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Home My WebLink AboutMINUTES - 11062007 - C.98 sE t TO: BOARD OF SUPERVISORS i —_ ; Contra FROM: INTERNAL OPERATIONS COMMITTEE Costa DATE: OCTOBER 15, 2007 Cj o u n t STA coox'�' y SUBJECT: INFORMATIONAL REPORT ON WELFARE FRAUD INVESTIGATION AND PROSECUTION SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION RECOMMENDATIONS: 1. ACCEPT report prepared jointly by the Employment and Human Services Director and the District Attorney regarding investigation and prosecution of public assistance fraud cases. 2. ACKNOWLEDGE that the County has an established process for recouping public assistance overpayments, typically through a reduction in future benefit payments. 3. REQUEST the departments to provide an update report to the Internal Operations Committee in August 2008 or at such time that fiscal year 2007/08 statistics are available. BACKGROUND: In September 2006,the Employment and Human Services (EHS) Department updated the Internal Operations Committee (IOC) on its efforts to improve internal security and loss prevention activities. The IOC had requested the department to report back in nine months on any tools and procedures that have been developed and implemented to detect changes in income eligibility for welfare benefits. CONTINUED ON ATTACHMENT: YES SIGNATURE: 00, �91,0, RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMEN AT ON OF BOARD COMMITTEE APPROVE OTHER qINI , SIGNATURE(S): SUSAN A. OBOLLf'6AC HAIR GAY UILKEMA ACTION OF BOARD ON APPROVE AS RECOMMENDE O VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT COPY OF AN ACTION TAKEN UNANIMOUS(ABSENT ,�'jC/ ) AND ENTERED ON THE MINUTES OF THE BOARD OF SUPERVISORS ON THE DATE AYES: NOES: SHOWN. ABSENT: ABSTAIN: ATTESTED: NOVEMBER 6,2007 CONTACT: JULIE ENEA(925)335-1077 JOHN CULLEN,CLERK OF THE BOARD OF SUPERVISORS AND COUNTY ADMINISTRATOR CC: INTERNAL OPERATIONS COMMITTEE STAFF DISTRICT ATTORNEY EMPLOYMENT AND HUMAN SERVICES DIRECTOR COUNTY ADMINISTRATOR(ENEA AND SANSOE) BY UTY Welfare Fraud Referral, Investigation, and Prosecution October 15, 2007 Board of Supervisors Page 2 Last May, EHS Director Joe Valentine made a report to the IOC describing what policies, procedures, and practices are employed by the Department to ensure that public benefits are provided only to those who continue to meet income eligibility requirements. The IOC accepted that report but asked the Director to compile data with the District Attorney to demonstrate the County's follow-through of reports of welfare fraud. Our Committee, on October 15, received the attached report prepared jointly by the EHS Director and the District Attorney describing the processes for welfare fraud referrals, follow-up, investigation, and prosecution, and illustrating the results of the program through statistical reports for 2005/06, 2006/07, and the first quarter of 2007/08. Our committee is recommending a follow-up report once full-year data becomes available for 2007/08. EMPLOYMENT AND HUMAN SERVICES CONTRA COSTA COUNTY DATE: October 15, 2007 TO: Internal Operations Committee of the Board of Supervisors FROM: Joe Valentine, Director, Employ and uman Services Robert Kochly,District Attorney 'Si e�- SUBJECT: Report on Welfare Fraud Investigations &Pr BACKGROUND In May 2007, the Internal Operations Committee (IOC) of the Board of Supervisors requested statistical evidence from the Employment and Human Services Department (EHSD) Director and the District Attorney (DA) demonstrating follow-through of investigations and prosecutions of public assistance fraud cases. This report is in response to that request and will provide a brief statement on the fraud detection, referral and investigative processes as well as statistical summaries for fiscal years 2005/2006, 2006/2007 and first quarter 2007/2008. EHSD WELFARE FRAUD INVESTIGATION PROCEDURES Citizens can report suspected public assistance fraud by calling any one of the following numbers: • California Department of Social Services Fraud Hotline: 1-800-344-8477 • Contra Costa County District Attorney's Office: (925) 646-2335 • EHSD fraud reporting line: (925) 313-1546 The above phone numbers are published on websites, in various publications and posted in EHSD Offices. All complaints are forwarded to the EHSD Fraud Prevention Manager for review and appropriate action. The EHSD Fraud Manger forwards complaints to the Eligibility Workers (EW) for their review and potential Early Fraud Investigation referrals. All requests for investigations are initiated by EWs via the EHSD Early Fraud Intranet referral system. Referrals are reviewed by the Fraud Manager and assigned to EHSD Fraud Investigators for investigation. Completed investigations are reviewed by the Fraud Maieger and returned to the EWs for appropriate actions. Actions taken by the EWs on cases where fraud is found include: • Case Denials • Case Discontinuances • Benefits Reduced • Referral for Overpayment Computation and Collection Completed investigations by EHSD Early Fraud that identify potential long term fraud are referred to the DA's Office for further investigation. D.A.'s PUBLIC ASSISTANCE FRAUD INVESTIGATION/PROSECUTION PROCEDURES The investigative staff in the District Attorney's Office for public assistance fraud investigations currently consists of • One full time investigator • One half time investigator for In Home Supportive Services (IHSS) • One half time supervisor The majority of referrals to the DA Public Assistance Fraud Investigative Unit are from EHSD. The investigative unit supervisor and the EHSD fraud manager meet on a regular basis to discuss and prioritize the case referrals. The cases selected for investigation are prioritized based on a number of factors to include the amount of the suspected loss or fraud,number of suspects involved,the scheme involved,whether the suspect has been previously reported as being involved in fraud, etc. The cases are then either assigned to the half time investigator for IHSS cases or the full time investigator for all other types of cases. Once the D.A.investigator has completed the investigation the report will be submitted to the investigative supervisor for review. If the investigation reveals that fraud was committed and there is sufficient evidence to support the allegation of fraud the case will be referred to the deputy district attorney(DDA) assigned to public assistance fraud for review. The DDA has several options which include: • Filing criminal charges • Declining to file charges • Returning the case to the investigator for additional investigation in order to make a subsequent filing decision The DDA also receives cases to review for criminal prosecution directly from the EHSD investigative units. The criminal charges that are filed in public assistance fraud cases have included: • 10980 Welfare&Institutions Code—Unlawfully Obtaining Public Aid;Unlawful Possession or Use of Food Stamps • 487 Penal Code—Grand Theft(for IHSS cases) • 118 Penal Code—Perjury Depending upon the nature of the case, suspects who have been criminally charged may either be sent a notice to appear in court or have a warrant issued for their arrest. Defendants who have been convicted on recent cases have received sentences involving: • jail time ranging from several days to 6 months (not all defendants received a jail sentence) • probation—generally 3 years • volunteer work—40 to 240 hours • restitution and fines • work programs STATISTICAL REPORTS Statistical Reports for fiscal years 2005/2006, 2006/2007, and first quarter 2007/2008 are attached for the following groups: • Early Fraud Investigations • Overpayments Investigations Unit • District Attorney Public Assistance Fraud Investigations The statistics used in these reports were extracted from the California State Department of Public Assistance (DPA) Form 266, Fraud Investigation Activity Reports which are submitted to the California State Fraud Bureau on a monthly basis. STATISTICAL OUTCOMES First Quarter 2007/2008 JULY 1, 2007 - SEPTEMBER 30, 2007 EARLY FRAUD INVESTIGATIONS (EFI) REFERRALS CASH FOOD STAMPS Investigation Referrals Received 168 174 Investigations Completed 176 179 Fraud Found 133 137 Fraud Not Found 43 42 INVESTIGATION RESULTS Denials 9 27 Discontinuances 25 29 Benefits Reduced 2 6 Allegation Unfounded 13 25 OVERPAYMENTS INVESTIGATIONS UNIT CASH FOOD STAMPS Overpayment Computation Referrals Received 40 76 Number of Overpayments Established 22 53 Dollar Amount of Overpayments $47,324 $62,544 Cases Referred for Prosecution 3 4 DISTRICT ATTORNEY PUBLIC ASISTANCE FRAUD INVESTIGATIONS IN-HOME SUPPORTIVE INVESTIGATIONS CASH FOOD STAMPS SERVICES Referrals Accepted 4 4 42 for Investigation Investigations 4 4 11 Completed PROSECUTIONS Cases Filed for Prosecution 3 3 7 Convictions 0 0 1 STATISTICAL OUTCOMES FOR FISCAL YEAR JULY 1, 2006 - JUNE 30, 2007 EARLY FRAUD INVESTIGATIONS (EFI) REFERRALS CASH FOOD STAMPS Investigation Referrals Received 800 814 Investigations Completed 786 803 Fraud Found 552 562 Fraud Not Found 234 241 INVESTIGATION RESULTS Denials 78 110 Discontinuances 63 61 Benefits Reduced 4 14 OVERPAYMENTS INVESTIGATIONS UNIT CASH FOOD STAMPS Overpayment Computation Referrals Received 198 449 Number of Overpayments Established 119 305 Dollar Amount of Overpayments $230,957 $259,866 Cases Referred for Prosecution 6 6 DISTRICT ATTORNEY PUBLIC ASSISTANCE FRAUD INVESTIGATIONS IN-HOME SUPPORTIVE INVESTIGATIONS CASH FOOD STAMPS SERVICES Referrals Accepted 22 25 62 for Investigation Investigations 15 15 41 Completed PROSECUTIONS Cases Filed for Prosecution 3 3 4 Convictions 6 6 7 STATISTICAL OUTCOMES FOR FISCAL YEAR JULY 1, 2005 - JUNE 30, 2006 EARLY FRAUD INVESTIGATIONS (EFI) REFERRALS CASH FOOD STAMPS Investigation Referrals Received 680 767 Investigations Completed 665 761 Fraud Found 463 534 Fraud Not Found 205 227 INVESTIGATION RESULTS Denials 106 87 Discontinuances 33 92 Benefits Reduced 2 4 OVERPAYMENTS INVESTIGATIONS-UNIT CASH FOOD STAMPS Overpayment Computation Referrals Received 391 662 Number of Overpayments Established 187 305 Dollar Amount of Overpayments $324,211 $285,584 Cases Referred for Prosecution 13 12 DISTRICT ATTORNEY PUBLIC ASSISTANCE FRAUD INVESTIGATIONS IN-HOME SUPPORTIVE INVESTIGATIONS CASH FOOD STAMPS SERVICES Referrals Accepted 21 22 54 for Investigation Investigations 17 17 14 Completed PROSECUTIONS Cases Filed for Prosecution 11 11 5 Convictions 16 14 0