County of San Diego Health and Human Services Agency HHSA CalFresh Program Guide Recoupment of Claims Number Page 63454 1 of 5 Revision Date 07102019 Background This section describes recoupment procedures for CalFresh overissuances Revisions have been made to reflect the change of policy that increases the claims establishment threshold for closed CalFresh cases Purpose This section details recoupment procedures for OI Policy 634541 NonFraud Error Claim Recoupment Notices Send the following notices to initiate a claim Overissuance Notice and Repayment Agreement and Budget computation notice Refer to Processing Guide 45401 for a list of the required NOAs OI Notices must explain the following The amount of benefits the household received The amount of benefits the household should have received The time period of the claim The specific cause of the overissuance The amount required to be repaid How the household or its sponsor may pay the claim The households or the sponsors right to a state hearing If the household or the sponsor disagrees with the amount of the claim the household has 90 days to request a fair hearing Repayment agreement notices must provide the household with the option to pay the claim by Lump Sum Payment either by cash or by paying from the EBT account or Benefit Reduction allotment reduction or Installments either paying monthly cash payments or by paying from the EBT account Budget computation notices must provide the household with Accurate budget information allowing customers to review the OI and determine if the OI was calculated correctly The budget notice will include the amount of earned andor unearned income household size and the allowed deductions 634542 NonFraud Error Claims Recoupment Procedures for Active Cases Households currently receiving CalFresh may choose to repay AE or IHE claims by benefit reduction lump sum payment or installment payments County of San Diego Health and Human Services Agency HHSA CalFresh Program Guide Recoupment of Claims Number Page 63454 2 of 5 Households choosing to repay By a lump sum payment may request to pay by cash check or money order or by a deduction from their CalFresh benefits EBT account In installments may request to pay by monthly cash check or money order payments or by recoupment from their monthly CalFresh benefits By benefit reduction allotment reduction will have their benefits reduced at the following rate o 5 or 10 whichever is greater for AE claims o 10 or 10 whichever is greater for IHE claims Households who fail to send back the repayment agreement notices within 30 days will have their claims reduced by benefit reduction Refer to Processing Guide 45001 for recoupment procedures for active cases 634543 Intentional Program Violation IPV Recoupment Procedures for Active Cases Recoupment by benefit reduction will be made at a rate of 20 or 20 whichever is greater Refer to CalFresh Processing Guide 45001 Timely notice is not required to reduce the households benefit due to an IPV disqualification Refer to 6330313 634544 Recoupment Regulations Initiate AE or IHE overissuance recoupment at the beginning of a payment period with timely notice Recoupment can stop midperiod when the overissuance has been completely recouped When a recoupment of one overissuance is completed recoupment of the next overissuance can begin midperiod if the recoupment does not result in a decrease in benefits Refer to 632851 632854 and 6328710 Customers can repay a claim by deducting CalFresh benefits from the EBT account at any time even if the claim is currently being recouped or the case has been discontinued To begin recoupment from the EBT account the responsible household member must complete and sign the 16102 HHSA form Authorization for Benefit Collection from EBT Account Refer to 634551 634545 Recoupment of Multiple Claims by Benefit Reduction Collection will be made on one active claim at a time Other pending claims will remain in Open status until the active claim is recouped in full Administrative error AE claims established under Lomeli will not be collected with any other type of claims at the same time through benefit reduction ACIN I12400 If a claim is being recouped and a new AE claim is established the new AE claim cannot be collected until the recoupment of the other claim is completed The 36month limit for the new AE claim would begin with the first month of benefit reduction ACL 0087 634546 Recoupment of Claims from Separate Households Claims may be recouped from separate households at the same time for the same claim from multiple adult members who received an overissuance as one household but moved to separate CalFresh households if each household includes an adult member of the household who received County of San Diego Health and Human Services Agency HHSA CalFresh Program Guide Recoupment of Claims Number Page 63454 3 of 5 the overissuance However the amount recouped from all households may not exceed the total overissuance Offset the amount of an IHE or IPV claim against an underissuance ACIN I5808 The ORR cannot request a tax intercept to pay a claim while the claim is being recouped by benefit reduction in an active CalFresh case EXAMPLE A CalFresh case includes a mother and adult son the mother was the head of household An overissuance occurred as a result of the mother failing to report the sons earnings The son left the household and the claim is being recouped by benefit reduction Question Can the county intercept the sons taxes while a benefitt reduction is being made to the mothers CalFresh case Answer No Although all adult household members are jointly and individually liable for the value of any overissuance the county cannot request a tax intercept at the same time when a benefit reduction is currently being used to collect the overissuance amount ACIN I1605 634547 Benefit Offset Offset the amount of IHE and IPV claims against any underissuance amount that has not been restored An underissuance cannot be offset against an AE overissuance The California Department of Social Services and California counties are permanently instructed by court order in Lopez v Glickman from applying the offset of AE error claims 634548 Installments and Lump Sum Payment Regulations Customers may choose to pay the OI by Lump sum payments check or money order Customers will not be required to liquidate resources to make a lump sum payment Partial payments can be paid on the claim Cash check or money order in monthly installments Installments paid by the customer must be equal to the amount which could be recovered through benefit reduction This amount will remain unchanged regardless of subsequent changes in the households monthly benefit Closed cases Customers or sponsors that fail to make the payments will be notified by ORR that no payment was received The customer may contact ORR and o Continue to pay the OI using the current payment schedule o Requests renegotiation of the payment schedule 634549 Postponement of IHE Recoupment Postpone recoupment action of IHE claims in cases where an overissuance is referred for possible legal prosecution or for administrative disqualification and the county determines that recoupment action will prejudice the case County of San Diego Health and Human Services Agency HHSA CalFresh Program Guide Recoupment of Claims Number Page 63454 4 of 5 6345410 IHE and AE Recoupment Procedures for Noncitizen Households with Sponsors Any noncitizens sponsor and the sponsored noncitizen will be held jointly and individually liable for repayment of any overissuance of CalFresh benefits that results from incorrect information provided by the sponsor Determine whether the incorrect information was provided due to error on the part of the noncitizen or the noncitizens sponsor prior to initiating recoupment action against the sponsored noncitizen household Establish a claim against the sponsor and the sponsored noncitizens household or establish the claim against the party most likely to repay first Establish a claim against the household if a claim was established against the sponsor and the sponsor failed to respond within 30 days of receipt of the notice of action requesting repayment The noncitizen household will be solely liable for repayment of an overissuance when it has been determined that the sponsor has good cause or was not at fault for providing incorrect information that resulted in the overissuance A sponsor will be determined without fault or to have good cause for when meeting all reporting responsibilities but when the noncitizen has failed to do so Initiate recoupment against the noncitizen household and the sponsor for all IHE claims unless one of the following conditions apply The sponsor did not have good cause or was at fault as specified above and The household or the sponsor cannot be located A sponsor will not be held at fault for an AE claim NOTE Return to the sponsor andor the household any amounts repaid in excess of the total amount of the claim 6345411 Collection Procedures for Closed Cases Effective June 1 2019 the CalFresh claims establishment threshold will be 40000 for closed CalFresh cases with an OI caused by an AE or IHE Previously the claims establishment threshold on closed cases was 12500 or less for an AE and 3500 or less for an IHE The new threshold does not apply to OIs arising from IPV or Quality Control QC reviews Any claim established on or after June 1 2019 on a closed case with an OI caused by an AE or IHE will be collected using the new threshold of 40000 This applies regardless of whether the OI itself occurred before June 1 2019 Any claim established before June 1 2019 on a closed case with an OI caused by an AE or IHE will not be affected by this policy change When a CalFresh case is discontinued with an outstanding claim balance a transaction is sent to Office of Revenue and Recovery ORR An account will be established and collection will be initiated on all overissuances over 400 Refer to Processing Guide 45401 for steps to take on OI for closed cases County of San Diego Health and Human Services Agency HHSA CalFresh Program Guide Recoupment of Claims Number Page 63454 5 of 5 6345412 Cases Reopened with Outstanding Claims Balances Refer to Processing Guide 45401 Procedure Refer to CalFresh Processing Guide 45401 BENDS 51484 Increasing CalFresh AE and IHE OI Threshold Eligibility Essentials CalFresh Program Impacts Automation BENDS 51484 Increasing CalFresh AE and IHE OI Threshold References ACL 1950 BENDS 51484 Increasing CalFresh AE and IHE OI Threshold Eligibility Essentials CalFresh ACL 1899 ACL No 1595 ACL 1379 ACL 1379E ACIN 13314 MPP 63801 Sunset Date This policy will be reviewed for continuance by 07312022 Approval for Release RICK WANNE Director Eligibility Operations