Administrative Disqualification Hearings for Food Assistance
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Administrative Disqualification Hearings for Food Assistance


Revised January 5, 2012



WAC 388-446-0015What is an Intentional program violation (IPV) and administrative disqualification hearings (ADH) for food assistance.

WAC 388-446-0015

WAC 388-446-0015

Effective March 21, 2014

WAC 388-446-0015 What is an Intentional program violation (IPV) and administrative disqualification hearings (ADH) for food assistance.

1.    An intentional program violation (IPV) is an act in which someone intentionally:

a.    Misrepresents, conceals or withholds facts in order to be found eligible for benefits or to receive more benefits than their actual circumstances would allow. This includes making a false statement regarding household circumstances.

b.    Acts in violation of the Food Nutrition Act of 2008, regulations for the supplemental nutrition assistance program (SNAP) under Title 7 of the Code of Federal Regulations or any state statute relating to the use, presentation, transfer, acquisition, receipt, trafficking, or possession of food assistance benefits including:

c.  Attempts to buy, sell, steal, or trade food assistance benefits issued and accessed via Electronic Benefit Transfer (EBT) cards, EBT card numbers, or personal identification numbers (PINs), for cash or anything other than eligible food, alone or acting with others.

2.    If we suspect someone has committed an IPV  we refer their case for an administrative disqualification hearing (ADH), if:

a.    The suspected IPV causes an over issuance of four hundred fifty dollars or more; or

b.    The suspected IPV is due to the trafficking of food benefits; and

c.    The person has not been referred for criminal proceedings.

3.    An administrative disqualification hearing (ADH) is a formal hearing to determine if a person committed an IPV.  ADHs are governed by the rules found in chapter 388-02 WAC.  However, rules in this section are the overriding authority if there is a conflict.

4.    A person suspected of an IPV can choose to waive their right to an ADH by signing a disqualification consent agreement that waives their right to the hearing and accepts the IPV penalty under WAC 388-446-0020  .

5.    If someone commits one or more IPVs and is suspected of committing another, we refer them for an ADH when the act of suspected violation occurred:

a.    After we mailed the disqualification notice to the client for the most recent IPV; or

b.    After criminal proceedings for the most recent IPV are concluded.

6.    When we suspect someone has committed an IPV, we refer their case for an administrative disqualification hearing (ADH). The office of administrative hearings (OAH) sends them notice of an ADH at least thirty days in advance of the hearing date. OAH sends the notice by certified mail, or personal service. The notice will contain the following information:

a.    The date, time, and place of the hearing;

b.    The charges against the person;

c.    A summary of the evidence, and how and where they may examine the evidence

d.    A warning that a decision will be based entirely on the evidence the department provides if they fail to appear at the hearing;

e.    A statement that the person has ten days from the date of the scheduled hearing to show good cause for  failing to attend the hearing and to ask for a new hearing date;

f.     A warning that a determination of IPV will result in a disqualification period; and

g.    A statement that if we schedule a telephone hearing they can request an in‑person hearing by filing a request with the administrative law judge one week or more prior to the date of the hearing.

7.    The department may combine an ADH and a regular hearing when the reason for both hearings is related.

8.    The person or a representative shall have the right to one continuance of up to thirty days if a request is filed ten days or more prior to the hearing date.

9.    The administrative law judge (ALJ) will conduct the ADH and render a decision even if the person or representative fails to appear, unless within ten days from the date of the scheduled hearing:

a.    The person can show good cause for failing to appear, and

b.    The person or representative requests the hearing be    re‑instated.

10. We may change a scheduled telephone hearing to an in‑person hearing if this is requested by the person or department representative at least a week in advance.  The person requesting a change less than one week in advance must show good cause for the requested change.

11. The ALJ issues a final decision as specified in WAC 388-02-0215  through WAC 388-02-0525. The decision determines whether the department had established with clear and convincing evidence that the person committed and intended to commit an IPV.

12. The department and the client each have the right to request a reconsideration of the decision as specified in WAC 388-02-0610 through WAC 388-02-0635  .  The final order or the reconsideration decision is the final agency decision.

13. We will not implement a disqualification and continue benefits at the current amount if:

a.    The client can show good cause for not attending the hearing within thirty days from the date the disqualification notice was mailed; and

b.    An administrative law judge determines the client had good cause; or

c.    The client requests reconsideration or files a petition for judicial review to appeal the disqualification as specified in WAC 388-02-530  (1) or (4).

 

This is a reprint of the official rule as published by the Office of the Code Reviser. If there are previous versions of this rule, they can be found using the Legislative Search page.

CLARIFYING INFORMATION

1.    An Intentional Program Violation (IPV) of the Food Assistance program can be determined by a decision in an Administrative Disqualification Hearing or by a decision of the court in a criminal prosecution.

2.    The department must decide whether to refer an IPV instance for prosecution or for an ADH; both procedures shall not be pursued at the same time. Upon completion of an ADH, the department may choose to then refer the case for prosecution.

3.    Separate instances of suspected IPV could be combined into one complaint that totals $450 or more. See FRAUD.

4.    The department must prove the IPV with "clear and convincing evidence". This means that the evidence must establish that it is highly probable the actions that resulted in the overpayment were intentional.

 


FHC RESPONSIBILITIES

  1. Review the Disqualified Recipient System (DRS) to determine if the person suspected of an IPV has a record of past disqualifications.

  2. Determine the appropriate penalty based on the record of past disqualifications, if any

  3. Review the department records to identify evidence that will establish:

    1. An overpayment or combination of overpayments exists which total over $450 (e.g. a copy of the overpayment letter with proof of service if already served, or a copy of the letter if the overpayment letter has not been served).

    2. The respondent was aware of the reporting responsibilities.

    3. There was a change in circumstances that affected eligibility (e.g. an employer report which establishes the date that work began)

    4. The respondent had an opportunity to report the change, and failed to do so (e.g. a change of circumstance completed during the period of the overpayment)

    5. The respondent provided false or misleading information (e.g. denied working at an eligibility review).

  4. Ensure that all of the evidence to be proposed at the hearing is included. The ALJ may not be able to admit new evidence at the hearing that was not included in the listing of evidence on the complaint.

  5. Complete the Disqualified Hearing Complaint, DSHS 12-119(x) or ACES letter 0055-02 (First or Second Occurrence), 0055-04 (Third Occurrence). Include a listing of the evidence that will be used at the hearing.

  6. Send the complaint to the Office of Administrative Hearings and include a blank envelope (not window), which shows the CSO return address. OAH will schedule the hearing and send the notice to the respondent in the CSO envelope.

  7. If the notice is unclaimed or otherwise undeliverable, it will be returned to the CSO. Determine whether delivery should be attempted again either by personal service or remailing of the certified mail.

  8. If no further attempts at delivery will be made, notify OAH immediately that delivery has not been accomplished and the case should be removed from the docket.

  9. Hold the case until it can be resubmitted to the OAH for scheduling.


Final Agency Decision

Review the final decision to determine whether you agree that the administrative law judge has applied the law correctly. If you agree, take appropriate action to implement the final decision. If you do not agree, request a reconsideration of the final order in accordance with WAC 388-02-0605 through WAC 388-02-0635.
Modification Date: January 5, 2012