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Page | 294 The most common suspected program violations occur because someone in the household:

1. Made false statements, either orally or in writing, to obtain benefits the household is not entitled to. 2. Concealed information to obtain more benefits than entitled to. 3. Altered Dakota EBT cards to obtain benefits the household is not entitled to. 4. Trafficked benefits for cash or non-food items.

Determinations on whether the overpayment was intentionally caused should be based on sound judgment and an evaluation of all the circumstances involved in each individual case. Factors that should be considered include:

1. Whether or not the household has a past history of failure to report changes in its status, after having been instructed to do so.

2. Whether the change involved was a change in circumstances since the date of certification or the last renewal or whether it was information that was withheld at the time of certification or renewal.

3. Whether there had been any other contacts with the household wherein there had been an opportunity to report the change.

4. Whether at the time of certification there was evidence of a pending change in status which the household was instructed to report and which it failed to report.

5. The relative importance of the type of change or information not reported by the household.

6. Whether or not the case file indicates that the Specialist's interviewing techniques were sufficiently thorough to leave no doubt that any information not obtained was intentionally withheld (verified by signed DSS-EA-301).

When questionable information is identified regarding unreported income, unreported household members, or other potentially inaccurate information, the Benefits Specialist must document in the case narrative that the case will be reviewed for a Suspected Program Violation (SPV). The narrative should be clear, concise, and straightforward.

The Supervisor must review all SPV referrals prior to signing off and sending to ORFI. If the Benefits Specialist misapplied policy, or the facts to do not support fraud, the supervisor will re- review the circumstances and take necessary action. No overpayment calculation for SPVs will be initiated until a determination of Intentional Program Violation (IPV) has been made.

Narratives Examples:  Unreported Income. Referring to ORFI as a potential SPV.  Unreported HH member (e.g. spouse, parent of child, or another mandatory HH member) with income that may exceed limit. Referring to ORFI as a potential SPV.  Questionable Information: Referral to ORFI as potential SPV