AB 1613, as introduced, Stone. CalWORKs: benefits overpayment.
Existing law establishes various social services programs that provide cash assistance and other benefits to qualified low-income families and individuals, including the California Work Opportunity and Responsibility to Kids (CalWORKs) program. Existing law requires applicants for, and recipients of, public social services programs to accurately report facts material to eligibility and grant payment determinations. Existing law authorizes current and future grants payable to an assistance unit to be reduced because of prior overpayments, and requires grant payments to be reduced by 5% of the maximum aid payment when the overpayment was caused by agency error. Existing law prohibits a county from attempting, if an individual is no longer receiving cash aid, to recover overpayments when the outstanding overpayments are less than $35, and requires reasonable cost-effective efforts at collection to be implemented if the overpayment amounts owed are $35 or more. Under existing law, however, a county is prohibited from establishing a CalWORKs overpayment based on any differences between the amount of income the county prospectively determined for the recipient and the income the recipient actually received, if the recipient’s report was complete and accurate.
This bill would specify that these overpayment provisions apply only to grants of CalWORKs cash aid. The bill would instead require grant payments to be reduced by 5% of the monthly payment in cases where the overpayment was caused by agency error and the amount to be collected is greater than an established minimum cost-effectiveness threshold or if the recipient would not be able to claim an equitable estoppel defense. The bill would prohibit the attempt to recover overpayment if the costs of collecting the outstanding overpayments are expected to exceed the amount to be recovered by the county. The bill would require reasonable cost-effective efforts to be implemented in all cases of recovering overpayments and authorizes the State Department of Social Services to establish an annual minimum cost-effectiveness threshold for collecting overpayments of cash aid. By increasing the duties of county agencies, this bill would create a state-mandated local program.
Existing law continuously appropriates moneys from the General Fund to defray a portion of county costs under the CalWORKs program.
This bill would instead provide that the continuous appropriation would not be made for purposes of implementing the bill.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to these statutory provisions.
Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: yes.
The people of the State of California do enact as follows:
Section 11004 of the Welfare and Institutions
2Code is amended to read:
begin insert(a)end insertbegin insert end insert The provisions of this code relative tobegin delete public social begin insert cash
4services for which state grants-in-aid are made to the countiesend delete
5aid provided pursuant to Chapter 2 (commencing with Section
611200)end insert shall be administered fairly to the end that all persons who
7are eligible and apply forbegin delete such public social servicesend deletebegin insert
cash aidend insert shall
8receive the assistance to which they are entitled promptly, with
P3 1due consideration for the needs of applicants and the safeguarding
2of public funds.
3(a) Any
end delete
4begin insert(b)end insertbegin insert end insertbegin insertAn end insertapplicant for, or recipient or payee of,begin delete such public social begin insert cash aid provided pursuant to Chapter 2 (commencing
5servicesend delete
6with Section 11200)end insert
shall be informed as to the provisions of
7eligibility and his or her responsibility for reporting facts material
8to a correct determination of eligibility and grant.
9(b) Any
end delete
10begin insert(c)end insertbegin insert end insertbegin insertAn end insertapplicant for, or recipient or payee of,begin delete such public social begin insert cash aid provided pursuant to Chapter 2 (commencing
11servicesend delete
12with Section 11200)end insert shall be responsible for reporting accurately
13and completely within his or her competence those facts required
14
of him or her pursuant to subdivisionbegin delete (a)end deletebegin insert (b)end insert and to report promptly
15any changes in those facts.
16(c)
end delete
17begin insert(d)end insert Current and future grants payable to an assistance unit may
18be reduced because of prior overpaymentsbegin insert, unless the agency is
19prohibited from requiring the collection of, or establishing, the
20overpayment pursuant to subdivision (h) of this section or
21subdivision (b) of Section 11004.1end insert.
In cases where the overpayment
22was caused by agency error,begin insert
and the amount to be recovered is
23greater than the minimum cost-effectiveness threshold established
24pursuant to subdivision (h) or if the recipient would not be able
25to claim an equitable estoppel defense,end insert grant payments shall be
26reduced by 5 percent of thebegin delete maximum aidend deletebegin insert monthlyend insert payment of the
27assistance unit. Grant payments to be adjusted because of prior
28overpaymentsbegin delete because ofend deletebegin insert forend insert any other reason shall be reduced by
2910 percent of the maximum aid payments for the assistance unit.
30A recipient may have an overpayment adjustment in excess of the
31amounts allowable under this section if the
recipient requests it.
32(d) No
end delete
33begin insert(e)end insertbegin insert end insertbegin insertA end insertdetermination of ineligibility shallbegin insert notend insert be made
34retrospectively so as to result in an assessment of an overpayment
35in circumstancesbegin delete whereend deletebegin insert whenend insert there is a failure on the part of an
36applicant or recipient to perform an act constituting a condition of
37eligibility, if the failure is caused by an error
made by a state
38agency or a county welfare department, and if the amount of the
39grant received by the applicant or recipient would not have been
40different had the act been performed.
P4 1(e)
end delete
2begin insert(f)end insert Prior to effectuating any reduction of current grants to recover
3past overpayments, the recipient shall be advised of the proposed
4reduction andbegin delete ofend delete his or her entitlement to a hearing on the propriety
5of the reduction.
6(f)
end delete
7begin insert(g)end insert If the department determines after a hearing that an
8overpayment has occurred, the county providing thebegin delete public social begin insert
cash aid pursuant to Chapter 2 (commencing with Section
9servicesend delete
1011200)end insert shall seek to recover in accordance with subdivisionbegin delete (c)end delete
11begin insert
(d)end insert
the full amount of the overpayment to the assistance unit,
12including any amount paid while the hearing process was pending.
13begin delete Suchend deletebegin insert Thisend insert adjustment shall be permitted concurrently with any
14suit for restitution, and recovery of overpayment by adjustment
15shall reduce by the amount ofbegin delete suchend deletebegin insert theend insert recovery the extent of
16liability for restitution.
17(g) If
end delete
18begin insert(h)end insertbegin insert end insertbegin insertRegardless of whether end insertthe individual isbegin delete no longerend deletebegin insert currentlyend insert
19 receiving aid under Chapter 2 (commencing with Section 11200)begin insert,end insert
20 recovery of overpayments received under that chapter shall not be
21attemptedbegin delete where theend deletebegin insert if the cost of collecting theend insert outstanding
22overpayments arebegin delete less than thirty-five dollars ($35). Where the
23overpayment amounts owed are thirty-five dollars ($35) or more,end delete
24begin insert
expected to exceed the amount to be recovered by the county,
25unless otherwise required in this section. In all cases,end insert reasonable
26cost-effective efforts at collection shall be implemented.
27begin delete Reasonable efforts shall include notification of the amount of the The department shall
28overpayment and that repayment is required.end delete
29define reasonable cost-effective collectionbegin delete methods.end deletebegin insert methods, and
30may establish an annual minimum costend insertbegin insert-effectiveness threshold for
31collecting overpayments of cash aid.end insert In cases involving fraud,
32every effort shall be made to collect the overpayments regardless
33of the amount.
34(h)
end delete
35begin insert(i)end insert If the individual responsible for the overpayment to the
36assistance unit is no longer eligible forbegin delete public social servicesend deletebegin insert cash
37aid provided pursuant to Chapter 2 (commencing with Section
3811200),end insert or if he or she becomes a member of another assistance
39unit, recoupment of overpayments shall be made against the
40individual or his or her present assistance unit, or both.
P5 1(i) Where
end delete
2begin insert(j)end insertbegin insert end insertbegin insertWhenend insert an overpayment has been made to an assistance unit
3begin delete whichend deletebegin insert thatend insert is no longer receivingbegin delete public social services,end deletebegin insert cash aid
4provided pursuant to Chapter 2 (commencing with Section 11200),end insert
5 recovery shall be made by appropriate action under state law
6against the income or resources of the individual responsible for
7the overpayment or against the family.
8(j)
end delete
9begin insert(k)end insert No civil or criminal action may be commenced against any
10person based on alleged unlawful application for or receipt of
11begin delete public social services, whereend deletebegin insert
cash aid provided pursuant to Chapter
122 (commencing with Section 11200), ifend insert the case record ofbegin delete suchend deletebegin insert thatend insert
13 person has been destroyed after the expiration of thebegin delete four-yearend delete
14begin insert three-yearend insert retention periodbegin delete pursuant toend deletebegin insert specified inend insert Section 10851.
15(k)
end delete
16begin insert(l)end insertbegin insert end insertbegin insert(1)end insert When an underpayment or denial ofbegin delete public social serviceend delete
17begin insert cash aid provided pursuant to Chapter 2 (commencing with Section
1811200)end insert occurs and as a result the applicant or recipient does not
19receive the amount to which he or she is entitled, the county shall
20providebegin delete public social servicesend deletebegin insert
cash aidend insert equal to the full amount of
21the underpayment unless prohibited by federal law. In cases that
22have both an underpayment and an overpayment, the underpayment
23shall be offset against the overpayment prior to correcting any
24remaining underpayment.
25Any
end delete
26begin insert(2)end insertbegin insert end insertbegin insertAnyend insert corrective payments made pursuant to this subdivision
27shall be disregarded in determining the income of the family and
28shall be disregarded in determining the resources of the family in
29the month the corrective payment is made and in the following
30month.
31(l)
end delete
32begin insert(m)end insert This subdivision shall be applicable only to applicants,
33recipients and payees under Chapter 2 (commencing with Section
3411200)begin delete of Part 3 of Division 9end delete. Any suits to recover overpayments
35described in subdivisionbegin delete (f)end deletebegin insert
(g)end insert shall be brought on behalf of the
36county by the county counsel unless the board of supervisors
37delegatesbegin delete suchend deletebegin insert thisend insert duty to the district attorney by ordinance or
38resolution.
No appropriation pursuant to Section 15200 of the
2Welfare and Institutions Code shall be made for purposes of this
3act.
If the Commission on State Mandates determines that
5this act contains costs mandated by the state, reimbursement to
6local agencies and school districts for those costs shall be made
7pursuant to Part 7 (commencing with Section 17500) of Division
84 of Title 2 of the Government Code.
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