County of San Diego Health and Human Services Agency HHSA CalFresh Program Guide NonFraud Claim Determination Number Page 63452 1 of 3 Revision Date 04012019 Background Inadvertent Household Errors IHE and Administrative Error AE claims are considered nonfraud OI claims This section is being reformatted and revised to reflect the change in regulation as a result of the settlement of the lawsuit Brown and Espinosa Tapia v Lightbourne This regulation changes the look back period for collection of Inadvertent Household Error IHE and Administrative Error AE overissuances from 6 years to 3 years Effective immediately all newly established IHE and AE claims must comply with the new 3 year look back timeframe OI claims established prior to this revision will not be affected Purpose This section details the establishment and determination of nonfraud CalFresh claims Policy 634521 Establishment of IHE Claims Initial IHE Overissuance Month For Inadvertent Household Error IHE claims the initial month of overissuance will be the first month that the customer received more benefits than it was entitled to unless the overissuance was caused by failure to report a required change In cases involving failure to report a required change the first month affected by the customers failure to report will be the first month in which the change would have been effective had it been reported timely Determination of IHE Claims When determining the amount of benefits the household should have received do not apply the twenty 20 percent earned income deduction to the portion of earned income the customer failed to report Calculate the amount of the IHE claim Offset the amount of the claim against any underissuance that was calculated for the same month of the new claim Adjust the claim balance to zero if the underissuance is more than the amount of the claim Issue the balance of the underissuace to the customer as a restoration of lost benefits Refer to 63456 Establish an IHE claim for households when the customer Failed to report required information accurately andor timely Failed to report a change on the SAR 7 for the Data Month and the SAR Payment period was incorrectly computed based on this failure Submits the SAR 7 late and benefits cannot be decreased due to tenday notice requirements If a CalFresh customer has an existing overissuance that is being recouped by benefit reduction and a recoupment for another type of overissuance needs to be calculated base the amount of the second overissuance recoupment on the initial CalFresh benefit not on the adjusted benefit after the OI has been deducted Refer to Definition and Examples 631103 for an example 634522 Establishment of AE Claims County of San Diego Health and Human Services Agency HHSA CalFresh Program Guide NonFraud Claim Determination Number Page 63452 2 of 3 Initial AE Overissuance Month For Administrative Error AE claims the initial month of overissuance will be the first month the household receives more benefits than it was entitled to due to an error caused by the county When the AE overissuance involves failure to act timely on a reported change the initial month of overissuance will be the first month of the SAR payment period for which a change should have been made subject to timely notice Determination of AE Claims Determine the claim amount by computing the difference between the allotment the customer received and the allotment the customer should have received for each month of the overissuance If a CalFresh customer has an existing overissuance that is being recouped by benefit reduction and a recoupment for another type of overissuance needs to be calculated base the amount of the second overissuance recoupment on the initial CalFresh benefit not on the adjusted benefit after the OI has been deducted Refer to Definition and Examples 631103 for an example Refer to 634515 for the threeyear time frame requirement to establish an AE claim Do not offset the amount of an AE claim against any amount of underissuances which have not yet been restored to the household Refer to 634547 634523 Determining NonFraud Claim Months Calculate the amount of the nonfraud overissuance that occurred during the 3 years before the date the overissuance was discovered as long as the overissuance was established timely within the 3year time frame If the overissuance is not established timely the overissuance cannot be recouped Refer to 63454 for recoupment regulations and procedures Date of Discovery The date that the budget is computed showing that the overissuance actually occurred Date Claim Established The date the claim is established is the date adequate notice demand letter budget and repayment agreement is issued to the household A claim is established when the following happens The amount and reason for the overissuance is entered in case comments and A demand overissuance letter is issued to the customer The date the overissuance letter is mailed to the customer is the date the claim is considered to be established for tracking purposes 634524 Lomeli v Saenz Court Settlement The Lomeli v Saenz court settlement established that all new AE overissuances established on March 1 2000 and ongoing are to be recouped at a rate of five percent 5 or 10 whichever is greater The allotment reduction will be set up for a period of 36 consecutive calendar months starting with the month the actual collection begins After the 36month period the collection will be suspended and the remaining balance will be forgiven compromised County of San Diego Health and Human Services Agency HHSA CalFresh Program Guide NonFraud Claim Determination Number Page 63452 3 of 3 Lomeli v Saenz claims can still be collected after the case is discontinued the months would continue to count towards the 36month limit When the 36month limit expires the claim will be compromised When the 36month period of recoupment collection expires the system will automatically compromise the claim reducing the remaining balance to zero 000 634525 Determination of an Overissuance in CalWIN Refer to Processing Guide 45001 634526 NonSystem Determined Claims NSDC Refer to How To 536 How To Enter a NonSystem Determined Claim Other Program Impacts NA References ACL 1899 MPP 63801111 63801112 63801311b How To 536 in Eligibility Essentials Processing Guide 45001 Sunset Date This policy will be reviewed for continuance on or by 04302022 Approval for Release RICK WANNE Director Eligibility Operations