Scenario Same as Scenario 1 but CalWORKs is approved March 25
Outcome The CalWORKs grant will be used in the CalFresh budget effective May
Under certain circumstances information is considered KnowntoCounty or could be provided through a thirdparty For example action in the following circumstances
Calculate an overissuance when the information received was a mandatory report and is obtained after benefits have been issued in the wrong amount such as in the case of Income and Eligibility Systems IEVS matches 632843C and
Take prospective action to change benefits midperiod or at the beginning of a semiannual period if you learn that the recipient failed to accurately report changes on a mandatory midperiod report on the SAR 7 or at recertification
In the case of third party reports that provide information that conflicts with what the household reported follow current regulations regarding how to handle discrepant case file information Refer to 6311731 and 63708
Contact the household to indicate that eligibility information is in question and give the opportunity to the household to verify the correct circumstances before taking action to reduce benefits
Refer to 631174 6311723 and 631173132
Example
Scenario Public Assistance Fraud Division PAFD reports that a person is no longer in the home
Outcome Although the household is not required to report household composition changes midperiod and a PAFD report is considered KnowntoCounty send a CF 3776 SAR to find out when the household member left the home If the household member was supposed to be reported during a mandatory report SAR 7 or recertification discontinue the person with timely notice and compute an overissuance effective the month the person should have been discontinued If the household member left during the current payment period send a No Change NOA write in case comments and in the Maintain Held Change Notes page in CalWIN for follow up with the next SAR 7 or recertification
632857 Action on Third PartyKnown to CountyInformation
All third party information that is received by or known to the county must be acted upon in accordance with SAR rules
A If a change is required to be reported by the household under SAR rules verify the information and take action based on the verified information
B If a change is not required to be reported such as a change of income that is not over the IRT or verified upon receipt VUR ensure that the next semiannual report SAR 7 or recertification is consistent with other information already reported KnowntoCounty Enter the information in case comments in the Maintain Held Change Notes page in CalWIN for follow up with the next SAR 7 or recertification
C If the information on the SAR 7 or recertification form is not consistent with what has already been reported or is being reported through a third party try to resolve the discrepancy If you cannot resolve the discrepancy the SAR 7 or recertification will be considered incomplete
It is important to note that while third party information may be useful to the worker under some circumstances you cannot take action For example do not take midperiod action based on third party information regarding changes that a household is not requiredto report during the certification period The exception is if the situation turns into a CountyInitiated Action such as approving aid in another household or a child being placed in Foster Care
If you receive information about changes in household composition midperiod do not take any case action based on this thirdparty information However if you receive or know about information that the household is required to report such as income in excess of the IRT and the household has not reported the information take action to resolve the discrepancy and take appropriate action once the information has been verified
Example 1
Scenario A worker is notified that a household member started a new job
Outcome The worker finds out that the household member started the job in the middle of the certification period and income from the job does not exceed the households IRT The household has no obligation to report the new job until the next SAR 7 or recertification whichever occurs first Do not take any action until the next SAR 7 or recertification Write in case comments and in the Maintain Held Change Notes page in CalWIN for follow up with the next SAR 7 or recertification At that time compare information that is known to the county with what the recipient reported and ensure that it is consistent
Example 2
Scenario An anonymous source reports that the absent parent moved back into the home midperiod This is a CalWORKsCalFresh case
Outcome CalWORKs and CalFresh This is not a mandatory report for CalWORKs or CalFresh Is not considered VUR for CalFresh because is reported by a third party If the second parent is not reported in the home on the following SAR 7 or recertification contact the AUhousehold to verify the circumstances of the Data Month The SAR 7 could also be considered incomplete
Example 3
Scenario A New Hire Report NHR or Public Assistance Reporting Information System PARIS reports show that a household member has earnings that have not been reported
Outcome NHR and the PARIS MediCal reports are not considered VUR If the amount of income showing on the report or the verification received for MediCal is or appears to be over the IRT request additional information and verification if needed via the CF 32 to determine when the income started if the income is over the IRT and if it can be reasonably anticipated to continue for the remainder of the certification period If the income is not over the IRT enter a held change note in CalWIN to be reviewed at the next SAR 7 or recertification whichever comes first If the income is over the IRT and will continue to be over the IRT discontinue the case with timely notice
632858 Data and Income Eligibility Verification System IEVSMatches
Refer to 632843C and 632857 for additional information
Evaluate information from data matches to determine if the information was required to be reported by the household on the SAR 7 recertification or as a mandatory midperiod report
A INCOME ELIGIBILITY VERIFICATION SYSTEM IEVS
The following Information from IEVS or the Payment Verification System PVS is considered Verified Upon Receipt VUR
1
Social Security and Supplemental Security Income SSI benefit information obtained from the Social Security Administration SSA and
2
Unemployment Insurance Benefits UIB or State Disability Insurance SDI information obtained from the Employment Development Department EDD
Take action when applicable to discontinue increase denyor reduce benefits based on the information reported by IEVSPVS If the information obtained from IEVSPVS about a household is questionable or if there is reason to doubt the applicability of IEVS information the information will not be considered VUR Refer to 63
1184 and 5
Information obtained from the IEVS could be used to increase decrease or discontinue benefits midperiod only if the income could be reasonably anticipated without contacting the household
Otherwise the information is not VUR Hold the results of the IEVS match until the SAR 7 or recertification whichever comes first unless the total households income including IEVS may be over the IRT If the income could be over the IRT request verification in writing allowing the household 10 days to respond Refer to 632834A and 632835
NOTE When reconciling IEVS matches with reported income from the SAR Data Month or recertification take prospective budgeting rules into consideration All reasonably anticipated rules apply even when retroactively considering the case for unreported information Refer to 63282
Refer to 63118 for processing timeframes
B OTHER IEVS DATA MATCHES
Information from the following IEVS matches are not considered VUR
1
Integrated Fraud DetectionEarnings Clearance System IFD Franchise Tax Board FTB Asset MatchInternal Revenue Service
2
Beneficiary Earnings Exchange Record BEER
3
Jail Reporting System JRS
4
Fleeing Felon Match FFM
5
Nationwide Prisoner Match NPM
6
Deceased Persons Match DPM
7
New Hire Registry NHR Match
For additional NHR information refer to 631189
Processing Eligibility Desk Guide EDG
For all matches write in Case Comments when the data does not
Refer to
63708 Data Matches
63287 Overissuances and Underissuances