Forms and Filing

All forms and documentation related to an overissuance should be imaged. This includes, but is not limited to:

  • “Claim Determination Worksheet” (DFA 842)
  • “Food Stamp Budget Worksheet” (DFA 285B/CF 285 SAR), for claims pre-CalSAWS or NSCDC
  • Notices of action, if not in CalSAWS
  • “Food Stamp Repayment Agreement” (DFA 377.7E for AEs, DFA 377.7C for IHEs, or DFA 377.7G for IPVs)
  • “Food Stamp Repayment Notice” (CF 377.7D for AEs, DFA 377.7B for IHEs, or DFA 377.7F for IPVs) and the Overissuance Budget Worksheet NOA (NA 1263)
  • “CalFresh Intentional Program Violation Disqualification Notification” (SC 1354)
  • “Disqualified Recipient Report” (DPS 524)
  • “FNS 209 Change Report” (SC 1531).

Repaid Claims

When it is verified that a claim is repaid, the EW must update the Record Adjustment window, if needed, and document in the Journal Detail page.

The signed repayment agreement must be imaged.

Change in Type or Amount of Overissuance

Reporting Requirements

The federal government requires that all status changes in overissuances be reported. The report summary, the “FNS 209”, completed by FMS-Budget Unit, is used for that purpose. Additionally, the client must be notified of all such changes.

Type Change

Send a completed “FNS 209 Change Report” (SC 1531) to Research and Statistics when errors are found in:

  • The determination of any type of overissuance, or
  • The amount of the claim which was collected as a result of an incorrect determination.

Amount Change

Send an SC 1531 to Research and Statistics to report a change in the amount of a claim due to:

  • An error.
  • A recalculation.

Client Notification

  • Notify the household of a change in the type or amount of an overissuance using the appropriate notice of action.
  • If the client's whereabouts are unknown at the time of change, complete a flash form to notify the next EW to send a new notice of action if the case reopens.

Closed Cases

Effective June 1, 2019, when a CalFresh case closes with an OI and the OI amount is $400 or less, cancel the OI claim and do not refer to collection.

Reopening a Closed Case with An Overissuance

When a closed case with an uncollected overissuance reopens, the EW must take the following action:

  1. Call Public Assistance Collections to get an updated outstanding balance on the overissuance. (The client may have made payments to Public Assistance Collections during the time when the case was closed.)
  2. Document Public Assistance Collections' response in the Journal Detail page.
  3. Make computer entries to:
    1. Update the overissuance balance if Public Assistance Collections received payments while the case was closed.
    2. Send a new Overissuance NOA and “Repayment Agreement”.
      1. DO NOT reduce benefits in the current month.
  4. Complete the Overissuance NOA and “Repayment Agreement”, and mail the original plus one copy of each to the head of household.
  5. Follow directions in STEP 10 of “HOW TO PROCESS AN OVERISSUANCE” when 30 days have elapsed or the “Repayment Agreement” is returned, whichever comes first. Refer to How to Process an Overissuance.

Related Topics

How to Process an Overissuance