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Title 7: SNAP Page 3 Iowa Department of Human Services Employees’ Manual Chapter J: Intentional Program Violation Administrative Disqualification Revised August 27, 2021 How to Refer a Case for an Administrative… How to Refer a Case for an Administrative Disqualification Legal reference: 7 CFR 273.16 To make a referral for an administrative disqualification hearing, complete form 470-3035, IPV Referral Cover Sheet, and obtain a supervisor’s signature. To refer more than one member of a household, send a separate form for each person. Email the IPV Referral Cover Sheet to the DHS Appeals Section at appeals@dhs.state.ia.us. The Appeals Section will set up the appeal record and notify staff once an appeal number has been assigned. Within two working days of receipt of the email stating the appeal file has been established, upload a copy of the IPV Referral Packet, along with copies of all supporting documentation, into the Appeals Information System (AIS). Once the supporting documentation is uploaded, the DHS Appeals Section will review and certify the referral to the Department of Inspections and Appeals so a hearing can be scheduled. When making the referral, make every effort to ensure you have the most recent, valid address for the person. When referring a person for more than one act (e.g., failure to report income or failure to report resources) during the same period, include referral information on all actions. (If the case is found guilty, only one disqualification period is established.) While additional information can later be submitted indicating further fraudulent behavior, only one disqualification period can be imposed for the same time period. Once a disqualification period is established, another disqualification period cannot be imposed for infractions that occurred before that period. This is true also if the household commits a second offense before the final decision being reached on the first offense. Although another disqualification period cannot be imposed, refer these cases for an IPV so the claim can be considered an IPV claim if appropriate.