DSS chief briefs legislators on fraud investigations
One thing you need to know about social services and fraud is that just because a person isn't living up to your standards doesn't mean that person is getting public assistance illegally.
The lady could be on her sixth boyfriend in 10 months. She could be pregnant with her seventh son. The man down the road could be a drunk or a pack rat. Both husband and wife could sit on the front porch all day smoking Senecas, or hit the corner deli every day to buy scratchers.
None of that constitutes evidence of fraud, according to Genesee County Social Services Commissioner Eileen Kirkpatrick.
Kirkpatrick spoke with the Human Services Committee today after a legislator raised questions about how DSS handles fraud cases.
While it's the responsibility of all DSS staff members to be on the look out for evidence of fraud, the department employs two full-time fraud investigators (the second position was created in 2006).
And those two investigators are kept busy.
Every day, DSS accepts 16 new applications for public assistance, and every one of them is a potential fraud case.
Of course, of the thousands of cases DSS handles every year, only a relatively few ever reach the stage of an actual fraud investigation.
In 2008, the two investigators formally investigated 342 cases, and there were 582 investigations in 2009.
"When you think about the number of cases we handle in our department, when you think about the thousands of cases, the number of complaints we investigate are really minuscule compared to what we are really doing," Kirkpatrick said.
A fraud investigation can either begin with a complaint, or during the initial application process, Kirpatrick said.
During the interview process, DSS workers look for inconsistencies, using a standardized set of "red flags": Has the applicant recently moved into the county; no documentation; primary tenant with no utility bills; landlord does not verify household composition; or an invalid social security number, for example.
Tips might come from law enforcement, other social services departments, friends, neighbors or even current welfare recipients.
"Clients are famous for ratting on other clients," Kirkpatrick said. "It's usually in defense of their own status. 'If you think what I'm doing is bad, how about ...'" motioning as if pointing to another person.
The screening process generally catches people coming into the county just looking for an easy way to get on public assistance, she said.
"People don't find it that easy to just come in and get on assistance in our department," Kirkpatrick said. "If they need help, we're going to help them, but they're going to have to do what they need to do to complete the program."
Which usually means looking for work, getting job-placement assistance, applying for job training and working to get off of public aid.
Contrary to what some may think or wish, evidence of drug abuse doesn't disqualify a person for public assistance, but all applicants are screened for substance abuse. If abuse is suspected, the person is referred to GCASA.
From time to time, a person makes it through the screening process when they shouldn't -- or gets on public assistance and then later starts earning money not originally reported.
For example, a person might start a new business and not report the income.
It's amazing, Kirkpatrick said, what a good Google search might find about a person's attempts to earn disqualifying income. Investigators also check Facebook and Twitter.
And even comments left on The Batavian -- and there have been examples, Kirkpatrick told legislators, of DSS recipients leaving comments on The Batavian that have led to investigations.
One gentleman on assistance set up a web page for his home business, complete with numerous pictures of his work, and was earning a good living making an undisclosed item. When his entreprenuerism was discovered, DSS shut off his assistance.
When a suspected case of fraud is found, assistance is terminated, but recipients have a right to appeal. During the appeal process, payments continue.
While all tips are welcome -- Kirkpatrick reiterated near the end of the meeting -- that just because a woman's millionaire boyfriend moves in, doesn't mean she is no longer eligible for medicaid. That's not fraud, she said. She could even continue to get food stamps if the boyfriend swore he bought and cooked his own food.
It's also not fraud to fail to comply with DSS rules. Rules violations could jeopardize benefits, but is not considered fraud.
Fraud is an intentional attempt to obtain benefits to which the recipient is not entitled, Kirkpatrick said.