348.7 Front end detection system (FEDS)
(a) Each social services district must take actions to ensure the
integrity of the public assistance (PA) caseload and the correctness of PA eligibility
determinations and establish procedures to identify and refer for investigation potential
cases of fraud, misrepresentation or questionable documentation prior to determining
applicants' eligibility for PA.
(b) The procedures established by each district must not delay the
determination of eligibility for PA or the provision of emergency assistance beyond the
timeframes established in this Title.
(c) Each social services district must submit a plan to the department
for approval, describing the procedures required by subdivision (a) of this section, in
such form and at such times as the department may require. The plan must include, but need
not be limited to:
(1) a description of the circumstances under
which referral to the FEDS investigative unit will be made.
(i) The referral
indicators must include the following circumstances:
(a) where the applicant states that the household's financial obligations are current
without a reasonable explanation of how the applicant met those obligations;
(b) where the applicant states that the ability to meet the household's expenses in the
past was the result of receiving income which was not declared to the appropriate tax
authorities;
(c) where the applicant states that the ability to meet the household's expenses in the
past was the result of loans or gifts received from family or friends;
(d) where the application contains information about the applicant which is inconsistent
with prior case information maintained by the district; and
(e) where the applicant has a history of previous denials of applications for assistance,
case closings, or overpayments or recoupments which resulted from investigations by a
social services district.
(ii) The referral
indicators also may include specific circumstances relating to the income/resources,
residence and identity of the applicant as follows:
(a) where the applicant is self-employed but does not have adequate business records to
support assertions about the applicant's finances made in the application;
(b) where the applicant has no documentation to verify his or her identity or the
documentation of identity provided is questionable;
(c) where the applicant is an alien, has no documentation to substantiate his or her
immigration status or the documentation of immigration status is questionable;
(d) where the applicant provides documentation or information which is inconsistent with
the information contained in the application, such as when a different name is used for a
signature or when an invalid social security number is used;
(e) where a post office box is used as a mailing address without a reasonable explanation;
(f) where the applicant's landlord does not verify the household's composition or provides
information inconsistent with the information contained in the application;
(g) where the applicant is the primary tenant but has no utility bills in his or her name;
(h) where the application states that there are children in the household under the age of
six and no birth certificates for the children are provided;
(i) where the applicant provides no information concerning an absent parent or the
information provided is inconsistent with information contained in the application; or
(j) where the applicant is unsure of his or her own address.
(2) procedures to be used by income maintenance
eligibility determination personnel and the FEDS investigators for receiving, monitoring
and investigating referrals;
(3) timeframes within which the FEDS
investigative unit must report the results of its investigation to the eligibility
determination personnel; and
(4) a designation of the social services
district's contact person responsible for FEDS and for the submission of FEDS reports
requested by the Department from time to time.