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Special Investigations Advisory Committee
September 9, 2003
DMA Building
Raleigh, NC
Paul Burge, Co-Chair, called the meeting to order. He made the announcement that Jane Kimsey, Co-Chair, had to resign from the committee due to conflict of schedule. He also stated he would be retiring in December of 2003. Mr. Burge had spoken with Larry Johnson, Chairperson of the Director’s Association, to assist in finding a new co-chair for this committee. He asked the committee to talk with their directors to see if any would consider serving on this committee.
The minutes for August were approved with a correction and an addition. The correction was that Larry Johnson is the new Chairperson of the Director’s Association. John Shore is the 2 nd Vice President. The addition was that Vi Simmons explained that tax intercept had been looked into and would not be a possibility for Child Care since the county repays the money through reimbursement adjustments, which means the client does not have a debt with the State. The question was raised, “What are counties to do with funds collected which they had been instructed to hold for the two years prior to the policy effective 10/02?” Ms. Simmons stated she thought counties had already been instructed. No one present was aware of this. Ms. Simmons stated the claims should be adjusted through the reimbursement system, and then the county could keep the funds collected to offset the reimbursement deduction.
Brenda Porter, DMA, stated that claims sent to DMA had a new address, which is now: DMA/Claims, 2501 Mail Service Center, Raleigh, NC 27699-2501. This is where all profile requests should be sent. You may continue to fax these requests to 919-715-7706. You may also e-mail Kelly Brantham at Kelly.branthom@ncmail.net .
DMA is not accepting the old profile requests (DMA-7063). Each county should be using the new 7063 that was effective 3/03. This is in part due to meeting HIPPA guidelines for confidentiality. DMA is also requesting that you put your name and title on the profile so they will know who is requesting the profile and please put the referral ID# on this. This is also for HIPPA guidelines. If a client requests their profile, be sure the client picks this up at the agency and brings ID to verify this is the client. You need to have client sign a receipt to the agency that they received this profile from you.
The collections for Medicaid for 8/03 were $205,621.72. For the fiscal year (which is 7/03 thru 8/03) the collections were $415,956.97.
A terminal message was sent out regarding the BEERS report and FRR report. These were sent to the counties in 8/03. The FRR report was sent 8/1/03 and the BEERS report was sent 8/5/03.
Another terminal message stated that extended Medicaid is no longer. It has gone back to transitional Medicaid. A report is in XPTR to show what cases was transferred to transitional.
The report FRD-509 (Cases Terminated, Closed, Transferred, Deleted) is showing that any claim that was transferred to another county is appearing as a TANF claim. This will be corrected in the future. At this time, each investigator needs to look at this report and determine what category this claim should be in.
Shara Britt, DMA, had put together a spreadsheet regarding statistics for Medicaid Claims and Referrals for all 100 counties. This was taken from the XPTR report. It shows how many pending Medicaid referrals each county has. It is very important that all referrals are being keyed into EPICS. If you are not receiving referrals from the caseworkers, you may want to talk with them about this. The spreadsheet shows the Medicaid Collections for the month of July of 2003 and the collections for June 2002 thru May 2003. This will also show balance of existing claims as of 6/30/03; number of claims established for 2003; and number of existing claims as of 6/30/03.
The question was brought forth regarding Federal Tax Intercept for Medicaid. At this point this is on the back burner with the committee that was formed. It will require federal legislation to do this. One way to increase collections is transfer of assets referrals. The clients usually want to stay on Medicaid and have the money to repay the Medicaid overpayment.
Paul Burge stated that his Child Support Supervisor had informed him that all information regarding tax intercepts should never be kept in the client’s record. This is a federal regulation and this may pertain to our records also. The investigators may need to check with their reps to find out this information. This is only regarding Federal Tax Intercepts and not State Tax Intercepts.
Marilyn Carpenter, USDA, has referred 135 individuals to the counties in the last 3 to 4 months. Please let USDA know whatever the outcome is with these referrals. The new undercover investigator, Calvin Bullock, may be attending the SIAC meeting next month.
Donna Smith, DSS, stated that the Federal Tax Program (TOP) is through the IRS and they do have confidentiality rules. All information on TOP is to be kept under lock and key. Any 60 day notices that are returned are to be kept also under lock and key. The Federal Tax Indicator in EPICS is being changed to TOP indicator.
Donna stated she had gone to the UCOWF conference in Baltimore and that the attendance was really down this year. Day Care Issues were discussed at the conference. Some states that the Day Care Subcommittee may wish to contact are Ohio, Minnesota, and Virginia. You may wish to contact either Michelle Laughter in VA, or Mary Ward in Virginia regarding Day Care Policy. Ms. Ward’s e-mail address is maw900@dss.state.va.us . George Sheer, Fraud Unit in VA may be another contact. His e-mail address is gms2@dss.state.va.us .
Donna also stated another reason for attending UCOWF was to find out about having TOP for TANF. After hearing the discussion, which at this point, was just a survey, it does not look promising for the state to consider this.
Donna stated that as of 9/12/03 she would be going back to Harnett Co. and will no longer be working with the State Office. This is due to personal reasons. She will be in the Food Stamp Unit in this county. She will miss each and every one.
Debbie Knowles, DSS, stated she has some re-organizational news. The Section Administrator will be Wilbert Morris, which falls under the Economic Services Section. The Assistant Program Administrator will be under Mr. Morris. This is the position that was vacated by Suzanne Marshall, which has not been filled as of this date. The interviewing has been completed. Under the Assistant Program Administrator will come several sections which include: Refugee Section, Food Stamp and Energy Section, ENT Section, Monitoring Section; and the PIRs.
The Food Stamp and Program Integrity Section has good news. One of the consultant positiions been rewritten as Program Integrity Consultant and this position will be posted either today or tomorrow, along with 2 other Food Stamp consultant positions. This will mean 3 Food Stamp policy writers and 1 Program Integrity consultant. Debbie Knowles has taken one of the Food Stamp policy positions and will not be working with Program Integrity. Someone will take over this as a full time position.
All Program Integrity questions need to go to your PIR first or through the Help Desk. EPICS questions need to go through the EPICS Help Desk.
Pam Baker, County Attorney for Mecklenburg County DSS and Assistant DA in Mecklenburg County, spoke about day care issues that she has been working on. She stated that she has noted since last fall that Child Care Subsidy fraud cases have dropped dramatically. She has discovered that in Mecklenburg County this has affected fraud in other programs. By cross-referencing cases, when looking at Day Care fraud she found that a client may be on Food Stamps and Day Care. That same client may state to one worker she is not working in order to receive Food Stamps, and to the Day Care caseworker state she is working in order to receive Child Care assistance.
After a request asking her about the federal law concerning repayments of day care fraud Vi Simmons sent Ms. Baker a copy of a letter written by Peggy Ball dated 11/20/02, even though this policy change was effective 9/02. The letter does not say a state has to repay overpayments immediately. It says that fraudulent payments need to be repaid to the federal government as they come into the state. The state does need to report the overpayments. By repaying at a later date, this would mean offsetting next year’s grant. There does not seem to be anything in Federal Law that states you are required to pay the money up front. The State Law has not changed. At this point the counties receive no incentive monies and have to pay the money up front. The federal statute is clear regarding the fact that states do have to recover fraud.
Paul Burge, Director’s Association, stated this has been a concern with the Director’s Association regarding the day care issue and how repayments are to be handled. The western half of the state will be having a meeting the end of the month and Mr. Burge will bring this up again to the directors.
Mr. Burge also stated that all voting rights that had been sent in thus far had been approved by Mr. Johnson.
Mr. Burge stated that a new program is underway which is “Leading by Results”, which has been implemented by the Director’s Association. This program is charging the committees to come up with ways to measure our success and measure what we do and use this as a guideline on how the committees will be conducted in the future.
Mr. Burge will continue to try and find a replacement co-chair.
Diane Daniel, Planning Committee, stated that the committee will meet at the Ramada Inn in Asheville on the 25 th and 26 th of this month. At that time, we will decide on the dates for the 2004 conference. If you have any suggestions for workshops, please contact Brenda Porter or Shara Britt. An invitation will be extended to Larry Johnson to attend the 2004 conference.
Sub Committee Reports:
Long Term Goal—Mandated Program Integrity
Shara Britt, Chair, will be sending out a survey regarding program integrity. This will be sent out to directors in a Dear County letter or memo. Also, the network presidents will need to bring this up at their network meetings.
Short Term Goal—Child Care
Shelia Dorsett stated they would be contacting the other states that were talked about at UCOWF to determine how they are set up on Child Care Fraud. They discussed with Pam Baker the information she has gathered together regarding what she has come up with. The committee is eagerly awaiting the outcome of Lee County court case regarding the child care fraud.
Short Term Goal—Increasing Collections
Robbie Brady, Chair, stated the committee would be contacting different counties and sharing information with the committee on how collections are done. They will also be looking at taking more clients to small claims court when the county has a signed repayment agreement.
Short Term Goal—Access to EPLN
Diane Daniel, Chair, stated they are still trying to get an answer from Child Support Office on how to go about getting this access. She will be checking with her Security Officer in her county when she returns from medical leave.
Short Term Goal—Training & Policy
Sharon Beasley, Chair, stated they are working on several different issues. Brenda Porter will be contacting the reps regarding the investigators receiving more training and being made aware of training & policy changes in all programs. They are looking into investigators talking with their directors regarding being included in policy training and changes. She asked that Paul Burge would advocate for the investigators at the Director’s Association that the investigators need to be included in these training & policy issues.
Short Term Goal—Contact List
Jean Jacobs stated she was the only one at the meeting; therefore there was no meeting. She did state they are getting with each region president to compile an updated list of investigators at this time.
The next meeting will be October 7, 2003 at the DMA building.
The meeting was adjourned.
Respectfully submitted by:
Linda C. Peters
SIAC Secretary
