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 services for which state grants-in-aid are made to counties 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 or 10% of the maximum aid payment when the overpayment was for any other reason. Existing law prohibits a county from attempting, if an individual is no longer receiving CalWORKs benefits, 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. 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.
This 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 require current and future grant payments be reduced by 5% of the monthly payment when the overpayment is because of agency error or 10% of the monthly payment when the overpayment was for any other reason. 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.begin insert The bill would require the department to issue an all-county letter or similar instructions by April 1, 2015, and to adopt regulations to implement the provisions of the bill by July 1, 2016.end insert 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:
(a) 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(b) Any applicant for, or recipient or payee of, such public social
10services shall be informed as to the provisions of eligibility and
11his or her responsibility for reporting facts material to a correct
12determination of eligibility and grant.
13(c) Any applicant for, or recipient or payee of, such public social
14services shall be responsible for reporting accurately and
15completely within his or her competence those facts required of
16him or her pursuant to subdivision (b) and to report promptly any
17changes in those facts.
18(d) (1) Current and future grants payable to an assistance unit
19may be reduced because of prior overpayments. In cases where
20the overpayment was caused by agency error, grant payments shall
21be reduced by 5 percent of the monthly payment of the assistance
22unit. Grant payments to be adjusted because of prior overpayments
23because of any other reason shall be reduced by 10 percent of the
24monthly payment for the assistance unit. A recipient may have an
25overpayment adjustment in
excess of the amounts allowable under
26this section if the recipient requests it.
27(2) A county shall not establish an overpayment if at least one
28of the following conditions is met:
P4 1(A) The costs of collecting the outstanding overpayments are
2expected to exceed the average amounts to be recovered by the
3county.
4(B) The amount of the overpayment is less than one hundred
5twenty-five dollars ($125) or the minimum cost-effectiveness
6threshold established by the department pursuant to subdivision
7(n), whichever is greater.
8(e) No determination of ineligibility shall be made
9retrospectively so as to result in an assessment of an overpayment
10in circumstances
where there is a failure on the part of an applicant
11or recipient to perform an act constituting a condition of eligibility,
12if the failure is caused by an error made by a state agency or a
13county welfare department, and if the amount of the grant received
14by the applicant or recipient would not have been different had
15the act been performed.
16(f) Prior to effectuating any reduction of current grants to recover
17past overpayments, the recipient shall be advised of the proposed
18reduction and of his or her entitlement to a hearing on the propriety
19of the reduction.
20(g) If the department determines after a hearing that an
21overpayment has occurred, the county providing the public social
22services shall seek to recover in accordance with subdivision (d)
23the full amount of the overpayment
to the assistance unit, including
24any amount paid while the hearing process was pending. This
25adjustment shall be permitted concurrently with any suit for
26restitution, and recovery of overpayment by adjustment shall reduce
27by the amount of the recovery the extent of liability for restitution.
28(h) If the individual is no longer receiving aid under Chapter 2
29(commencing with Section 11200), recovery of overpayments
30received under that chapter shall not be attempted where the
31outstanding overpayments are less than one hundred twenty-five
32dollars ($125) or the minimum cost-effectiveness threshold
33established by the department pursuant to subdivision (n),
34whichever is greater. If the overpayment amounts owed exceed
35one hundred twenty-five dollars ($125) or the minimum
36cost-effectiveness threshold established by the department pursuant
37to
subdivision (n), if that amount is greater, reasonable
38cost-effective efforts at collection shall be implemented.
39Reasonable efforts shall include notification of the amount of the
40overpayment and that repayment is required. The department shall
P5 1define reasonable cost-effective collection methods. In cases
2
involving fraud, every effort shall be made to collect the
3overpayments regardless of the amount.
4(i) If the individual responsible for the overpayment to the
5assistance unit is no longer eligible for public social services or if
6he or she becomes a member of another assistance unit, recoupment
7of overpayments shall be made against the individual or his or her
8present assistance unit, or both.
9(j) Where an overpayment has been made to an assistance unit
10that is no longer receiving public social services, recovery shall
11be made by appropriate action under state law against the income
12or resources of the individual responsible for the overpayment or
13against the family.
14(k) No civil, administrative, or
criminal action may be
15commenced against any person based on alleged unlawful or
16erroneous application for or receipt of public social services, if the
17case record of that person has been destroyed after the expiration
18of the three-year retention period pursuant to Section 10851.
19(l) (1) When an underpayment or denial of public social service
20occurs and as a result the applicant or recipient does not receive
21the amount to which he or she is entitled, the county shall provide
22public social services equal to the full amount of the underpayment
23unless prohibited by federal law. In cases that have both an
24underpayment and an overpayment, the underpayment shall be
25offset against the overpayment prior to correcting any remaining
26underpayment.
27(2) Any corrective
payments made pursuant to this subdivision
28shall be disregarded in determining the income of the family and
29shall be disregarded in determining the resources of the family in
30the month the corrective payment is made and in the following
31month.
32(m) This subdivision shall be applicable only to applicants,
33recipients, and payees under Chapter 2 (commencing with Section
3411200). Any suits to recover overpayments described in subdivision
35(g) shall be brought on behalf of the county by the county counsel
36unless the board of supervisors delegates such duty to the district
37attorney by ordinance or resolution.
38(n) The department may establish a minimum cost-effectiveness
39threshold consistent with Part 225 of Title 2 of the Code of Federal
40Regulations for collecting an overpayment
established under
P6 1Chapter 2 (commencing with Section 11200) that is greater than
2one hundred twenty-five dollars ($125). If the department
3establishes such a threshold, each county shall implement the new
4threshold.
(a) Notwithstanding the Administrative Procedure
6Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of
7Division 3 of Title 2 of the Government Code), the State
8Department of Social Services shall implement this act through
9an all-county letter or similar instructions from the director no
10later than April 1, 2015.
11(b) The department shall adopt regulations as necessary to
12implement this act no later than July 1, 2016.
No appropriation pursuant to Section 15200 of the
15Welfare and Institutions Code shall be made for purposes of this
16act.
If the Commission on State Mandates determines that
19this act contains costs mandated by the state, reimbursement to
20local agencies and school districts for those costs shall be made
21pursuant to Part 7 (commencing with Section 17500) of Division
224 of Title 2 of the Government Code.
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