AB 1613, as amended, 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 servicesbegin delete programsend deletebegin insert end insertbegin insertfor which state grants-in-aid are made to countiesend insert 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 receivingbegin delete cash aid,end deletebegin insert CalWORKs benefits,end insert 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.begin insert
Existing law provides that no civil or criminal action may be commenced against a person based on alleged unlawful application for or receipt of public social services if the case record of the person has been destroyed after the required retention period.end insert
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.
end deleteThis bill would authorize the State Department of Social Services to establish a minimum cost-effectiveness threshold, as specified, for collecting an overpayment established under CalWORKs that is greater than $125, and would require counties to implement the new threshold if one is established by the department pursuant to these provisions. The bill would prohibit a county from establishing an overpayment if the costs of collecting the outstanding payments are expected to exceed the average amounts to be recovered by the county, or the amount of the overpayment is less than $125, or the minimum cost-effectiveness threshold, whichever is greater. The bill would prohibit a county from attempting to recover CalWORKs overpayments if an individual is no longer receiving CalWORKs benefits and the outstanding overpayments are less than $125, or the minimum cost-effectiveness threshold, whichever is greater. The bill would also prohibit a civil, administrative, or criminal action against a person based on alleged unlawful or erroneous application for or receipt of public social services if the case record of the person has been destroyed after the required retention period. By increasing the duties of county agencies, this bill would create a state-mandated local program.
end insertExisting 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:
begin insertSection 11004 of the end insertbegin insertWelfare and Institutions
2Codeend insertbegin insert is amended to read:end insert
begin insert(a)end insertbegin insert end insert The provisions of this code relative to public social
4services for which state grants-in-aid are made to the counties shall
5be administered fairly to the end that all persons who are eligible
6and apply for such public social services shall receive the assistance
7to which they are entitled promptly, with due consideration for the
8needs of applicants and the safeguarding of public funds.
9(a)
end delete
10begin insert(b)end insert Any applicant for, or recipient or payee of, such public social
11services shall be informed as to the provisions of eligibility and
12his or her responsibility for reporting facts material to a correct
13determination of eligibility and grant.
14(b)
end delete
15begin insert(end insertbegin insertc)end insert Any applicant for, or recipient or payee of, such public social
16services shall be responsible for reporting accurately and
17completely within his or her
competence those facts required of
18him or her pursuant to subdivisionbegin delete (a)end deletebegin insert
(b)end insert and to report promptly
19any changes in those facts.
20(c)
end delete
21begin insert(end insertbegin insertd)end insert begin insert(1)end insertbegin insert end insert Current and future grants payable to an assistance unit
22may be reduced because of prior overpayments. In cases where
23the overpayment was caused by agency error, grant payments shall
24be reduced by 5 percent of the maximum aid
payment of the
P4 1assistance unit. Grant payments to be adjusted because of prior
2overpayments because of any other reason shall be reduced by 10
3percent of the maximum aid payments for the assistance unit. A
4recipient may have an overpayment adjustment in excess of the
5amounts allowable under this section if the recipient requests it.
6(2) A county shall not establish an overpayment if at least one
7of the following conditions is met:
8(A) The costs of collecting the outstanding overpayments are
9expected to exceed the average amounts to be recovered by the
10county.
11(B) The amount of the overpayment is less than one hundred
12twenty-five dollars ($125) or the minimum cost-effectiveness
13threshold established by the department pursuant to subdivision
14(n), whichever is greater.
15(d)
end delete
16begin insert(end insertbegin inserte)end insert No determination of ineligibility shall be made
17retrospectively so as to result in an assessment of an overpayment
18in circumstances where there is a failure on
the part of an applicant
19or recipient to perform an act constituting a condition of eligibility,
20if the failure is caused by an error made by a state agency or a
21county welfare department, and if the amount of the grant received
22by the applicant or recipient would not have been different had
23the act been performed.
24(e)
end delete
25begin insert(end insertbegin insertf)end insert Prior to effectuating any reduction of current grants to recover
26past overpayments, the recipient shall be advised of the proposed
27reduction and of his or her entitlement to a hearing on the propriety
28of the reduction.
29(f)
end delete
30begin insert(end insertbegin insertg)end insert If the department determines after a hearing that an
31overpayment has occurred, the county providing the public social
32services shall seek to recover in accordance with subdivisionbegin delete (c)end delete
33begin insert (d)end insert the full amount of the overpayment to the assistance unit,
34including any amount paid while the hearing process was pending.
35begin delete Suchend deletebegin insert Thisend insert adjustment shall be permitted
concurrently with any
36suit for restitution, and recovery of overpayment by adjustment
37shall reduce by the amount ofbegin delete suchend deletebegin insert theend insert recovery the extent of
38liability for restitution.
39(g)
end delete
P5 1begin insert(end insertbegin inserth)end insert If the individual is no longer receiving aid under Chapter 2
2(commencing with Section 11200)begin insert,end insert
recovery of overpayments
3received under that chapter shall not be attempted where the
4outstanding overpayments are less thanbegin delete thirty-five dollars ($35). begin insert
one hundred twenty-five dollars ($125) or the minimum
5Whereend delete
6cost-effectiveness threshold established by the department pursuant
7to subdivision (n), whichever is greater. Ifend insert the overpayment
8amounts owedbegin delete are thirty-five dollars ($35) or more,end deletebegin insert exceed one
9hundred twenty-five dollars ($125) or the minimum
10cost-effectiveness threshold established by the department pursuant
11to subdivision (end insertbegin insertn), if that amount is greater,end insert reasonable
12cost-effective efforts at collection shall be implemented.
13Reasonable efforts shall include notification of the amount of the
14overpayment and that repayment is required. The department shall
15define reasonable cost-effective collection methods. In cases
16
involving fraud, every effort shall be made to collect the
17overpayments regardless of the amount.
18(h)
end delete
19begin insert(end insertbegin inserti)end insert If the individual responsible for the overpayment to the
20assistance unit is no longer eligible for public social services or if
21he or she becomes a member of another assistance unit, recoupment
22of overpayments shall be made against the individual or his or her
23present assistance unit, or both.
24(i)
end delete
25begin insert(end insertbegin insertj)end insert Where an overpayment has been made to an assistance unit
26begin delete whichend deletebegin insert thatend insert is no longer receiving public social services, recovery
27shall be made by appropriate action under state law against the
28income or resources of the individual responsible for the
29overpayment or against the family.
30(j)
end delete
31begin insert(end insertbegin insertk)end insert No civilbegin delete orend deletebegin insert, administrative, orend insert criminal action may be
32commenced against any person based on alleged unlawfulbegin insert
or
33erroneousend insert application for or receipt of public social services,begin delete whereend delete
34begin insert ifend insert the case record ofbegin delete suchend deletebegin insert thatend insert person has been destroyed after the
35expiration of thebegin delete four-yearend deletebegin insert three-yearend insert retention period pursuant to
36Section 10851.
37(k)
end delete
38begin insert(end insertbegin insertl)end insert begin insert(1)end insertbegin insert end insert When an underpayment or denial of public social service
39occurs and as a result the applicant or recipient does not receive
40the amount to which he or she is entitled, the county shall provide
P6 1public social services equal to the full amount of the underpayment
2unless prohibited by federal law. In cases that have both an
3underpayment and an overpayment, the underpayment shall be
4offset against the overpayment prior to correcting any remaining
5underpayment.
6 Any
end delete
7begin insert(2)end insertbegin insert end insertbegin insertAnyend insert corrective payments made pursuant to this subdivision
8shall be disregarded in determining the income of the family and
9shall be disregarded in determining the resources of the family in
10the month the corrective payment is made and in the following
11month.
12(l)
end delete
13begin insert(m)end insert This subdivision shall be
applicable only to applicants,
14recipients and payees under Chapter 2 (commencing with Section
1511200)begin delete of Part 3 of Division 9end delete. Any suits to recover overpayments
16described in subdivisionbegin delete (f)end deletebegin insert
(g)end insert shall be brought on behalf of the
17county by the county counsel unless the board of supervisors
18delegates such duty to the district attorney by ordinance or
19resolution.
20(n) The department may establish a minimum cost-effectiveness
21threshold consistent with Part 225 of Title 2 of the Code of Federal
22Regulations for collecting an overpayment established under
23Chapter 2 (commencing with Section 11200) that is greater than
24one hundred twenty-five dollars ($125). If the department
25establishes such a threshold, each county shall implement the new
26threshold.
No appropriation pursuant to Section 15200 of the
28Welfare and Institutions Code shall be made for purposes of this
29act.
If the Commission on State Mandates determines that
31this act contains costs mandated by the state, reimbursement to
32local agencies and school districts for those costs shall be made
33pursuant to Part 7 (commencing with Section 17500) of Division
344 of Title 2 of the Government Code.
Section 11004 of the Welfare and Institutions
36Code is amended to read:
(a) The provisions of this code relative to cash aid
38provided pursuant to Chapter 2 (commencing with Section 11200)
39shall be administered fairly to the end that all persons who are
40eligible and apply for
cash aid shall receive the assistance to which
P7 1they are entitled promptly, with due consideration for the needs
2of applicants and the safeguarding of public funds.
3(b) An applicant for, or recipient or payee of, cash aid provided
4pursuant to Chapter 2 (commencing with Section 11200)
shall be
5informed as to the provisions of eligibility and his or her
6responsibility for reporting facts material to a correct determination
7of eligibility and grant.
8(c) An applicant for, or recipient or payee of, cash aid provided
9pursuant to Chapter 2 (commencing with Section 11200) shall be
10responsible for reporting accurately and completely within his or
11her competence those facts required
of him or her pursuant to
12subdivision (b) and to report promptly any changes in those facts.
13(d) Current and future grants payable to an assistance unit may
14be reduced because of prior overpayments, unless the agency is
15prohibited from requiring the collection of, or establishing, the
16overpayment pursuant to subdivision (h) of this section or
17subdivision (b) of Section 11004.1.
In cases where the overpayment
18was caused by agency error,
and the amount to be recovered is
19greater than the minimum cost-effectiveness threshold established
20pursuant to subdivision (h) or if the recipient would not be able to
21claim an equitable estoppel defense, grant payments shall be
22reduced by 5 percent of the monthly payment of the assistance
23unit. Grant payments to be adjusted because of prior overpayments
24for any other reason shall be reduced by 10 percent of the
25maximum aid payments for the assistance unit. A recipient may
26have an overpayment adjustment in excess of the amounts
27allowable under this section if the
recipient requests it.
28(e) A determination of ineligibility shall not be made
29retrospectively so as to result in an assessment of an overpayment
30in circumstances when there is a failure on the part of an applicant
31or recipient to perform an act constituting a condition of eligibility,
32if the failure is caused by an error
made by a state agency or a
33county welfare department, and if the amount of the grant received
34by the applicant or recipient would not have been different had
35the act been performed.
36(f) Prior to effectuating any reduction of current grants to recover
37past overpayments, the recipient shall be advised of the proposed
38reduction and his or her entitlement to a hearing on the propriety
39of the reduction.
P8 1(g) If the department determines after a hearing that an
2overpayment has occurred, the county providing the
cash aid
3pursuant to Chapter 2 (commencing with Section 11200) shall
4seek to recover in accordance with subdivision
(d)
the full amount
5of the overpayment to the assistance unit, including any amount
6paid while the hearing process was pending. This adjustment shall
7be permitted concurrently with any suit for restitution, and recovery
8of overpayment by adjustment shall reduce by the amount of the
9recovery the extent of liability for restitution.
10(h) Regardless of whether the individual is currently receiving
11aid under Chapter 2 (commencing with Section 11200), recovery
12of overpayments received under that chapter shall not be attempted
13if the cost of collecting the outstanding overpayments are
expected
14to exceed the amount to be recovered by the county, unless
15otherwise required in this section. In all cases, reasonable
16cost-effective efforts at collection shall be implemented. The
17department shall define reasonable cost-effective collection
18methods, and may establish an annual minimum cost-effectiveness
19threshold for collecting overpayments of cash aid. In cases
20involving fraud, every effort shall be made to collect the
21overpayments regardless of the amount.
22(i) If the individual responsible for the overpayment to the
23assistance unit is no longer eligible for cash aid provided pursuant
24to Chapter 2 (commencing with Section 11200), or if he or she
25becomes a member of another assistance unit, recoupment of
26overpayments shall be made against the individual or his or her
27present assistance unit, or both.
28(j) When an overpayment has been made to an assistance unit
29that is no longer receiving cash aid provided pursuant to Chapter
302 (commencing with Section 11200), recovery shall be made by
31appropriate action under state law against the income or resources
32of the individual responsible for the overpayment or against the
33family.
34(k) No civil or criminal action may be commenced against any
35person based on alleged unlawful application for or receipt of
cash
36aid provided pursuant to Chapter 2 (commencing with Section
3711200), if the case record of that person has been destroyed after
38the expiration of the three-year retention period specified in Section
3910851.
P9 1(l) (1) When an underpayment or denial of cash aid provided
2pursuant to Chapter 2 (commencing with Section 11200) occurs
3and as a result the applicant or recipient does not receive the
4amount to which he or she is entitled, the county shall provide
5
cash aid equal to the full amount of the underpayment unless
6prohibited by federal law. In cases that have both an underpayment
7and an overpayment, the underpayment shall be offset against the
8overpayment prior to correcting any remaining underpayment.
9(2) Any corrective payments made pursuant to this subdivision
10shall be disregarded in determining the income of the family and
11shall be disregarded in determining the resources of the family in
12the month the corrective payment is made and in the following
13month.
14(m) This subdivision shall be applicable only to applicants,
15recipients and payees under Chapter 2 (commencing with Section
1611200). Any suits to recover overpayments described in subdivision
17
(g) shall be brought on behalf of the county by the county counsel
18unless the board of supervisors delegates this duty to the district
19attorney by ordinance or resolution.
No appropriation pursuant to Section 15200 of the
21Welfare and Institutions Code shall be made for purposes of this
22act.
If the Commission on State Mandates determines that
24this act contains costs mandated by the state, reimbursement to
25local agencies and school districts for those costs shall be made
26pursuant to Part 7 (commencing with Section 17500) of Division
274 of Title 2 of the Government Code.
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