Fair Hearings - Administration Disqualification Hearings for Food Assistance

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Fair Hearings - Administration Disqualification Hearings for Food Assistance

Revised October 28, 2007

CLARIFYING INFORMATION

An Intentional Program Violation (IPV) of the Food Assistance program can be determined by a decision in an Administrative Disqualification Hearing or by a decision of the court in a criminal prosecution.

The department must decide whether to refer an IPV instance for prosecution or for an ADH; both procedures shall not be pursued at the same time. Upon completion of an ADH, the department may choose to then refer the case for prosecution.

Separate instances of suspected IPV could be combined into one complaint that totals $450 or more. See FRAUD.

The department must prove the IPV with "clear and convincing evidence". This means that the evidence must establish that it is highly probable the actions that resulted in the overpayment were intentional.

FHC RESPONSIBILITIES

Review the Disqualified Recipient System (DRS) to determine if the person suspected of an IPV has a record of past disqualifications.

Determine the appropriate penalty based on the record of past disqualifications, if any

Review the department records to identify evidence that will establish:

An overpayment or combination of overpayments exists which total over $450 (e.g. a copy of the overpayment letter with proof of service if already served, or a copy of the letter if the overpayment letter has not been served).

The respondent was aware of the reporting responsibilities.

There was a change in circumstances that affected eligibility (e.g. an employer report which establishes the date that work began)

The respondent had an opportunity to report the change, and failed to do so (e.g. a change of circumstance completed during the period of the overpayment)

The respondent provided false or misleading information (e.g. denied working at an eligibility review).

Ensure that all of the evidence to be proposed at the hearing is included. The ALJ may not be able to admit new evidence at the hearing that was not included in the listing of evidence on the complaint.

Complete the Disqualified Hearing Complaint, DSHS 12-119(x) or ACES letter 0055-02 (First or Second Occurrence), 0055-04 (Third Occurrence). Include a listing of the evidence that will be used at the hearing.

Send the complaint to the Office of Administrative Hearings and include a blank envelope (not window), which shows the CSO return address. OAH will schedule the hearing and send the notice to the respondent in the CSO envelope.

If the notice is unclaimed or otherwise undeliverable, it will be returned to the CSO. Determine whether delivery should be attempted again either by personal service or remailing of the certified mail.

If no further attempts at delivery will be made, notify OAH immediately that delivery has not been accomplished and the case should be removed from the docket.

Hold the case until it can be resubmitted to the OAH for scheduling.

Final Agency Decision
Review the final decision to determine whether you agree that the administrative law judge has applied the law correctly. If you agree, take appropriate action to implement the final decision. If you do not agree, request a reconsideration of the final order in accordance with WAC 388-02-0605 through WAC 388-02-0635.

Fair Hearings - Administration Disqualification Hearings for Food Assistance
Revised October 28, 2007

CLARIFYING INFORMATION An Intentional Program Violation (IPV) of the Food Assistance program can be determined by a decision in an Administrative Disqualification Hearing or by a decision of the court in a criminal prosecution. The department must decide whether to refer an IPV instance for prosecution or for an ADH; both procedures shall not be pursued at the same time. Upon completion of an ADH, the department may choose to then refer the case for prosecution. Separate instances of suspected IPV could be combined into one complaint that totals $450 or more. See FRAUD. The department must prove the IPV with "clear and convincing evidence". This means that the evidence must establish that it is highly probable the actions that resulted in the overpayment were intentional.
FHC RESPONSIBILITIES Review the Disqualified Recipient System (DRS) to determine if the person suspected of an IPV has a record of past disqualifications. Determine the appropriate penalty based on the record of past disqualifications, if any Review the department records to identify evidence that will establish: An overpayment or combination of overpayments exists which total over $450 (e.g. a copy of the overpayment letter with proof of service if already served, or a copy of the letter if the overpayment letter has not been served). The respondent was aware of the reporting responsibilities. There was a change in circumstances that affected eligibility (e.g. an employer report which establishes the date that work began) The respondent had an opportunity to report the change, and failed to do so (e.g. a change of circumstance completed during the period of the overpayment) The respondent provided false or misleading information (e.g. denied working at an eligibility review). Ensure that all of the evidence to be proposed at the hearing is included. The ALJ may not be able to admit new evidence at the hearing that was not included in the listing of evidence on the complaint. Complete the Disqualified Hearing Complaint, DSHS 12-119(x) or ACES letter 0055-02 (First or Second Occurrence), 0055-04 (Third Occurrence). Include a listing of the evidence that will be used at the hearing. Send the complaint to the Office of Administrative Hearings and include a blank envelope (not window), which shows the CSO return address. OAH will schedule the hearing and send the notice to the respondent in the CSO envelope. If the notice is unclaimed or otherwise undeliverable, it will be returned to the CSO. Determine whether delivery should be attempted again either by personal service or remailing of the certified mail. If no further attempts at delivery will be made, notify OAH immediately that delivery has not been accomplished and the case should be removed from the docket. Hold the case until it can be resubmitted to the OAH for scheduling.
Final Agency Decision Review the final decision to determine whether you agree that the administrative law judge has applied the law correctly. If you agree, take appropriate action to implement the final decision. If you do not agree, request a reconsideration of the final order in accordance with WAC 388-02-0605 through WAC 388-02-0635.

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