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.1 General Criteria
.11 The CWD shall take all reasonable steps necessary to promptly correct any overpayment or underpayment of transportation, ancillary, and diaper supportive services payments to a recipient or a service provider including, but not limited to, all cases involving fraud and abuse, consistent with these regulations.
.12 Diaper supportive service is subject to underpayment no earlier than April 1, 2018.
.2 Overpayment Identification
.21 When the county has determined that an overpayment exists, the county shall calculate the amount of the overpayment and determine the appropriate method of recovery.
.22 Counties shall be allowed to use recovery methods as specified in Section 42-751.4(e) concurrently.
.221 The methods that result in the maximum recovery without interfering with program participation shall be used.
NONLINKING FACTORS OF PUBLIC ASSISTANCE ELIGIBILITY
.3 Adjustment Amounts
.31 When an underpayment or denial of supportive services occurs and as a result the applicant or recipient does not receive the amount to which he or she should have received, the CWD shall pay the applicant/recipient the balance or provide supportive services equal to the full amount of the underpayment.
.4 Collection of Overpayments
(a) If the individual is no longer receiving aid under CalWORKs, recovery of nonfraudulent overpayments will not be attempted where the outstanding overpayments is less than two hundred and fifty dollars ($250). For closed cases with an overpayment claim amount totaling $250 or more, the county will follow the current procedures as outlined in Section 44352.4 for recovering the overpayment. If the overpayment is being repaid in installments, the county shall cease collection efforts once the balance of the outstanding overpayment falls under $250, or the county's approved higher threshold amount per Section 44-350.161. Reasonable cost-effective efforts at collection shall be implemented where the nonfraudulent overpayment amounts owed are $250 or more (see Section 44-350.161).
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NONLINKING FACTORS OF PUBLIC ASSISTANCE ELIGIBILITY
(b) If the overpayment is the result of fraud, the CWD shall attempt to recover the overpayment regardless of the amount.
(c) Initial Recovery Procedures and Establishing Repayment Agreements
(1) The county shall initiate recovery within 30 calendar days of the date the overpayment is first discovered by notifying the individual in writing that he/she has an overpayment and that he/she must contact the county within ten calendar days of the date the notice is mailed to arrange repayment.
(A) If the participant does not respond to the overpayment notice within ten calendar days of the date of the initial notice is mailed or the participant does respond to the initial notice, but fails or refuses to enter into a repayment agreement, the county shall use the payment adjustment method of recovery as specified in Section 42-751.4(g) unless:
1. The county determines that the deferred repayment provisions of Section 42-751.4(d) apply.
(B) The overpayment notice shall include:
1. The name of the overpaid person;
2. The amount owed;
3. The reason for the claim;
4. The period of time that the claim covers;
5. A statement regarding the right of the participant to a State hearing if the participant disagrees with any aspect of the claim;
6. The reasons repayment may be deferred as specified in Section 42751.4(d);
7. A statement that recovery will occur as specified in Section 42751.4(c)(1)(A) if the individual fails to respond within ten calendar days.
(C) The county shall attempt to obtain a signed repayment agreement from the overpaid individual subject to the recovery methods specified in Section 42751.4(e) and provide a copy of the agreement to the overpaid individual.
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NONLINKING FACTORS OF PUBLIC ASSISTANCE ELIGIBILITY
(d) Overpayment Collection Deferrals
(1) The collection and recovery of any overpayment shall be deferred if it is not cost effective to pursue the collection. The CWD shall defer collection and recovery of any overpayment if the collection would result in disruption of child care arrangements, preclude participation in welfare-to-work activities, or prevent employment.
(2) The CWD shall: (1) notify the participant of the deferral and when a decision to defer overpayment collection is made; (2) reevaluate the need for deferring repayment when necessary; (3) document the expected ending date of the deferred repayment status.
(e) Reasonable efforts shall include written notification of the amount of the overpayment and that repayment is required. The following are reasonable cost-effective collection methods:
(1) Balancing.
When an individual has both an overpayment and an underpayment, the CWD may offset one against the other, subject to the provisions specified in Section 42751.4(g).
(2) Voluntary Cash Recovery.
The CWD shall accept any voluntary cash payment from an individual to pay any portion of an existing overpayment.
(3) Grant Adjustment.
The individual shall be permitted to have supportive services overpayments adjusted from the CalWORKs grant when the individual is receiving CalWORKs, provided:
(A) The individual chooses this method of recovery; and
(B) The individual agrees with the amount of the CalWORKs grant adjustment.
(SAR) (4) Recoupment by grant adjustment shall be conducted in accordance with Section 44352.41(SAR).
(f) Individuals shall be allowed to revoke a repayment agreement incorporating grant adjustment at any time and enter into a new repayment agreement with the CWD.
NONLINKING FACTORS OF PUBLIC ASSISTANCE ELIGIBILITY
(g) Supportive Services Payment Adjustment
(1) The following payment adjustment provisions shall be applicable only to current welfare-to-work participants.
(A) The maximum recovery from the current payment(s) shall be as follows:
1. Ten percent of the total payment, for recipient-caused overpayments, unless the individual volunteers to pay a higher percentage.
2. Five percent of the total payment for overpayments resulting from administrative error, unless the individual volunteers to pay a higher percentage.
(B) When recovery is made in full from a subsequent supportive services payment, the participant shall be informed in writing.
(C) When the current payment adjustment is not enough to recover the entire overpayment or no claim is received in a given month, then the remaining amount of the overpayment shall be applied to succeeding month(s), and the adjustment process shall be repeated as specified above.
(D) When any adjustment is made, the CWD shall notify the participant in writing.
(E) When no subsequent payment(s) are available for an adjustment to be made, because the individual becomes exempt and does not volunteer to participate or loses eligibility for CalWORKs the CWD shall attempt to establish or obtain a new repayment agreement.
(F) The CWD shall notify the participant in writing when a reduction is made to adjust current supportive services.
(h) If the individual responsible for the overpayment to the assistance unit is no longer eligible for CalWORKs, or if he or she becomes a member of another assistance unit:
(1) Recoupment of overpayments will be made against the individual or his or her present assistance unit, or both.
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NONLINKING FACTORS OF PUBLIC ASSISTANCE ELIGIBILITY
(i) Where an overpayment has been made to an assistance unit which is no longer receiving CalWORKs, recovery will be made by appropriate action under state law against the income or resources of the individual responsible for the overpayment or against the members of the former assistance unit.
(j) Recovery of Overpayments.
(1) Any suits to recover overpayments from CalWORKs applicants, recipients and payees will be brought on behalf of the county by the county counsel unless the board of supervisors delegates such duty to the district attorney by ordinance or resolution.
NOTE: Authority cited: Sections 10553, 10554, and 10604, Welfare and Institutions Code and Senate Bill 726 (Chapter 930, Statutes of 2018). Reference: Sections 11004(g), (h), (i), (k), and (l), 11265.2, 11323.2, and 11323.4(b), Welfare and Institutions Code.