Chapter 5101:4-8 Restoration of Lost Benefits; Claims Against Households

5101:4-8-03 Food assistance: restoration and entitlement of lost benefits.

(A) What is restoration of food assistance benefits?

Restoration of benefits is when an assistance group is issued benefits because they have been determined eligible, and additional benefits are due to them because an incorrect amount was issued.

(B) Who is eligible for a restoration of benefits?

Assistance groups who:

(1) Have lost benefits due an agency error.

(2) Were determined to have committed an intentional program violation that has been reversed.

(a) An individual would not be entitled to restoration of lost benefits for the period of disqualification based solely on the fact that a criminal conviction could not be obtained, unless the individual successfully challenged the disqualification period imposed by an administrative disqualification in a separate court action. Participation in an administrative disqualification hearing in which the assistance group contests the county agency assertion of intentional program violation shall be considered notification that the assistance group is requesting restored benefits.

(b) For each month the individual was disqualified, not to exceed twelve months prior to county agency notification, the amount to be restored, if any, shall be determined by comparing the allotment the assistance group received with the allotment the assistance group would have received had the disqualified member been allowed to participate. If the assistance group received a smaller allotment than it should have received, the difference equals the amount to be restored.

(3) Receive a judicial action determining benefits were wrongfully withheld. When the assistance group's situation has been reviewed and determined through the judicial process that the benefits have been wrongfully withheld, the county agency shall restore the assistance group's benefits. If the judicial action is the first action the recipient has taken to obtain restoration of lost benefits, the benefits shall be restored for a period of no more than twelve months from the date the court action was initiated. When the judicial action is a review of a county agency action, the benefits shall be restored for a period of no more than twelve months from the first of the following dates.

(a) The date the county agency receives a request for restoration; or

(b) If no request for restoration is received, the date the fair hearing action was initiated; but never more than one year from when the county agency is notified of, or discovers, the loss.

(4) Have gained categorical eligibility. Assistance groups who gain categorical eligibility are entitled to restored benefits back to the date of the original food assistance application, the date it gained categorical eligibility, or the date categorical eligibility for the specific type of assistance group was created, whichever is later. To determine the prior months of eligibility and the date when restored benefits should begin, consult rule 5101:4-4-27 of the Administrative Code.

(5) Have been found to be eligible for a restoration of benefits which was discovered by the agency. The county agency shall automatically take the necessary action to restore the benefits. No action by the assistance group is necessary. Benefits shall not be restored if the benefits were lost more than twelve months prior to the month the loss was discovered by the county agency in the normal course of business, or were lost more than twelve months prior to the month the county agency was notified in writing or orally of a possible loss to a specific assistance group.

The county agency shall notify the assistance group of its:

(a) Entitlement;

(b) Amount of benefits to be restored;

(c) Any offsetting that was done;

(d) The method of restoration; and

(e) The right to appeal through the fair hearing process.

(C) What are the specific timeframes for making a restoration?

(1) County agencies shall issue restored benefits within thirty days from the date the lost benefits were discovered.

(2) Restored benefits due under rule 5101:4-2-02 of the Administrative Code shall be restored to assistance groups that are categorically eligible within ten days after the discovery date.

(3) If a restoration is ordered through a compliance as a result of a fair hearing decision, it must be completed in accordance with division 5101:6 of the Administrative Code.

(D) When can a restoration be made?

Benefits can only be restored up to twelve months prior to whichever occurs first:

(1) The date the county agency receives the request for a restoration from the assistance group; or

(2) The date the county agency is notified or otherwise discovers that a loss to an assistance group has occurred.

(E) How are restorations tracked?

(1) Each county shall maintain an accounting system for documenting an assistance group's eligibility for restored benefits and calculating the balance. At a minimum, the county agency shall use the JFS 07424, "Report of Claim Determination/Lost Benefits" (rev. 08/01) in the case record.

(2) The calculation of the restored benefit should also be documented and stored in the case record.

(3) The county agency shall have a system in place that readily identifies outstanding claims against assistance groups so they can be offset against the restored benefit amount prior to issuing the restoration.

(F) How is eligibility determined for lost benefits?

The county agency shall determine if the assistance group was actually eligible for the month the loss occurred. In cases where there is insufficient information in the assistance group's case the county agency shall advise the assistance group of what must be provided to demonstrate eligibility for these months. For each month the assistance cannot provide the necessary information to demonstrate its eligibility, the assistance group shall be considered ineligible.

(G) How is the amount of the restoration determined?

After correcting the loss for future months and excluding those months for which benefits may have been lost prior to the twelve-month time limits, the county agency shall calculate the amount to be restored as follows:

(1) Incorrect allotment - if the assistance group was eligible but received an incorrect allotment, the loss of benefits shall be calculated only for those months the assistance group participated.

(a) Under issuance - if the assistance group received a smaller allotment than it was eligible to receive, the difference between the actual and correct allotments equals the amount to be restored.

(b) Offsetting claims - if a claim against an assistance group is unpaid or terminated as provided in rule 5101:4-8-19 of the Administrative Code, the amount to be restored shall be offset against the amount due on the claim before the balance, if any, is restored to the assistance group. At the point in time the assistance group is certified and receives an initial allotment, the initial allotment shall not be reduced to offset claims, even if the initial allotment is paid retroactively.

(2) Delay, denial, or termination - if the loss was caused by an incorrect delay, denial, or termination of benefits, the months affected by the loss shall be calculated as follows:

(a) Incorrect denial: if an eligible assistance group's application was incorrectly denied, the month the loss initially occurred shall be the month of application, or for an eligible assistance group filing a timely reapplication, the month following the expiration of its certification period.

(b) Incorrect delay: if an eligible assistance group's application was delayed, the months for which benefits may be lost shall be calculated in accordance with procedures in rule 5101:4-2-01 of the Administrative Code.

(c) Incorrect termination: if an assistance group's benefits were incorrectly terminated, the month the loss initially occurred shall be the first month benefits were not received as a result of the erroneous action.

(H) What are the payment methods of restoration?

There are two ways to issue a restoration of benefits:

(1) Lump sum - the county agency shall restore lost benefits to an assistance group by issuing an allotment equal to the amount of benefits that were lost. The amount restored shall be issued in addition to the allotment the assistance group is currently eligible to receive.

(2) Monthly installment - the county agency shall honor reasonable requests by assistance groups to restore lost benefits in monthly installments if, for example, the assistance groups fears the excess benefits may be stolen or that the amount to be restored is more than it can use in a reasonable period of time.

(I) What if the assistance group make up is different than when the benefit loss occurred?

When lost benefits are owed to an assistance group and the assistance group's membership has changed, the county agency shall restore the lost benefits to the assistance group containing a majority of the individuals who were assistance group members at the time the loss occurred. If the county agency cannot locate or determine the assistance group which contains a majority of assistance group members, the county agency shall restore the lost benefits to the assistance group containing the individual who was head of the assistance group at the time the error occurred.

(J) What happens if the assistance group disagrees with the determination of the restoration request or benefit amount?

If the assistance group does not agree with the county agency's decision regarding the lost benefits or with the amount of lost benefits computed by the county agency the following procedures apply:

(1) If the assistance group does not agree with the amount to be restored as calculated by the county agency or any other action taken by the county agency to restore lost benefits, the assistance group may request a fair hearing within ninety days from the date the assistance group is notified of its entitlement to restoration of lost benefits. If a fair hearing is requested prior to or during the time lost benefits are being restored, the assistance group shall receive the lost benefits as determined by the county agency pending the results of the fair hearing. If the fair hearing decision is favorable to the assistance group, the county agency shall restore the lost benefits in accordance with that decision.

(2) If an assistance group believes it is entitled to restoration of lost benefits, but the county agency does not agree, the assistance group has ninety days from the date of the county agency determination to request a fair hearing. The county agency shall restore lost benefits to the assistance group only if the fair hearing decision is favorable to the assistance group. Benefits lost more than twelve months prior to the date the county agency was initially informed of the assistance group's possible entitlement to lost benefits shall not be restored.

Replaces: 5101:4-8-03

Effective: 02/10/2011
R.C. 119.032 review dates: 11/01/2015
Promulgated Under: 111.15
Statutory Authority: 5101.54
Rule Amplifies: 329.04 , 329.042 , 5101.54
Prior Effective Dates: 6/2/80, 1/22/82, 3/20/83, 7/1/83 (Temp.), 8/19/83, 9/24/83 (Temp.), 11/11/83, 4/10/84 (Emer.), 8/1/84 (Emer.), 10/20/84, 1/16/87 (Emer.), 4/6/87, 6/22/87, 4/1/89, 1/5/90 (Emer.), 3/22/90, 10/1/90, 8/1/92 (Emer.), 10/30/92, 8/1/95, 10/1/96, 5/1/99, 10/1/01 (Emer.), 10/11/01, 12/01/05

5101:4-8-15 Food assistance: claims against assistance groups.

(A) The county agency shall establish and collect a claim against any assistance group that trafficked benefits or received more food assistance benefits than it was entitled to receive. A recipient claim is an amount owed because of overpaid benefits or benefits that are trafficked. Trafficking is defined in paragraph (J) of rule 5101:4-8-17 of the Administrative Code. Prompt corrective action to prevent further overpayment is required. A food assistance claim is a federal debt subject to this rule and other regulations governing federal debts. This rule describes the three types of claims and the procedures the county agency must follow when handling these claims.

(B) Who is responsible for paying a claim?

(1) Each person who was an adult member of the assistance group when the overpayment or trafficking occurred. For collection purposes, an adult is an individual aged eighteen or older at the time of the overpayment, except for individuals under the age of twenty-two living in the home of their parent(s). Additionally, collection is required from individuals under the age of eighteen when the individual is the head of the assistance group or the only person in the assistance group.

(2) Any person connected to the assistance group, such as an authorized representative, who actually trafficks or otherwise causes an overpayment or trafficking.

(3) A sponsor of an alien household member if the sponsor is at fault or contributed to the claim.

(4) If a change in assistance group composition occurs, county agencies may pursue collection action against any assistance group that includes a member who was an adult member of the assistance group that received the overpayment. The county agency may also offset the amount of the claim against restored benefits owed to any assistance group containing a member who was an adult member of the original assistance group at the time the overpayment occurred.

(C) What are the three types of claims?

(1) Intentional program violation claim: any claim for an overpayment or trafficking resulting from an individual committing an intentional program violation. An intentional program violation is defined in paragraph (B) of rule 5101:6-20-02 of the Administrative Code.

(2) Inadvertent household error claim: any claim for an overpayment resulting from a misunderstanding or unintended error on the part of the assistance group.

(3) Agency error claim: any claim for an overpayment caused by an action or failure to take action by the county agency.

(D) When is a claim considered an intentional program violation?

A claim shall be handled as an intentional program violation claim if the overpayment or trafficking consisted of the individual intentionally:

(1) Making a false or misleading statement, or misrepresenting, concealing or withholding facts; or

(2) Committing any act constituting a violation of the Food and Nutrition Act of 2008, the food assistance program regulations, or any state statute for the purpose of using, presenting, transferring, acquiring, receiving, possessing or trafficking of food assistance benefits, or the electronic benefit transfer (EBT) card.

(E) What instances require an intentional program violation determination?

A claim shall be handled as an intentional program violation claim only when an individual is disqualified as a result of:

(1) An administrative disqualification hearing;

(2) A determination by a federal, state, or local court;

(3) Signing the JFS 04026 "Waiver of Administrative Disqualification Hearing (rev.5/2001); or

(4) Signing the JFS 04027 "Disqualification Consent Agreement" (rev. 5/2002) a disqualification consent agreement in cases referred for prosecution.

(F) When is a claim considered an inadvertent household error?

A claim shall be handled as an inadvertent household error claim if the overpayment was caused by:

(1) A misunderstanding or unintended error on the part of the assistance group;

(2) A misunderstanding or unintended error on the part of a categorically eligible assistance group provided a claim can be calculated based on a change in net income and/or assistance group size; or

(3) Social security administration action or failure to take action resulting in the assistance group's categorical eligibility, provided a claim can be calculated based on a change in net income and/or assistance group size.

(G) What instances require an inadvertent household error claim determination?

Instances of inadvertent household error which may result in a claim include, but are not limited to, the following;

(1) The assistance group unintentionally failed to provide the county agency with correct or complete information;

(2) The assistance group unintentionally failed to report to the county agency changes in its circumstances which it was required to report; or

(3) The assistance group unintentionally received benefits or more benefits than it was entitled to receive pending a fair hearing decision because the assistance group requested a continuation of benefits based on the mistaken belief it was entitled to such benefits.

(H) When is a claim considered an agency error?

A claim shall be handled as an agency error claim if the overpayment was caused by county agency action or failure to take action, or, in the case of categorical eligibility, an action by a county agency or the state or local government resulting in the assistance group's improper eligibility for public assistance provided a claim can be calculated based on a change in net income and/or assistance group size.

(I) What instances require an agency error claim determination?

Instances of agency error which may result in a claim include, but are not limited to, the following:

The county agency:

(1) Failed to take prompt action on a change reported by the assistance group;

(2) Incorrectly computed the assistance group's income or deductions, or otherwise assigned an incorrect allotment;

(3) Incorrectly issued a duplicate EBT card to an assistance group and the card was subsequently transacted;

(4) Continued to provide the assistance group with food assistance benefits after its certification period expired and no reapplication interview was conducted; or

(5) Failed to provide an assistance group a reduced level of food assistance benefits because its public assistance grant changed.

(J) When is a claim determination not required?

A claim shall not be established if an overpayment occurred due to the agency's failure to ensure the assistance group fulfilled the following :

(1) Signed the application form;

(2) Completed current work registration; or (3) Was certified in the correct county.

(K) How is a claim documented against an assistance group?

(1) The JFS 07424 "Reporting of Claim Determination/Lost Benefits" (rev. 08/01) shall be completed on all food assistance claims including trafficking related claims.

(2) All JFS 07424 forms shall be completed and properly filed at the county agency. The county department of job and family services director or designee is responsible for reviewing and approving all claims regardless of the amount.

(3) Prompt corrective action to prevent a further overpayment is required.

(L) What is the claim management process?

(1) Within three months of the complaint, the county agency must screen to determine if a potential claim exists. If a potential claim exists the claim must be logged into client registry information system-enhanced (CRIS-E). The date the complaint is entered into CRIS-E is the "discovery or referral date" unless the referral of a potential claim is based on a quality control finding as set forth in paragraph (L)(3) of this rule.

(2) When a potential claim exists, within five months of the "discovery or referral date", the county agency must investigate, obtain verification, calculate the claim and mail the initial demand notice which is the "established date" unless a potential intentional program violation exists. When a potential intentional program violation exists the claim must be referred to the county prosecutor or the ODJFS bureau of state hearings for an administrative disqualification hearing within three months of the date the claim is calculated. Once the decision is rendered, the initial demand notice is issued.

(3) For potential claims based on quality control findings, within ten business days after receiving the quality control finding the county agency must enter the potential claim into CRIS-E. This is the "discovery or referral date". The county agency must investigate, obtain verification, calculate the claim, and mail the initial demand notice within five months of the referral date.

(4) The county agency must ensure that no less than ninety per cent of all claim referrals are either established or disposed of according to the above time frames.

(M) What is the process if it is determined that internal fraud or gross negligence has occurred during the county certification process?

If it is determined by the United States department of agriculture (USDA), or the office of families and children food assistance section in conjunction with USDA, that there has been gross negligence or fraud on the part of the county agency in the certification of assistance groups or the issuance of food assistance benefits, the county agency will be liable for the dollar amount of benefits issued as the result of such negligence or fraud.

Replaces: 5101:4-8-15

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Effective: 01/01/2011
R.C. 119.032 review dates: 01/01/2016
Promulgated Under: 111.15
Statutory Authority: 5101.54
Rule Amplifies: 329.04 , 329.042 , 5101.54
Prior Effective Dates: 6/2/80, 10/1/81, 9/27/82, 1/1/83, 6/10/83, 8/1/83, 9/24/83 (TEMP.), 11/11/83, 4/1/84 (TEMP.), 6/1/84, 8/1/84 (EMER.), 10/20/84, 12/31/84 (EMER.), 4/1/85, 8/1/85, 8/20/86 (EMER.), 11/15/86, 3/24/88 (EMER.), 6/18/88, 10/1/88 (EMER.), 11/18/88, 4/1/89, 5/1/89 (EMER.), 7/11/89 (EMER.), 7/17/89, 10/1/90, 7/1/94, 7/1/95, 8/1/95, 12/1/95, 9/22/96 (EMER.), 10/1/96, 10/1/96 (EMER.), 11/22/96, 11/22/96 (EMER.), 8/1/98, 5/1/99, 8/1/01 (EMER.), 8/11/01, 12/01/02 (EMER.), 1/6/03, 10/1/07

5101:4-8-17 Food assistance: calculating the overpayment claim amount.

The county agency shall calculate claims, make collections, and disqualify assistance group members based on the date of overpayment, date of discovery, and the food assistance regulations in effect at the time of the overpayment.

(A) How is the claim amount calculated for non-trafficking claims?

(1) A county agency must calculate a claim back to at least twelve months prior to when it became aware of the overpayment. For all claims, the county agency cannot include any amounts occurring more than six years before it became aware of the overpayment. For an intentional program violation claim, the claim must be calculated back to the month the act of the intentional program violation first occurred.

(2) To calculate a claim, the county agency shall:

(a) Determine the correct amount of benefits for each month an assistance group received an overpayment. Do not apply the earned income deduction to any earned income the assistance group failed to report in a timely manner. If the agency failed to act on reported earned income apply the earned income deduction.

(b) To determine the overpayment subtract the amount of the benefit the applicant should have received from the benefit amount actually received. If the overpayment equals zero or is negative dispose of the claim referral.

(c) If the county agency is aware of any expunged benefits from the assistance group's electronic benefit transfer account the county agency should reduce the overpayment amount by the amount of the expunged benefits. The county agency must document any reduction of an overpayment claim by use of expunged benefits via the client registry information system enhanced (CRIS-E). The difference from the amount of the expunged benefits and the overpayment amount is the amount of the claim.

(B) How is the amount of an intentional program violation claim calculated?

If an assistance group member is found to have committed an intentional program violation, the county agency shall disqualify that individual and initiate collection action against the remaining adult assistance group members.

For intentional program violation claims, the amount of food assistance benefits collected shall be the greater of twenty percent or twenty dollars per month of the assistance group's monthly entitlement, before disqualification of the assistance group member found to have committed the intentional program violation.

If the assistance group member is determined to have committed the intentional program violation by intentionally failing to report a change in the assistance group's circumstances, the first month affected by the assistance group's failure to report shall be the first month in which the change would have been effective had it been reported timely. When calculating the claim amount, the county agency shall allow the maximum reporting allowance of ten days from the date of change plus the maximum allowance for notice of adverse action of fifteen days. Therefore, for the purposes of claim calculation, a change cannot be effective sooner than twenty-five days from the date the change occurred.

Prior to the determination of an intentional program violation or the signing of either a waiver of right to a disqualification hearing or a disqualification consent agreement in cases of deferred adjudication, the claim against the assistance group shall be handled as an inadvertent household error claim.

(C) How is the amount of an inadvertent household error claim calculated?

If due to a misunderstanding or inadvertent error on the part of the assistance group, the assistance group failed to report a change in its circumstances within ten days of the date the change became known to the assistance group, the first month affected by the assistance group's failure to report shall be the first month in which the change would have been effective had it been reported timely. When calculating the claim amount, the county agency shall allow the maximum reporting allowance of ten days from the date of change plus the maximum allowance for notice of adverse action of fifteen days. Therefore, for the purposes of claim calculation, a change cannot be effective sooner than twenty-five days from the date the change occurred.

(D) How is the amount of an administrative error claim calculated?

If the assistance group timely reported a change, but the county agency did not timely act on the change, the first month affected by the county's failure to act shall be the first month the county agency should have made the change effective. Therefore, if a notice of adverse action was required but was not provided, the county agency shall assume that the maximum advance notice period of fifteen days would have expired without the assistance group requesting a fair hearing.

(E) How are trafficking claims calculated?

Claims arising from trafficking-related offenses shall be the value of the trafficked benefits as determined by:

(1) The individual's admission;

(2) Adjudication; or

(3) The documentation that forms the basis for the trafficking determination.

(F) Claim offset

After calculating the amount of the claim, the county agency shall offset the amount of the claim (even if the claim is one hundred twenty-five dollars or less) against any amount of lost benefits which have not yet been restored to the assistance group. The county agency shall not offset against retroactive or initial benefits in accordance with paragraph (J) of rule 5101:4-8-03 of the Administrative Code. The county agency shall then initiate collection action for the remaining balance, if any. If the county agency did not complete a JFS 07424,"Report of Claim Determination/Lost Benefits" (rev. 8/01) because the claim was one hundred twenty-five dollars or less, at the time the offset action is taken, the county agency shall complete the JFS 07424 so documentation exists as to why the lost benefit amount was reduced.

(G) Processing intentional program violations

Individuals found to have committed an intentional program violation either through an administrative disqualification hearing, a federal, state, or local court, or who have signed either a waiver of right to an administrative disqualification hearing, or a disqualification consent agreement in cases referred for prosecution, shall be ineligible to participate in the program for a period of twelve months for the first offense, except as provided in paragraphs (H) to (K) of this rule, for a period of twenty- four months upon the second occasion of any intentional program violation, except as provided in paragraphs (H) to (K) of this rule, and permanently for a third occasion of any intentional program violation.

The disqualification period for non-participants at the time of the administrative disqualification or court decision shall take precedence in accordance with division 5101:6 of the Administrative Code.

(H) Controlled substance violation

Individuals found by a federal, state, or local court to have used or received food assistance benefits in a transaction involving the sale of a controlled substance (as defined in section 102 of the Controlled Substances Act ( 21 U.S.C. 802 )), (1/2007) shall be ineligible to participate in the program for a period of twenty-four months upon the first occasion of such a violation and permanently upon the second occasion of such a violation.

(I) Firearms, ammunition, or explosives violation

Individuals found by a federal, state, or local court to have used or received food assistance benefits in a transaction involving the sale of firearms, ammunition, or explosives shall be permanently ineligible to participate in the program upon the first occasion of such violation.

(J) Trafficking food assistance benefits of five hundred dollars or more

An individual shall be permanently disqualified if he/she is convicted by a federal, state, or local court of trafficking food assistance benefits for an aggregate amount of five hundred dollars or more.

For purposes of this rule, "trafficking" is defined as fraudulently using, transferring, altering, acquiring or possessing food assistance benefits or presenting food assistance benefits for payment or redemption knowing the same to have been fraudulently obtained or transferred for cash or consideration other than eligible food. "Acquiring food assistance benefits" does not include providing false information as part of the certification, reapplication, or reporting changes processes.

(K) Receipt of multiple benefits simultaneously

An individual shall be ineligible to participate in the food assistance program for a ten-year period if the individual is found, through an administrative disqualification hearing, a federal, state, or local court, or who has signed either a waiver of right to administrative disqualification hearing or a disqualification consent agreement in cases referred for prosecution, of having made a fraudulent statement or representation with respect to the identity or place of residence of the individual in order to receive multiple benefits simultaneously under the food assistance program.

Effective: 12/01/2009
R.C. 119.032 review dates: 08/31/2009 and 12/01/2014
Promulgated Under: 111.15
Statutory Authority: 5101.54
Rule Amplifies: 329.04 , 329.042 , 5101.54
Prior Effective Dates: 6/2/80, 6/20/80, 10/1/81, 6/2/82, 8/15/82, 9/27/82, 1/1/83, 6/10/83, 8/1/83, 9/24/83 (TEMP.), 11/11/83, 4/1/84 (TEMP.), 6/1/84, 8/1/84 (EMER.), 10/20/84, 12/31/84 (EMER.), 4/1/85, 5/3/85 (EMER.), 8/1/85, 8/20/86 (EMER.), 11/15/86, 3/24/88 (EMER.), 6/18/88, 10/1/88 (EMER.), 11/18/88, 4/1/89, 5/1/89 (EMER.), 7/11/89 (EMER.), 7/17/89, 9/17/89, 1/5/90 (EMER.), 5/22/90, 10/1/90, 10/1/91, 2/3/92, 8/1/92 (EMER.), 10/30/92, 6/1/94, 7/1/94, 9/1/94, 7/1/95, 8/1/95, 12/1/95, 5/1/96, 9/22/96 (EMER.), 10/1/96 (EMER.), 11/22/96, 11/22/96 12/1/95, 5/1/96, 9/22/96 (EMER.), 10/1/96 (EMER.), 11/22/96, 11/22/96 (EMER.), 1/1/97 (EMER.), 2/7/97, 3/1/97, 3/23/97, 10/1/97, 2/1/98 (EMER.), 2/23/98, 8/1/98, 5/1/99, 7/15/99, 8/1/01 (Emer.), 8/11/01, 9/1/04

5101:4-8-19 Food assistance: initiating collection action and managing claims.

(A) When must a county agency initiate collection on a claim?

(1) When a claim is over one hundred twenty-five dollars.

(2) When a claim is one hundred twenty-five dollars or less if:

(a) The assistance group is participating in the program; or

(b) The claim has already been established; or

(c) The claim was discovered as an overpayment in a quality control review; or

(d) The county agency has adopted the policy to pursue all claims regardless of the amount. If the county agency chooses this option, assistance groups shall be informed of this policy.

(B) When can a county agency opt not to collect on a claim?

(1) For claims of one hundred twenty-five dollars or less that cannot be recovered by reducing the assistance group's allotment because they are not participating in the program, the county agency must record the amount of the claim in the case file so that this amount may be used to offset any lost benefits that may be owed the assistance group at a later date. The county agency does not have to complete the JFS 07424, "Report of Claim Determination/Lost Benefits" (rev. 8/01).

(2) In addition, the county agency shall have the option to initiate collection action for claims of one hundred twenty- five dollars or less at such time multiple overpayments for an assistance group total in excess of one hundred twenty-five dollars. If the county agency chooses this option, assistance groups shall be informed of this policy.

(C) What is the process for notifying assistance groups of the intent to collect on a claim?

(1) The county agency must notify the assistance group in writing that the county agency intends to begin collection action on a claim, in accordance with Chapter 5101:6-2 of the Administrative Code.

(2) The claim is considered established for tracking purposes as of the date of the initial demand letter or written notification.

(3) If the claim or the amount of the claim was not established at a hearing, the county agency must provide the assistance group with a one-time notice of adverse action.

(4) The due date or time frame for repayment must be no later than thirty days after the date of the initial written notification or demand letter.

(5) If any nonparticipating assistance group, against which collection action has been initiated, does not respond to the first demand letter, additional demand letters may be sent at reasonable intervals, such as thirty days, until the assistance group has responded by paying or agreeing to pay the claim, the criteria for terminating collection action has been met, or the county agency initiates other collection actions. If an assistance group falls behind in making payments or is unable to pay the claim, the assistance group's eligibility shall not be affected.

(D) What must repayment agreements contain?

Any repayment agreement for any claim must contain due dates or timeframes for the periodic submission of payments. The agreement must specify that the assistance group is subject to involuntary collection action(s) if payment is not received by the due date and the claim becomes delinquent.

(E) What determines if a claim is delinquent?

(1) The claim is considered delinquent when it has not been paid by the due date and a satisfactory payment arrangement has not been made. The date of delinquency is the due date on the initial written notification/demand letter. The claim will remain delinquent until payment is received in full, a satisfactory payment agreement is negotiated, or allotment reduction is invoked.

(2) The claim is considered delinquent when a payment arrangement is established and a scheduled payment has not been made by the due date. The date of delinquency is the due date of the missed installment payment. The claim will remain delinquent until payment is received in full, allotment reduction is invoked, or if the county agency determines to either resume or renegotiate the repayment schedule.

(3) The claim is not delinquent if another claim for the same assistance group is currently being paid either through an installment agreement or allotment reduction and the county agency expects to begin collection on the claim once the prior claim(s) is settled.

(4) The claim is not delinquent if the county agency is unable to determine delinquency status because collection is coordinated through the court system.

(F) How are claims handled when a claim is subject to a fair hearing?

(1) If the hearing officer determines a claim exists against the assistance group, the assistance group must be re-notified of the claim. Delinquency must be based on the due date of this subsequent notice and not on the initial pre-hearing demand letter sent to the assistance group.

(2) If the hearing officer determines a claim does not exist then the claim is terminated or written off in accordance with paragraph (I) of this rule.

(G) Reduction of claim amount by court or local prosecutor:

Reduction by a court or local prosecutor of the amount an assistance group owes on a claim does not automatically relieve the county agency from administratively pursuing collection of the total claim amount. For example, if the amount of the original claim was two hundred dollars but this amount was arbitrarily reduced by a local county prosecutor to one hundred dollars, the county agency has the obligation to administratively pursue the total of two hundred dollars. The county agency may attempt to collect any overpayment it has determined to have been received by an assistance group in excess of the amount ordered to be repaid by a court. The assistance group cannot be forced, however, to pay the excess amounts. The county agency shall not invoke allotment reduction without the assistance group's permission to collect amounts in excess of the court-ordered restitution. Should new evidence be produced which, according to current regulations, alters the county's determination on the original claim, the original claim amount shall be revoked and a new amount initiated.

(H) When can a county agency compromise on a claim amount?

A county agency may compromise a claim or any portion of a claim if it can be reasonably determined an assistance group's economic circumstances dictate that the claim will not be paid in three years. Compromising a claim is an agreement to adjust the total owed at the end of three years if the assistance group has made payments corresponding with its financial circumstances throughout that period of time.

(1) The county agency may use the full amount of the claim (including any amount compromised) when determining the amount of benefits that must be offset in accordance with rule 5101:4-8-03 of the Administrative Code.

(2) The county agency may reinstate any compromised portion of a claim if the claim becomes delinquent.

(I) When can a county agency terminate and write off a claim?

A terminated claim is a claim in which all collection action has ceased. A claim written off is no longer considered an account receivable subject to continued federal, state and county agency collection and reporting requirements.

The following sets forth the claim termination policy:

(1) Invalid claim: if the county agency finds the claim is invalid it must discharge the claim and reflect the event as a balance adjustment rather than a termination, unless it is appropriate to pursue the overpayment as a different type of claim (i.e., as an inadvertent household error rather than an intentional program violation claim.)

(2) Death of all adult assistance group members: if all adult assistance group members die then the county agency must terminate and write off the claim, unless the county agency plans to pursue the claim against the estate.

(3) Claim balance less than twenty-five dollars: if the claim balance is less than twenty-five dollars and the claim has been delinquent for ninety days or more the county agency must terminate and write off the claim, unless other claims exist against this assistance group resulting in an aggregate claim total of twenty-five dollars or more.

(4) Not cost effective: if the county agency determines it is not cost effective to pursue the claim any further (i.e., the cost of further collection action exceeds the amount that can be recovered) the county agency must terminate and write off the claim.

(5) Delinquent claim: if the claim is delinquent for three years or more the county agency must terminate and write off the claim unless it plans to continue to pursue the claim through the treasury offset program.

(6) Cannot locate the assistance group: if the assistance group cannot be found the county agency may terminate and write off the claim.

(J) When can a terminated or written off claim be reinstated?

(1) Previously terminated or compromised claims may be reactivated if the assistance group provides a voluntary payment. County agencies shall only reactivate an amount equal to the offset or voluntary payment amount, rather than reactivating the full value of the outstanding claim amount. Reactivating only the amount equal to the offset or the voluntary payment does not change the status of the original claim. The balance remains in terminated or compromised status. To reactivate a previously compromised claim, the balance of the claim must be recompromised by renegotiating with the assistance group.

(2) If a specific event (e.g. winning the lottery) occurs which increases the likelihood of further collections, the county agency may reinstate the claim in accordance with paragraph (J) of this rule.

(K) What are acceptable forms of payment?

(1) Reducing benefits before issuance: this includes allotment reductions and offsets to restored benefits; however, the county agency must follow the instructions and limits found in paragraphs (L)(1) and (L)(3) of this rule.

(2) Reducing benefits after issuance: benefits may be recouped from an assistance group's electronic benefit transfer (EBT) account; however, the county agency must follow the instruction and limits found in paragraph (L)(2) of this rule.

(3) Cash: cash, check, money order and credit or debit cards are acceptable forms of repayment; however, if a county agency does not have the capability to accept credit or debit cards it does not have to accept this form of repayment.

(4) Public service: an assistance group member may be required to perform public service to repay a claim; however, this form of payment must be ordered by a court specifically for the repayment of a claim. If the court does not order a rate of pay, the federal minimum wage shall be used.

(5) Treasury offset program: to offset the claim with federal payments the county agency must follow the procedures found in rule 5101:4-8-30 of the Administrative Code.

(L) What collection methods are available to the county agency?

(1) Allotment reduction: a county agency must automatically collect payments for any claim by reducing the amount of monthly benefits an assistance group receives in accordance with rule 5101:4-8-17 of the Administrative Code unless the assistance group agrees to make higher regular payments to repay the claim.

(a) For an intentional program violation claim, limit the amount reduced to the greater of twenty dollars per month or twenty per cent of the assistance group's monthly entitlement, unless the assistance group agrees to a higher amount.

(b) For an inadvertent household error or administrative error claim, limit the amount reduced to the greater of ten dollars per month or ten per cent of the assistance groups monthly allotment, unless the assistance group agrees to a higher amount.

(c) The county agency shall not reduce the initial allotment when the assistance group is first certified unless the assistance group agrees to this reduction.

(2) EBT reduction: the county agency must allow an assistance group to pay its claim using benefits from its EBT account.

The county agency must comply with the following EBT claims collection and adjustment requirements:

(a) Collecting from active (or reactivated) EBT benefits:

(i) The county agency must obtain written permission from the assistance group pursuant to paragraph (L)(2)(d) of this rule. This permission may be obtained in advance.

(ii) Oral permission is allowed for one time reductions as long as the county agency sends the assistance group a receipt of the transaction within ten days after the reduction.

(iii) The county agency may retain a percentage of the collection as an incentive pursuant to rule 5101:4-8-23 of the Administrative Code.

(b) For making an adjustment with expunged EBT benefits:

(i) The county agency must adjust the amount of any claim by subtracting any expunged amount from the EBT benefit account for which the county agency becomes aware. The county agency must document the use of the expunged benefits as a claim offset in CRIS-E to ensure no duplicate use.

(ii) The county agency cannot retain a percentage of the collection as an incentive pursuant to rule 5101:4-8-23 of the Administrative Code when using expunged benefits to collect on an overpayment claim.

(c) A collection from an EBT account must be non-settling against the benefit drawdown account.

(d) At a minimum, any agreement with the assistance group to collect a claim using active EBT benefits must include:

(i) A statement that this collection activity is strictly voluntary;

(ii) The amount of the payment;

(iii) The frequency of the payment (i.e., whether monthly or one time only);

(iv) The length (if any) of the agreement; and

(v) A statement that the assistance group may revoke this agreement at any time.

(3) Offsets to restored benefits: the county agency must reduce any restored benefits owed to an assistance group by the amount of any outstanding claim, except for an "initial" benefit month in accordance with paragraph (J) of rule 5101:4-8-03 of the Administrative Code. Offsetting may be done at any time during the claim establishment and collection process.

(4) Lump sum payments: the county agency must accept any payment for a claim whether it represents full or partial payment. The payment may be in any of the acceptable formats.

(5) Installment payments: the county agency may accept installment payments made for a claim as part of a negotiated repayment agreement.

If the assistance group fails to submit a payment in accordance with the terms of its negotiated repayment schedule, the assistance group's claim becomes delinquent and will be subject to additional collection actions.

(6) Public service: if authorized by a court, the value of a claim may be paid by the assistance group performing public service. If the court does not order a rate of pay, the federal minimum wage shall be used.

(7) Other collection actions: the county agency may employ any other collection actions to collect claims. These actions include, but are not limited to, referrals to collection and/or other similar private and public sector agencies, and small claims court.

(8) Unspecified joint collections: when an unspecified joint collection is received for a combined public assistance and food assistance recipient claim, each program must receive its pro rata share of the amount collected. An unspecified joint collection is when funds are received in response to correspondence or a referral containing both the food assistance and other program claim(s) and the debtor does not specify which claim to apply the collection.

The county agency must not use additional collection methods against individuals in an assistance group that is already having its benefit reduced unless the additional payment is voluntary.

The county agency may continue to use any other collection method against any individual who is not a current member of the assistance group even if the assistance group is undergoing allotment reduction.

For administrative error claims established prior to September 22, 1996 the county agency may not use involuntary allotment reduction for the collection. If an individual volunteers for allotment reduction the county agency must accept the allotment reduction for collection.

(M) How much of an assistance group's allotment can be collected when there are multiple claims?

(1) Inadvertent household errors and administrative error claims: the greater of ten per cent or ten dollars must be deducted each month for each category of claim.

(2) Intentional program violation claims: the greater of twenty per cent or twenty dollars must be deducted each month for each category of claim.

(3) Multiple claims: if an assistance group has multiple claims against it, the county agency shall invoke allotment reduction on one claim at a time. The county agency shall recoup claims in sequence, obtaining full payment on the oldest claim before proceeding to the next claim. The county agency shall not consider subsequent claims to be delinquent while the assistance group has a current allotment reduction on an earlier claim.

(N) What happens if an assistance group overpays on a claim?

If an assistance group has overpaid a claim, the county agency must determine if there are other food assistance claims the overage can be applied to. If there are no other claims the overage must be refunded. The assistance group shall be paid by whatever method the county agency deems appropriate considering the circumstances. The county agency shall issue that amount to the assistance group which includes the incentive retained by the county agency.

(O) How is the claim handled if a food assistance recipient moves to or from another state?

(1) Unless a transfer occurs as outlined in paragraph (O)(2) of this rule, the county agency is responsible for initiating and continuing collection action on any food assistance recipient claim regardless of whether the assistance group remains in the state.

(2) The county agency may accept a claim from another state agency if the assistance group with the claim moves into the county. The state agency which overpaid benefits to the assistance group shall have the first opportunity to collect any overpayment. However, if the state agency which overpaid benefits to the assistance group does not take prompt action to collect, then the county agency administering the area into which the assistance group moves should initiate action to collect the overpayment. Prior to initiating action to collect such overpayments the county agency shall contact the state agency which overpaid benefits to ascertain that it does not intend to pursue prompt collection. The incentive for any collected claims shall be retained by the county agency collecting the overpayment. Once a county agency accepts the responsibility for an overpayment claim, the claim is the county agency's responsibility for future collection and reporting.

(P) How is a claim handled if a food assistance recipient moves to a different county?

(1) When an assistance group moves and applies for or receives food assistance benefits from a new county of residence, the assistance group case file material shall be transferred to the new county of residence.

(2) Any associated claim case shall not transfer from the original county of residence to the new county of residence. However, the transferred assistance group case file must contain copies of documentation that a claim exists. When there is an associated claim case, the county shall follow the procedures outlined in the case file transfer procedures for food assistance.

(3) The county establishing the claim remains responsible for any applicable court action or collection action concerning an outstanding claim balance.

(4) The new county of residence shall implement allotment reduction for claim collection upon the request of the original county.

(5) When the new county of residence makes a collection on a claim, it shall be entered into the client registry information system enhanced (CRIS-E).

(6) The county agency that initially completes the claim and, in the case of an intentional program violation the prosecution or administrative disqualification hearing, is entitled to the applicable incentive. These incentives will be restored on a quarterly basis.

(Q) Bankruptcy

A county or state agency shall act on behalf of the United States department of agriculture food and nutrition service (FNS) in any bankruptcy proceeding against bankrupt assistance groups with outstanding recipient claims. Bankruptcy information must be documented in CRIS-E. Bankruptcy of one assistance group member does not terminate a claim if there are other adult assistance group members liable for the claim.

Effective: 02/01/2012
R.C. 119.032 review dates: 12/01/2014
Promulgated Under: 111.15
Statutory Authority: 5101.54
Rule Amplifies: 329.04 , 329.042 , 5101.54
Prior Effective Dates: 6/2/80, 6/20/80, 10/1/81, 6/2/82, 8/15/82, 9/27/82, 1/1/83, 6/10/83, 8/1/83, 9/24/83 (Temp.), 11/11/83, 4/1/84 (Temp.), 6/1/84, 8/1/84 (Emer.), 10/20/84, 12/31/84 (Emer.), 4/1/85, 5/3/85 (Emer.), 8/1/85, 8/20/86 (Emer.), 11/15/86, 3/24/88 (Emer.), 6/18/88, 10/1/88 (Emer.), 11/18/88, 4/1/89, 5/1/89 (Emer.), 7/11/89 (Emer.), 7/17/89, 9/17/89, 1/5/90 (Emer.), 5/22/90, 10/1/90, 10/1/91, 2/3/92, 8/1/92 (Emer.), 10/30/92, 6/1/94, 7/1/94, 9/1/94, 7/1/95, 8/1/95, 12/1/95, 5/1/96, 9/22/96 (Emer.), 10/1/96 (Emer.), 11/22/96, 11/22/96 (Emer.), 1/1/97 (Emer.), 2/7/97, 3/1/97, 3/23/97, 10/1/97, 2/1/98 (Emer.), 2/23/98, 8/1/98, 5/1/99, 8/1/01 (Emer.), 8/11/01, 09/01/04, 3/23/06, 12/1/09

5101:4-8-23 Food assistance: claims retention rates and accounting procedures.

(A) The retention rates for county agencies are as follows:

If you collect an Then the retention rate is

Intentional program violation(IPV) claim Thirty-five per cent

Inadvertent household error(IHE) claim Twenty per cent

Administrative error(AE) claim Nothing

These rates do not apply to any reduction in benefits when you disqualify someone for an IPV.

If a succession of IHE and AE occurred over a period of months in such a manner as to prevent a determination of what months can be attributed solely to assistance group (AG) error twenty per cent shall not be retained by the county. If the county discovers overpayments spanning several months, some months attributable solely to AG error and some months to agency error, two claims must be established in order to retain twenty per cent of the collections on the IHE claim. Overpayments occurring in months attributable to AG error must be calculated independently of the months attributable to agency error. Separate JFS 07424 "Report of Claim Determination/Lost Benefits", (rev.8/01) forms must be completed.

If an overpayment is a result of IHE and AE with the same month, the claim will be considered an AE and twenty per cent shall not be retained by the county.

(B) Change in claim status: established IHE claim to IPV claim

The county agency shall retain twenty per cent of the value of cash monies, coupons collected, lost benefits offset, or allotment reductions on an IHE claim. The county agency shall retain twenty per cent of the amounts recovered on a claim being handled as an IHE claim pending a determination by an administrative disqualification hearing officer or a court of appropriate jurisdiction that IPV was committed, or receipt of either a signed waiver or consent agreement. Once the determination or signed document is obtained, the county agency may recover from the state an additional fifteen per cent incentive on collections made before the change in claim status. The county agency shall update the client registry information system enhanced (CRIS-E) when there is a change in claim status. The county agency shall revise the JFS 07424 when the status of a claim is changed from IHE to IPV.

(C) Claims accounting procedures

(1) As a county agency, you must maintain an accounting system for monitoring recipient claims against AGS. This accounting system shall consist of both the system of records maintained for individual debtors and the accounts receivable summary data maintained for these debts.

At a minimum, the accounting system must document the following for each claim:

(a) The date of discovery;

(b) The reason for the claim;

(c) The calculation of the claim;

(d) The date you established the claim;

(e) The methods used to collect the claim;

(f) The amount and incidence of any claim processing charges;

(g) The reason for the final disposition of the claim;

(h) Any collections made on the claim;

(i) Any correspondence, including follow-up letters, sent to the AG.

(j) In cases of IPV also include the administrative disqualification hearing decision, a disqualification consent agreement, waiver of administrative disqualification hearing, or court order indicating the AG was convicted of IPV.

(k) In cases of terminated claims, also include the basis for termination of collection action.

(2) At a minimum, your accounting system must also identify the following for each claim:

(a) Those AGs whose claims have become delinquent. CRIS-E automatically issues a notice to recipients whose installment agreement repayments are delinquent.

(b) Those situations in which an amount not yet restored to an AG can be used to offset a claim owed by the AG; and

(c) Those AGs with outstanding claims that are applying for benefits.

(3) When requested and at intervals determined by the food and nutrition service (FNS), your accounting system must also produce:

(a) Accurate and supported outstanding balances and collections for established claims; and

(b) Summary reports of the funds collected, the amount submitted to the state, the claims established and terminated, any delinquent claims processing charges, the uncollected balance and the delinquency of the unpaid debt.

(4) On a quarterly basis, unless otherwise specified, your account system must reconcile summary balances reported to individual supporting records.

(D) Correlating claim repayments with FNS billings

The following procedures are to be followed until food stamp coupons are totally replaced by EBT:

(1) Certain transactions caused by administrative error shall be reported via the FNS-46 "Issuance Reconciliation Report", (rev.8/89) and any related claim repayments designated by entering a "Y" (yes) on BVRC, "46 billing." The JFS 07424 shall be completed and earmarked for special handling by the county agency.

(2) Coupons collected for such claims shall be destroyed via the FNS-471. Copies of pertinent FNS-471 forms, "Coupon Account And Destruction Report", (rev.4/86) shall be retained to submit for credit upon receipt of the FNS-46 billing.

(3) Counties are encouraged to establish separate accounting procedures for overpayments that are included in the FNS-46 report so that when the next FNS-46 billing arrives, all the proper records are readily available to determine the accuracy of the billing amount and the amount of monies retained by the county agency in anticipation of the FNS-46 billing.

(4) Coupon destruction

(a) The county agency shall be responsible for the destruction of coupons collected for the repayment of food stamp claims within thirty days from the close of the month in which the coupons were received. FNS-471 shall be used to account for the destruction of such coupons. The FNS-471 shall be completed and properly filed at the county agency.

(b) The destruction of coupons collected for the repayment of food stamp claims shall not be reflected on the FNS-250 "Food Coupon Accountability Report.", (rev.10/98)

(c) The county agency shall destroy the coupons and coupon books by burning, shredding, tearing, or cutting so as to make them nonnegotiable. Destruction must be witnessed by a county agency official and one other witness.

(d) Claim repayments made by coupons shall not be entered into CRIS-E until the completed destruction can be documented by a signed FNS-471.

(E) Public assistance(PA) fund repayment adjustment

The county agency is eligible to retain, as an incentive, a percentage of collections made on IPV and IHE claims. The county agency shall deposit all cash collections reported into its PA fund. The county's PA fund then will be adjusted, as part of the quarterly reconciliation process, to reflect the amount of total collections the county agency is entitled to retain. Monies are automatically deducted or restored as identified via claim repayment entries on CRIS-E.

Effective: 03/23/2006
R.C. 119.032 review dates: 09/01/2009
Promulgated Under: 111.15
Statutory Authority: 5101.54
Rule Amplifies: 329.04 , 329.042 , 5101.54
Prior Effective Dates: 6/2/80, 6/20/80, 10/1/81, 6/2/82, 8/15/82, 9/27/82, 1/1/83, 8/1/83, 9/24/83 (Temp.), 11/11/83, 4/1/84 (Temp.), 6/1/84, 5/3/85 (Emer.), 8/1/85, 10/1/88 (Emer.), 11/18/88, 7/11/89 (Emer.), 9/17/89, 1/5/90 (Emer.), 5/22/90, 10/1/90, 10/1/91, 2/3/92, 8/1/92 (Emer.), 10/30/92, 6/1/94, 9/1/94, 8/1/95, 12/1/95, 5/1/96, 9/22/96 (Emer.), 10/1/96, 10/1/96 (Emer.), 11/22/96, 1/1/97 (Emer.), 3/1/97, 3/23/97, 10/1/97, 2/1/98 (Emer.), 2/23/98, 8/1/98, 5/1/99, 7/15/99, 8/1/01 (Emer.), 8/11/01, 09/01/04

5101:4-8-30 Food assistance: Treasury offset program.

(A) The treasury offset program (TOP) allows the offset of eligible federal payments as a means of collecting delinquent food assistance program claims. Eligible federal payments include federal income tax refunds; federal salary income, including military pay; federal retirement income, including military retirement income; contractor/vendor payments; certain federal benefit payments, such as social security, railroad retirement (other than tier 2), and black lung (part B) benefits; and other federal payments, including certain loans that are not exempt from offset. The Ohio department of job and family services (ODJFS) certifies to the United States department of the treasury (treasury) a list of applicable debtors. The treasury then offsets the certified debts against applicable amounts payable to the debtors, and notifies the debtors and ODJFS of offsets which have been made.

(B) Claims referred to the TOP shall be past-due and legally enforceable. A claim is past-due when the county agency is receiving neither regular voluntary payments nor regular involuntary payments. A claim on which payment has not been received for one hundred twenty days and the debtor has not responded to notice of default is subject to referral to the TOP. A claim is not considered past-due if a state hearing decision on the issue of the claim is pending; if the thirty days allowed for the assistance group's response to a JFS 07442 "Food Assistance Repayment Agreement" (rev. 11/2008) or its CRIS-E equivalent, have not yet expired; or if the assistance group is making payments pursuant to an agreed-upon schedule of payments. In order for a claim to be legally enforceable, the case record must contain verification that the assistance group has been notified of hearing rights concerning the claim. There are five additional criteria for claims to be referred to the TOP:

(1) Only properly established claims may be submitted. The county agency shall have documentation showing that the claim was properly established.

(2) The claim balance is twenty-five dollars or more.

(3) The claim has not been discharged in bankruptcy, nor is there a bankruptcy stay in effect.

(4) The entire balance due for each individual claim shall be submitted separately. Each claim submitted shall have at least one liable adult referred for offset.

(5) Claims may not be submitted for offset unless debtors have been provided notice of this intended action and of the right to a review.

(C) Before certifying the debt to the TOP, an automated notice of intent shall be mailed to the debtor. The notice shall inform the debtor that agency records document that the debtor is liable for a specified unpaid food assistance claim balance, that the debtor had previously been notified about the claim, and that prior collection efforts have been made. The notice shall also state that the claim is past-due and legally enforceable, and that the county agency will refer the claim to the TOP unless the debtor pays the claim within sixty days of the date of the notice or makes other acceptable repayment arrangements. The notice shall include instructions about how to pay the claim and how to contact someone at the county agency to discuss the claim and the intended offset. The notice shall also advise the debtor to contact the county agency if the debtor believes that a bankruptcy proceeding prevents collection of the claim or if the claim has been discharged in bankruptcy; and that a married debtor may contact the internal revenue service before filing a joint income tax return, regarding protecting the share of the income tax refund which may be payable to a spouse who is not a delinquent debtor to the United States government.

The following information about requesting a formal review is included on the notice.

(1) The debtor is entitled to request a formal review concerning the intent to refer the debt for offset.

(2) The county agency will not conduct a formal review which is requested later than sixty days after the date of the notice.

(3) A claim for which a formal review has been requested will not be referred for offset while under review.

(4) A request for a formal review shall include evidence or documentation of the reason the debtor believes that the claim is not past-due or is not legally enforceable. A request for formal review is not considered received until such documentation is received.

(5) A request for formal review shall contain the debtor's social security number.

(6) If someone other than the debtor makes a written request for review on behalf of the debtor, it shall include a statement, signed by the debtor, authorizing the person to represent the debtor.

(D) Each county agency shall have nationwide toll-free telephone service available to TOP debtors during the agency's regular business hours. The toll-free telephone number and a mailing address for the applicable county agency shall be printed on all TOP notices to debtors.

When a debtor who has received a sixty-day notice of intent to offset contacts the applicable county agency, the agency shall verify the debtor's identifying information, access the claim case information, and discuss the case with the debtor. If the debtor wishes to make arrangement for repayment, the debtor shall be informed of repayment arrangements acceptable to prevent offset.

When the debtor contacts the county agency in writing, the county agency shall determine whether the debtor is requesting a review, and, if so, whether the request is for formal review or informal review. A request for formal review shall include evidence or documentation of the reason the debtor believes that the claim is not past-due or not legally enforceable. The county agency shall respond to all requests for review.

(E) If the notified debtor makes acceptable repayment arrangements, the claim shall not be referred for offset. For purposes of the TOP, acceptable repayment arrangements are as follows:

(1) If the applicable claim(s) balance is five hundred dollars or less, the balance shall be paid in full within sixty days of the mailing date of the sixty-day notice.

(2) If the applicable claim(s) balance is more than five hundred dollars, payment totaling five hundred dollars and written agreement to repay the balance shall be received by the county agency within sixty days of the mailing date of the sixty-day notice.

(F) Any repayment which the county agency receives in response to a debtor's receipt of a sixty-day TOP notice of intent to refer a claim for offset shall be credited to the claim which is proposed to be referred for offset. The county agency shall enter the repayment information into CRIS-E on the day that the repayment is received.

(G) The county agency shall issue a written decision within fifteen days of receipt of a debtor's request for formal review. The decision shall notify the debtor whether the claim is determined to be past due and legally enforceable.

(H) The county agency shall determine that the claim is past-due and is legally enforceable unless the individual documents that:

(1) The claim is not past-due or is not legally enforceable because it was already paid;

(2) The individual is not liable for the claim;

(3) A bankruptcy action prohibits collection of the claim because the debtor has filed for bankruptcy or the claim was discharged by the bankruptcy proceeding; or

(4) There is another documented reason that the claim is not past-due or is not legally enforceable.

(I) If the county agency determines that the claim is past-due and legally enforceable, the county agency shall notify the debtor in writing of the continued intent to refer the claim for offset. The debtor shall also be notified that the debtor is entitled to have a United States department of agriculture (USDA) food and nutrition service (FNS) review of the decision and provided instructions and time limits for requesting the FNS review. The request for an FNS review must be received by the USDA FNS midwest regional office within thirty days from the date of the state's decision letter.

(J) If the county agency determines that the claim is not past-due or is not legally enforceable, the county agency shall notify the debtor in writing that the claim will not be referred for offset, and may take any action necessary to establish and/or recover the claim or other action as may be required.

(K) ODJFS shall not refer for offset any claim for which a formal review has been requested if:

(1) The county agency determines that the claim is not past-due or is not legally enforceable;

(2) The county agency does not complete a requested formal review and notify the debtor of the results of that review at least thirty days prior to the deadline for certification of the offset file; or

(3) FNS notifies ODJFS that it has determined that a claim reviewed by FNS is not past-due or is not legally enforceable, or FNS notifies ODJFS that FNS has not completed its review of the claim.

(L) FNS notifies ODJFS and the debtor of its decision concerning any debtor's request for FNS review of a county agency review decision. If the FNS review decision is that the county agency correctly determined that the claim is past-due and legally enforceable, FNS notifies the debtor that any further appeal must be made through the courts. If the FNS review decision is that the county agency incorrectly determined that the claim is past-due and legally enforceable, FNS also notifies ODJFS about any corrective action which must be taken with respect to the claim. ODJFS will then notify the applicable county agency.

(M) When the county agency receives a written request for review, and the request is not accompanied by documentation of the reason the debtor believes that the claim is not past-due or is not legally enforceable, the county agency shall conduct an informal review addressing whether the claim is past due and legally enforceable and shall issue a written review decision to the debtor.

(N) Following the selection of a claim for potential referral, and continuing throughout the notification and offset processes, CRIS-E generates reports to each county agency and to treasury concerning cancellations and changes. After the final certification of a referral, ODJFS sends weekly update information to treasury. Changes entered into CRIS-E, such as payments received, repayment arrangements made, decreases in claim balances, reopening of food assistance program cases, and bankruptcy filings, automatically update referral data already sent to treasury.

(O) When county agency or ODJFS staff become aware that a claim referred or to be referred for offset does not meet all criteria for referral, ODJFS shall cancel the referral. If the reason for cancellation of the referral is not recognizable to CRIS-E, the county agency shall inform ODJFS of the inappropriate referral. The county agency shall submit the JFS 07430, "Offset Programs Referral Cancellation / Refund Request" (rev. 01/2004). The county agency shall submit the JFS 07430 by fax or email to ODJFS within one workday after the date of the determination that the referral shall be canceled. ODJFS shall update the referral file within one workday after the date of receipt of the JFS 07430.

(P) When an offset occurs, ODJFS shall credit the applicable claim(s) and update CRIS-E accordingly.

(Q) Promptly upon receiving notice of an offset, ODJFS shall refund to an individual any over-collection which results from the offset.

(R) ODJFS and the county agency shall safeguard internal revenue service (IRS) information from unauthorized access and use. For the purpose of the TOP, IRS information includes printed reports and on-line CRIS-E information provided to authorized personnel. This information shall be used only as needed for the administration of the TOP and collection of food assistance debt, and shall be protected from overt and inadvertent disclosure.

Effective: 04/15/2010
R.C. 119.032 review dates: 04/01/2014
Promulgated Under: 111.15
Statutory Authority: 111.15 , 5101.54
Rule Amplifies: 329.04 , 329.042 , 5101.54
Prior Effective Dates: 8/1/1995, 7/1/96, 9/13/96, 9/1/98 (Emer), 11/1/98, 1/01/04, 4/01/09