1 DHS Office of Inspector General

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

3 Description l OIG will investigate to substantiate or refute discrepancies and suspicions. This includes but is not limited to telephone contacts, home calls, collateral contacts, etc. l 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. l Investigation will continue until resolved.

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

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

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

7 Team/Resources l County Directors, District Mgrs. & FIMs l 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. l OIG Staff l Access database: Loaded on both OIG and local office staff computers for recording and tracking case actions and generating reports.

8 Investigation Referral Process l 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. l Referrer updates & completes “Action Taken” (Section IV) as a result of Investigation”. Referrer

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

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

11 Investigation Referral Process l l 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.) l l Submits referral packet to OIG and DHS Management if requested. Referrer

12 Investigation Referral Process l Review packet for completeness. l 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. FIM/OIG Mgr.

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

14 Investigation Referral Process l 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 day standard of promptness. Referrer determines if an extension will be allowed or act on information available. l Prepares a written report of the investigation. l Submits a copy of the completed Investigation Report (Section III) to the Specialist and/or FIM. OIG AGENT

15 Investigation Referral Process – OIG AGENT l l Retains a copy of the FEE Referral (Section I & II) in pending file. (Await final action from FIS/ES). l l 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.

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

17 Investigation Referral Process l 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. l Cost Savings for programs other than SNAP & FIP must be is estimated manually. l Forwards a Signed & Dated Section IV identifying their response to the OIG agent. l Make a request for full investigation through the recoupment specialist in accordance with normal operating procedures, if warranted. Referrer

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

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

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

21 Investigation Referral Process l Receives investigation file with disposition. l 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. l Generate reports as needed. – SOP reports, follow up with agent to make sure FIS/ES is notified if day SOP will not be met. OIG MANAGER

22 Investigation Referral Process – Monitors the SOP on responses from FIS/ES on dispositions (action taken as a result of OIG’s findings). – Monitors OIG Agent’s 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. – Monitors Agent caseloads, for future assignments. OIG MANAGER

Oakland County’s 2011 FEE Stats n District #2 Madison Heights generated 730 referrals, cost savings $990, n District #3 Walled Lake generated 243 referrals, cost savings $170, n District #4 Saginaw Street generated 211 referrals, cost savings $65, n Oakland saved a Grand Total of $1,226, n Statewide Total 30.6 Million $$$$$$ 23

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