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(a) The Department shall conduct a thorough and reliable program of quality control with respect to the administration of assistance under this Article VII.
(b) The quality control program shall include, but not be limited to:
(1) The selection and full field review of a random, representative sample of cases drawn from all active County Adult Assistance Programs cases.
(2) The identification and analysis of administrative errors and discrepancies contained in the sample and the actual and projected fiscal impact thereof.
(3) The development and implementation of measures to correct or alleviate the errors and discrepancies.
(As Sec. 20.59.11, amended by Ord. 212-80, App. 5/16/80; Ord. 152-98, App. 5/8/98; redesignated as Sec. 20.7-39 and amended by Ord. 153-16, File No. 160636, App. 8/1/2016, Eff. 8/31/2016, Oper. 1/1/2017)
(a) The Department may report quality control findings to the Human Services Commission.
(b) The report may contain, but not be limited to:
(1) The number of cases in the sample by month and year to date.
(2) The number of cases found ineligible, overpaid, or underpaid for the month and year to date.
(3) The actual and projected total fiscal impact resulting from ineligibility and overpayments for the month and year to date.
(4) The corrective actions proposed and the schedule of implementation for corrective actions.
(5) The status of previous corrective actions and any other information requested by the Board of Supervisors.
(As Sec. 20.59.12, amended by Ord. 212-80, App. 5/16/80; Ord. 152-98, App. 5/8/98; redesignated as Sec. 20.7-40 and amended by Ord. 153-16, File No. 160636, App. 8/1/2016, Eff. 8/31/2016, Oper. 1/1/2017)
The Department shall maintain a case record for every Recipient. The Department shall also maintain a record on those Applicants whose requests for assistance were denied; such record shall include name and address of Applicant and the reason(s) for denials.
(As Sec. 20.59.13, amended by Ord. 212-80, App. 5/16/80; redesignated as Sec. 20.7-41 and amended by Ord. 153-16, File No. 160636, App. 8/1/2016, Eff. 8/31/2016, Oper. 1/1/2017)
All County Adult Assistance Programs records shall be confidential and shall not be opened to examination or inspection except by the Grand Jury of the County or by a board or an officer of the State or the County charged with the administration, supervision, or direction of the County Adult Assistance Programs, or upon written waiver by the Applicant or Recipient.
(As Sec. 20.59.14, amended by Ord. 212-80, App. 5/16/80; redesignated as Sec. 20.7-42 and amended by Ord. 153-16, File No. 160636, App. 8/1/2016, Eff. 8/31/2016, Oper. 1/1/2017)
Except as otherwise provided in Section 20.31, all inactive case records that are over three years old may be destroyed. All records pertaining to denial of initial eligibility may be destroyed after five years.
(As Sec. 20.59.15, amended by Ord. 212-80, App. 5/16/80; redesignated as Sec. 20.7-43 and amended by Ord. 153-16, File No. 160636, App. 8/1/2016, Eff. 8/31/2016, Oper. 1/1/2017)
Whenever any person has, by means of false statement or representation or by impersonation or other fraudulent device, or by intentional failure to report facts required by this Article VII or Department regulations, obtained aid under this Article, the matter shall be referred to the District Attorney’s office for appropriate action.
Further, upon the first discontinuance of aid within a 24-month period due to false statement or representation or by impersonation or other fraudulent device, or by intentional failure to report facts required by the Article or department regulations, an Applicant or Recipient shall be unable to reapply for aid for a period of 30 days.
Upon the second such discontinuance within a 24-month period, the Applicant or Recipient shall be unable to reapply for aid for a period of 60 days.
Upon the third, or additional, such discontinuance within a 24-month period, the Applicant or Recipient shall be unable to reapply for aid for a period of 90 days.
(As Sec. 20.59.16, amended by Ord. 212-80, App. 5/16/80; amended by Proposition V, 11/2/93; Ord. 152-98, App. 5/8/98; redesignated as Sec. 20.7-44 and amended by Ord. 153-16, File No. 160636, App. 8/1/2016, Eff. 8/31/2016, Oper. 1/1/2017)
An Applicant for or Recipient of assistance under this Article VII dissatisfied with any actions of the Department relating to withholding, decrease, denial, discontinuance, and/or recoupment of overpayment of aid shall be accorded a fair hearing upon filing a timely request with the Department.
(As Sec. 20.60, amended by Ord. 271-81, App. 5/21/81; redesignated as Sec. 20.7-45 and amended by Ord. 153-16, File No. 160636, App. 8/1/2016, Eff. 8/31/2016, Oper. 1/1/2017)
The Department shall issue a Notice of Proposed Action whenever it intends to withhold, decrease, or impose denial, discontinuance, and/or recoupment of overpayment of aid. In all cases, except where an initial denial is involved, this notice shall be hand delivered or mailed at least 10 calendar days prior to the proposed action.
In those cases where an expedited hearing is provided for, notice shall be delivered or mailed at least five calendar days prior to the proposed action. Such notice shall include all alleged acts in the record known to the Department at the time upon which such action can be based under Department regulations. The notice shall describe with reasonable particularity the act or acts which form the basis for the proposed action.
(As Sec. 20.60.1, amended by Ord. 271-81, App. 5/21/81; redesignated as Sec. 20.7-46 and amended by Ord. 153-16, File No. 160636, App. 8/1/2016, Eff. 8/31/2016, Oper. 1/1/2017)
A claimant or an authorized representative may request a fair hearing verbally or in writing. Where a Recipient requests a hearing to challenge a Discontinuance, the Recipient shall make the hearing request within three business days of the effective date of the Discontinuance. Where an Applicant or Recipient requests a hearing to challenge any agency action other than a Discontinuance, including but not limited to Decreases and Denials, the Applicant/Recipient shall make the hearing request within ten calendar days of the effective date of the agency action. If no written request for a hearing is either delivered to the Department or postmarked within that period and no verbal request is made within that period, no hearing shall be granted except in cases of verified hospitalization, verified illness, verified incarceration, verified disability, or other good cause satisfactorily shown to the Executive Director.
(As Sec. 20.60.2, amended by Ord. 212-80, App. 5/16/80; Ord. 152-98, App. 5/8/98; redesignated as Sec. 20.7-47 and amended by Ord. 153-16, File No. 160636, App. 8/1/2016, Eff. 8/31/2016, Oper. 1/1/2017)
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