5101:1-1-36 Income and eligibility verification system (IEVS) program.

(A) Section 1137 of the Social Security Act (5/2006) mandates that state agencies administering federally funded public assistance programs develop and implement an income and eligibility verification system (IEVS). In Ohio, IEVS contains income and benefit information from the following sources:

(1) The Ohio department of job and family services (ODJFS), office of unemployment compensation, bureau of program services; and

(2) The social security administration (SSA).

(B) Under the IEVS program, the match data will be furnished to the county agency. The county agency will have a forty-five day to one hundred twenty day processing time frame to receive the match data, to compare the match information to the information in the assistance group (AG) record, to obtain verification when applicable, to determine eligibility, and to initiate appropriate corrective action. The county agency shall take action to review and process the information immediately upon receipt.

(C) Integration of IEVS into the client registry information system-enhanced (CRIS-E) system

(1) All IEVS functions of ODJFS are provided through CRIS-E. The IEVS CRIS-E alert processing instruction guide located at http://innerweb.odjfs.state.oh.us/ofs/BPI/00FCfc.shtml provides the procedure for the processing of match data reviews.

(2) The regular matching of social security numbers of assistance group members is reflected through the IEVS system, which consists of the following three CRIS-E components:

(a) Data exchange;

(b) Compliance tracking; and

(c) Reporting.

(D) Specific sources of IEVS matches

Under the IEVS system, ODJFS will regularly match social security numbers of applicants and AG members with data from the following source agencies:

(1) ODJFS - wage records.

(a) The ODJFS, unemployment compensation bureau of program services acts as the state's wage information collection agency (SWICA). Section 4141.20 of the Revised Code requires employers to report quarterly earnings of all employees by the last day of the month following the end of each calendar quarter. ODJFS will match all Ohio works first (OWF) and food assistance applicants and AG members against the SWICA files on a quarterly basis. Matches shall be displayed to the county agency as soon as they are received.

(b) The county agency shall treat information received from this source as a lead to possible employment. Verification of earnings must be obtained from the employer or AG member before benefits may be affected.

(2) ODJFS -unemployment compensation records.

(a) ODJFS will compare all OWF and food assistance applicants and AG members against the ODJFS files on a weekly basis. Matches shall be displayed in CRIS-E to the county agency as soon as they are received.

(b) Information received from this source should be considered verified unless the client statement and/or case record fails to support the accuracy of the information.

(3) SSA benefit earnings exchange record (BEER).

(a) SSA obtains wage records from employers on an annual basis. Twice a month ODJFS transmits a request through the SSA's BEER for all new OWF and food assistance applicants and AG members. This data is included in the master file at that agency. Whenever information is added to the master file, it is matched against all other data in the file. The SSA processes the BEER request twice a month and returns the matched file information to ODJFS for review.

(b) The BEER match includes out of state and federal employers. The federal wage records match includes employers who do not report to SWICA. Matches from this source will be displayed in CRIS-E to the county agency as soon as they are received and are to be considered as a lead that the county agency shall verify before benefits may be affected.

(c) Employment information received from this source is considered as a lead towards possible current employment. Data verification shall be obtained before the county agency may initiate any adjustment to the AG case.

(4) Retirement survivors disability insurance (RSDI) and supplemental security income (SSI) benefits

(a) SSA provides information on social security (SS) and SSI benefits of individual public assistance participants. The ODJFS state verification and exchange system (SVES) provides electronic interface with the SSA. The interface allows the transfer of SS and SSI benefit information from the SSA.

(b) Beneficiary and SSI entitlement information is considered verified. Dual entitlement information should be verified when, or if, the AG record does not support the accuracy of the information.

(E) Processing time frames

(1) Federal regulations require the county agency to process IEVS matches in forty-five days.

(2) A county agency may only exceed the forty-five day time period on up to twenty per cent of its reviews, provided that the reason for the delay is due to nonreceipt of verifications, and provided that the review is completed by the next case action. During the forty-five and one hundred twenty day periods, the county agency shall review the AG record, contact the AG, obtain verification when necessary, determine eligibility and make appropriate case adjustments.

(3) Once the county agency completes the IEVS match process, the results will be recorded in CRIS-E history.

(4) When the county agency determines that an IEVS match displayed is for an AG whose case record is now active in another county and/or is delinquent, the county agency shall refer to the CRIS-E transfer procedure.

(F) IEVS priority levels

(1) County agencies are assigned IEVS match information in the CRIS-E system with one of two priority levels: high or low . These priority levels are based upon ODJFS determined error prone factors.

High priority matches shall be reviewed and completed by county agencies within forty-five days.

(2) Low priority matches are issued to county agency for informational purposes only. These matches are available for a minimum of one hundred eighty days. The county agency will not be required to follow-up or report the results of these reviews. Low priority alerts will be systematically inactivated every one-hundred eighty to two hundred days.

(G) IEVS safeguarding requirements and disclosure of match information

(1) Match information which contains federal tax data must be protected from disclosure to unauthorized persons. Federal tax information (FTI) remains tax information even after it has been verified. The determining factor is the source of the information.

(a) If the source is the social security administration or some other federal agency authorized to release FTI, this information is tax information.

(b) If the source is the individual involved, an authorized representative of the individual or entity, or a third party (from their records), the information is not considered tax information.

(2) If the individual, or payer institution, verifies by writing the information on a separate document, the information is not tax information. Therefore, it is possible to have two documents with the same information and, depending on the source of the information, one document shall require safeguarding while the other shall not.

(3) Computer screen printouts or copies of letters mailed or received regarding FTI shall be safeguarded and are subject to the prescribed record retention schedule and safeguarding procedures as outlined in rules 5101:9-9-21 and 5101:9-9-25 of the Administrative Code.

(4) SSA federal tax information can be commingled within the AG case record, but the AG case record must then be safeguarded in its entirety, clearly labeled to indicate that SSA FTI is included.

(5) FTI must be logged and tracked so that the location of the FTI is known at all times.

(6) The IEVS match information may be disclosed only under the following circumstances:

(a) Any IEVS match information may be given to the AG member who is the subject of the information;

(b) An assistance group member may be given social security administration (SSA) information about other members in the same assistance group if the information is needed in connection with determining eligibility for benefits. A JFS 07341 "Applicant/Recipient Authorization for Release of Information" (rev. 4/2004) form shall be signed by the individual for whom the information is requested. When there is a request to review the AG case file, a member of the AG or its currently authorized representative may have access to the information provided by the release. However, the county agency may withhold confidential information, such as the names of individuals who have disclosed information about the AG without the AG's knowledge, or the nature or status of pending criminal prosecutions;

(c) An AG member may be given tax return information if the individual is the taxpayer to whom the information relates;

(d) Tax return information may be given to the taxpayer's duly-appointed representative who has the explicit authority to obtain the tax return information if the disclosure is necessary to verify eligibility for benefits, including past benefits, and such disclosure may be made only when there is no other means of verifying the unearned income information. A signed JFS 07341 shall also be required from the taxpayer; and

(e) IEVS match information may be given to another state or local agency or official who needs the information for the purpose of determining eligibility or investigating alleged or suspected fraud or abuse for the programs as delineated in rule 5101:1-1-03 of the Administrative Code. This includes court officials, prosecutors, and investigators.

(H) Records of disclosure of IEVS match information

(1) ODJFS and the county agency shall keep a record of any disclosure of IEVS information, including IEVS match information, to any person or agency who is not an employee of ODJFS or the county agency. The record of the disclosure must be retained for five years or the active life of the application, whichever is longer.

(2) The eligibility determiner must note in the AG record any disclosure to any person (other than the AG member), agency, or official who is not an employee of a county agency or ODJFS. The county agency must record all such disclosures in its central file of IEVS information disclosures. The record of disclosure must contain a description of the information disclosed, the date of the disclosure, the identity of the persons or agencies to whom the information was disclosed, and the purpose of the disclosure.

(3) The county agency should refer to rule 5101:9-9-21 of the Administrative Code for closed IEVS documentation procedure.

(I) Required county agency action.

(1) Upon receipt of an IEVS match, the county agency shall:

(a) Refer to the IEVS CRIS-E alert processing instruction guide.

(b) Regard the match information (unless SSA beneficiary and SSI entitlement or unemployment compensation) as a lead indicating the possible receipt of income to an AG member, not as verification.

(c) Determine if the IEVS information is consistent with the information already provided by the AG. When the AG case record does not have information which resolves the IEVS match, the county agency may contact the AG.

(2) When a county agency contacts an AG for verification of income, the county agency shall give the AG ten calendar days to submit verification. The request for verification shall also state that if the AG fails to provide the information and/or contact the county agency, assistance may be terminated. At the end of the time period, if there has been no contact by the AG or if there has been a refusal to provide verification, prior notice shall be sent proposing termination because the county agency is unable to determine continued eligibility. Since the information from the IEVS match does not coincide with the information from the AG case record, the county agency shall verify the match information. It is the responsibility of the AG to provide the information necessary to determine eligibility and to clarify any incomplete, inconsistent, or contradictory information received.

(3) If the AG agrees to cooperate in providing the requested information but is unable to provide the information, the county agency shall obtain a JFS 07341 to forward to the third party who may have the information , such as an employer.

(4) Any adverse action resulting from information produced by a matching program shall be processed in accordance with Chapter 5101:6 of the Administrative Code.

(5) When the review of the IEVS match results in a determination that the benefit amounts issued were incorrect and should be increased or decreased accordingly, the county agency shall initiate at least one of the following:

(a) Ineligibility-terminate benefits or deny application;

(b) Overpayment-recover the overpayment; or

(c) Underpayment-issue the underpayment.

(6) When the review of the IEVS match results in the discovery of previously unknown employment, the county agency shall secure appropriate third-party resource forms.

(J) The IEVS match investigation

The county agency shall investigate the IEVS match using the following guidelines:

(1) The county agency shall not deny, delay, or discontinue benefits while waiting for information when other evidence establishes the AG's eligibility;

(2) The primary task of the IEVS match review is to check previous and current eligibility. The review also attempts to find and recover all overpayments whether they are AG error or agency error;

(3) The eligibility determiner's purpose in the IEVS match is to discover the facts of the AG's situation during the match period and to decide whether the AG received the correct amount of benefits; and

(4) Fraud investigation is an activity for the county agency benefit recovery unit and the county prosecuting attorney.

(K) IEVS reviews

ODJFS monitors the county agency IEVS activities by reviewing selected cases for timeliness, accuracy of the processing of alerts, and the safeguarding of IEVS information. Reviews are scheduled in each county agency a minimum of every three years.

Effective: 03/01/2013
R.C. 119.032 review dates: 11/28/2012 and 03/01/2018
Promulgated Under: 119.03
Statutory Authority: 5101.02 , 5107.05
Rule Amplifies: 5107.05
Prior Effective Dates: 1/1/83, 12/1/86, 3/13/87 (Emer.), 5/4/87, 9/1/89 (Emer.), 11/30/89, 1/1/90 (Emer.), 4/1/90, 1/1/93, 9/1/94, 11/1/96, 7/1/98, 7/1/99, 7/1/00, 11/1/02 , 12/6/07