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FOOD AND NUTRITION SERVICES CERTIFICATION CLAIMS ____________________________________________________________________________________

5 Section 800 Change #1-2017 April 1, 2017

c. Establish an AE claim if information reported to Food and Nutrition Services was not acted upon promptly and/or correctly. Follow rules in the Food and Nutrition Services Certification Manual regarding reporting requirements and how the caseworker must respond to the information.

d. Do not establish a claim if the recipient was not required to report the change, the income was excluded, or the income could not have been anticipated, unless it was reported to Food and Nutrition Services and required to be acted on according to FNS Manual Section 400.03.

2. Review the evidence for proof of an intent to commit a violation.

a. A false statement or withheld information at application or review must be present for an IPV claim. Document proof of intent in the file.

b. Reporting change(s) that increase benefits, but failing to report required change(s) that decrease benefits, may demonstrate fraudulent intent.

c. Additional evidence of fraudulent intent may include falsified documents or information withheld for more than one application or review.

d. Consider a claim to be an IHE and not an IPV if the local agency records contain evidence of a mental or physical condition that may significantly impair the client’s ability to understand and follow program rules or to communicate clearly and/or accurately with the local agency. Consideration should be given to an individual’s possible limited English proficiency and possible illiteracy when determining if the debtor knowingly and willfully intended to commit fraud.

e. Establish an IHE claim when the overissuance is not an Agency Error or Intentional Program Violation by the client or representative.

f. Factors to evaluate in determining whether there was fraudulent intent include prior reporting history, other incidents of dishonesty by the individual in dealing with the local agency, the length of the period of overissuance, and evidence of reasonable efforts by the individual to contact the local agency and report the information.

F. Collection of AE and IHE claims:

1. Enter the claim information in EPICS to generate the letter of overissuance. Use the Maintain Client screen in EPICS to add an address when EPICS address fields are blank. Use your best available information.

2. EPICS automatically begins recoupment procedures for active households unless debtor(s) are blocked. Debtors are blocked from recoupment if an X is placed in the FS Appeal Indicator on the Debtor Detail screen.

3. Upon establishment of a claim, negotiate a Voluntary Repayment Agreement with the debtor(s). Use DSS-8604 to document the agreement if the DSS-8554, Letter of Overissuance was not returned and accepted. Enter the repayment