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Introduction

Introduction. Front End Eligibility (FEE) targets active cases with immediate concerns i.e., dual assistance . FEE targets cases that meet certain error prone criteria or irregularities. Description.

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Introduction

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  1. Introduction • Front End Eligibility (FEE) targets active cases with immediate concernsi.e., dual assistance. • FEE targets cases that meet certain error prone criteria or irregularities.

  2. Description • OIG will investigate to substantiate or refute discrepancies and suspicions. This includes but is not limited to telephone contacts, home calls, collateral contacts, etc. • OIG’s objective is to complete Specialist’s referrals within 10 working days of receipt. For OIG data mining cases the SOP is 30 working days i.e., “Out of State” referrals. • Investigation will continue until resolved.

  3. Goals • Develop a partnership between the FIS/ES Staff and OIG Staff. • Reduce errors and mispayments. • Identify costs savings to all DHS Assistance programs. • Implement the program statewide in all assistance programs administered by DHS.

  4. Technology • Smartlinx was created to assist governmental agencies in accessing numerous public records and personal information through a single online transaction • ChoicePoint is an online web-based Data Broker informational system that provides Credit Information.

  5. Technology - Continued • ChoicePoint transactions will be conducted by OIG staff. • SmartLinx, a web based application that provides comprehensive reports on individuals, businesses, real estate, criminal history, tax information and much more.

  6. Team/Resources • County Directors, District Mgrs. & FIMs • Local office staff: Support and cooperation of County staff, who are responsible for processing DHS applications and recertification i.e., Specialist & SSPC East and West. • OIG Staff • Access database: Loaded on both OIG and local office staff computers for recording and tracking case actions and generating reports.

  7. Investigation Referral Process Referrer • Referrer (FIS/ES, FIMs & OIG) initiates the Front-End Eligibility Referral Process by completing “Application/Referral Information” (Sections I and II) via the FEE Database. • Referrer updates & completes “Action Taken” (Section IV) as a result of Investigation”.

  8. Investigation Referral Process Referrer • Referral Criteria • Customer’s expenses exceeds income • Questionable resources • Questionable identity • Cases with earned/unearned income • Contradictory or confusing information provided by the applicant. • Household Composition questioned.

  9. Investigation Referral Process Referrer • Work clothing that suggest possible employment. • Cases with sanctioned members. • Cases with shared/prorated shelter cost - utilities exceeds shelter cost, yet listed as included in shelter cost. • Cases identified as error prone or mutually agreed upon for inclusion in the project. • Questionable Residence.

  10. Investigation Referral Process Referrer • Prepares a referral packet consisting of Section I & II (printed from the database), copy of application and all suspect documentation or supporting documents (i.e., shelter forms, employment verifications, etc.) • Submits referral packet to OIG and DHS Management if requested.

  11. Investigation Referral Process FIM/OIG Mgr. • Review packet for completeness. • Forwards the referral packet with documentation to the OIG agent. • OIG agents will pick up referral packets each morning from their designated DHS District Office(s) or electronically via FEE database.

  12. Investigation Referral Process OIG AGENT • Receives assigned referral. • Run data broker transactions and evaluate data received from the transaction. • Follow up on leads identified via LexisNexis Smart Linx transaction and/or information provided by the specialist. • Verification process will include home and collateral calls, telephone calls, etc.

  13. Investigation Referral Process OIG AGENT • Completes the investigation within 10 or 30 work days. • Note: The investigation process does not allow for mail requests. Must notify referrer if the response will not meet the 10- 30 day standard of promptness. Referrer determines if an extension will be allowed or act on information available. • Prepares a written report of the investigation. • Submits a copy of the completed Investigation Report (Section III) to the Specialist and/or FIM.

  14. Investigation Referral Process OIG AGENT • Retains a copy of the FEE Referral (Section I & II) in pending file. (Await final action from FIS/ES). • Follow up with Specialist/Referrer on outstanding Section IV (Action Taken) dispositions or completes Bridges queries to affirm accuracy of case determination completed by Specialist and completes Section IV.

  15. Investigation Referral Process Referrer • Receives OIG response via Section III, Investigative Findings Form. • Determines appropriate action within SOP; wait a specified period for reply to DHS Notices or base decision on information available. • Determines appropriate action to be taken based on OIG’s findings in Section IV by issuing full benefits, reduced, or deny benefits.

  16. Investigation Referral Process Referrer • FEE database automatically calculates group program cost avoidance by subtracting benefits issued from the estimated full benefits identified on the Average SNAP & FIP Benefits chart. • Cost Savings for programs other than SNAP & FIP must be is estimated manually. • Forwards a Signed & Dated Section IV identifying their response to the OIG agent. • Make a request for full investigation through the recoupment specialist in accordance with normal operating procedures, if warranted.

  17. Average SNAP Benefit $$$$Use this table to calculate program savings if, in fact an application is denied or modified based upon FEE

  18. Average FIP Benefit $$$$$Use this table to calculate program savings if, in fact an application is denied or modified based upon FEE

  19. Investigation Referral Process OIG AGENT • Receives response from Specialist. • Reviews to ensure the disposition has been entered on the database & a Closed Date is listed. • Notifies OIG Manager of case completion. • Files disposition in investigation file.

  20. Investigation Referral Process OIG MANAGER • Receives investigation file with disposition. • Reviews disposition to determine if the Agent/Referrer recommended an OIG Full Investigation. If so the investigation will continue to determine prior & on-going fraud. • Generate reports as needed. • SOP reports, follow up with agent to make sure FIS/ES is notified if 10-30 day SOP will not be met.

  21. Investigation Referral Process OIG MANAGER • Monitors the SOP on responses from FIS/ES on dispositions (action taken as a result of OIG’s findings). • Monitors OIG Agent’s 10- 30 day SOP (OIG SOP Pending/Overdue Rpt.) • Cost avoidance reports, savings based on the amount of assistance the applicant(s) would have received had benefits been approved or not issued at a reduced rate. • MonitorsAgent caseloads, for future assignments.

  22. Oakland County’s 2011 FEE Stats • District #2 Madison Heights generated 730 referrals, cost savings $990,872.88. • District #3 Walled Lake generated 243 referrals, cost savings $170,615.04. • District #4 Saginaw Street generated 211 referrals, cost savings $65,399.36 • Oakland saved a Grand Total of $1,226,887.28 • Statewide Total 30.6 Million $$$$$$

  23. Question & Answer Session

  24. Thank you For joining the Front End Eligibility Presentation We look forward to working with you.

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