Matches Received by SIU

Overview 

The state sends five matches directly to Special Investigations Unit (SIU0 electronically. Information contained on the reports must be verified against public records prior to sending requests to district office for any case actions. 

Jail and Prison matches include:

  • Jail Reporting System (JRS)
  • California Youth Authority (CYA)
  • Nationwide Prisoner Match (NPM)
  • Fleeing Felon Match (FFM)

In addition to the jail matches SIU also receives the Deceased Person Match (DPM)

Match information is only an indication that fraud MAY be occurring. Therefore, the following actions are required to fully process match information:

STAGE WHO ACTION
1 Investigator
  • Receives JRS, CYA, NPM, DPM, and FFM match reports.
  • Establishes the match is valid. (i.e. information is appropriate, it appears to be the same individual as on the case record, checks CalSAWS.record for aid received, clarifies incomplete or inconsistent match information with the jail/CYA/prison, etc.).
  • Sends a “Public Assistance Fraud Match” (DA 1) and response document to the EW.

  • NOTE: If the case is a Medi-Cal only, the investigation will be completed by a state Department of Health Services Investigator.
2 Eligibility Worker
  • Compares the information provided in the match and processes according to match processing guidance. If further SIU investigation is needed, communicates with SIU.
  • Returns findings, and summary of action taken to SIU.
3 SIU Investigator
  • Conducts an investigation to gather facts proving or disproving the allegations as needed.
  • Makes a referral for the OP/OI computation to IEVS, if applicable.
4 EE from IEVS
  • Computes/processes any resulting overpayments and/or overissuances
  • Returns the case to the SIU Investigator.
5 SIU Investigator
  • Completes the IEVS response document and provides statistical reporting to the state.

Jail Reporting System (JRS)

The California Department of Social Services (CDSS) developed the Jail Reporting System (JRS) Match as a result of Senate Bill 1556, Chapter 10 to Part 2 of Division 9 of the W & I Code. This legislation requires city and county jails throughout California to report to the state (CDSS), persons who are or were incarcerated for more than 30 days.

Once a month, the information is matched against the MEDS Master Eligibility File to determine if individuals have received cash aid, CalFresh or Medi-Cal while incarcerated. The initial match criteria used is the Soicial Security Number (SSN). Criteria for the secondary match include name, aliases, birth dates, and sex.

The state sends the JRS Matches to the SIU.

California Youth Authority (CYA)

The California Youth Authority (CYA) matches are completed using the California Youth Authority files and matching against the MEDS Master Eligibility file for beneficiaries for the month of incarceration plus one prior month.

Note: The age of persons who are confined by the California Youth Authority can range from age 10-25 years old.

Once a month, the information is matched to determine if individuals have received cash aid, CalFresh or Medi-Cal while incarcerated. The initial match criteria used is the SSN. Criteria for the secondary match include name, aliases, birth dates and, sex.

The state sends the CYA Matches to the SIU.

Nationwide Prisoner Match (NPM)

The Nationwide Prisoner Match (NPM) is a semi-annual match run in April and October of each year. This match is run nationwide using the individual’s SSN. The NPM file is run against the JRS file to eliminate any duplicate prisoner information. The match uses the Social Services Agency (SSA) Prisoner Update Program System (PUPS) database to match against CalFresh, CalWORKs and Medi-Cal recipients. Incarceration is not a mandatory mid-period report, except in Annual Renewal Child-Only (AR/CO) cases. When incarceration is known to the county the EW must take mid-period action for both CalFresh and CalWORKs.

This information will only be returned if the client is still incarcerated or has been released within 90 days of the current date.

The NPM information is ONLY an indicator of possible program ineligibility. Therefore, EWs must verify whether the individual identified in the abstract is in the home. If the client presents conflicting information, refer the case to the DA investigators.

The Prisoner Report Section of the applicant IEVS abstract (RS-IEV410-R001) includes the following information:

SECTION

DESCRIPTION

REPORT DATE

The date the information was reported to SSA

NAME

The last name followed by the first name

DATE OF BIRTH

The date of birth as known by the correctional facility

CONFINEMENT DATE

The date the individual entered the correctional facility

FACILITY TYPE

The type of facility

FACILITY CONTACT

The name of the person who can be contacted for further information

FACILITY TELEPHONE

The phone number for the facility contact person

FACILITY FAX NUMBER

The fax number for the facility contact person

FACILITY/PRISON NAME

The name of the facility

FACILITY PRISON ADDRESS

The address of the facility

PRISONER ID NO

The identification number used by the facility for this individual

SEX

The sex of the individual per facility records

RELEASE DATE

The date of the actual release from the facility if known

Processing the NPM

NPM information is only an indication that fraud may be occurring. The following actions are required to fully process match information:

STAGE WHO ACTION
1 Investigator
  • Receives NPM match reports.
  • Establishes the match is valid. (i.e. information is appropriate, it appears to be the same individual as on the case record, checks CalSAWS record for aid received, clarifies incomplete or inconsistent match information.
  • Sends a “Public Assistance Fraud Match” (DA 1) and response document to the EW.

  • NOTE: If the case is a Medi-Cal only, the investigation will be completed by a state Department of Health Services Investigator.
2 Eligibility Worker
  • Compares the information provided in the match and processes according to match processing guidance. If further SIU investigation is needed, communicates with SIU.
  • Returns findings, and summary of action taken to SIU.
3 SIU Investigator
  • Conducts an investigation to gather facts proving or disproving the allegations as needed.
  • Makes a referral for the OP/OI computation to IEVS, if applicable.
4 EE from IEVS
  • Computes/processes any resulting overpayments and/or overissuances
  • Returns the case to the SIU Investigator.
5 SIU Investigator
  • Completes the IEVS response document and provides statistical reporting to the state.

EW Actions for NPM

Once the incarceration period has been verified for CalFresh:

  • If an adult household member is incarcerated more than 30 days and continues to be incarcerated the EW sends a notice of action to remove the individual and adjust benefits accordingly.
  • If at RRR/SAR 7 the household failed to report a household member is incarcerated and a NPM is received after the fact notifying the county of the incarceration the EW must access if an Overissuance should be established and send out a notice of action, as appropriate.
  • If the individual is no longer incarcerated and was not incarcerated during RRR/SAR 7 there is no discrepancy.

Once the incarceration period has been verified for CalWORKs:

  • If the adult was incarcerated on the first of a calendar month, is expected to continue incarcerated for one full calendar month or more, and continues to be incarcerated the EW sends a notice of action to remove the individual from the Assisted Unit (AU) and adjust benefits accordingly.
  • If the adult was incarcerated for a full calendar month when the AU applied for aid, at SAR 7, or RRR and the AU failed to report the incarceration of the adult, the EW must access whether and overpayment (OP) should be established and send a notice of action, as appropriate.
  • If the adult is no longer incarcerated ans was not incarcerated at application, SAR 7 or RRR the EW processes the match with no discrepancy.
  • For AR/CO cases it is a requirement to report incarceration within 10 days. The EW is required to recalculate benefits based on the change effective the first of the month following the change. OP are calculated according to the regulations for mid-period reports.

Note: For Medi-Cal cases refer to detailed instructions located in the Medi-Cal Handbook.

Action on Unclear Information

If the information in the NPM is not verified by a third party or the EW cannot readily determine its effect on the AU/HH’s continued eligibility or benefit allotment, the information is considered unclear and the EW must send a ‘Request for Verification Form’ (CW 2200) with the match results to the recipient. The notice must clearly explain what information the household must provide and the consequences of failing to respond to the notice. If the household does not respond to the notice of match results or does respond but fails to provide sufficient information to clarify its circumstances, the EW must remove the individual listed on the match from the household and adjust benefits accordingly. The EW must issue a notice of adverse action at least ten (10) days before the adverse action is taken.

Reminder: The 45-day processing rule does not apply to the NPM. Failure to remove an incarcerated individual from the AU/HH within 45-days is not considered a county error. OP/OI must be established by the quarter following the quarter in which the match was received. An OP/OI is only established if the AU/HH fails to report the change at initial application, SAR or RRR.

Fleeing Felon Match (FFM)

In July 1998, CDSS began implementing the Fleeing Felon Match (FFM). This match is run on a monthly basis using the Department of Justice’s Wanted Persons file (WPF). The information is matched against the MEDS Master Eligibility File to determine if individuals on the FFM have received cash aid or CalFresh.

Deceased Person Match (DPM)

The Death Person Match (DPM) matches the SSNs of CalFresh and CalWORKs recipients on aid with those of individuals reported deceased according to the Social Security Administration. Death is not a mandatory mid-period report, except in Annual Renewal Child-Only (AR/CO) cases. However, when a county becomes aware of a death, the county must take action mid-period. As a result, the match will often result in the disqualification of individuals currently receiving aid. However, an OP or OI may only be assessed under specific circumstances as outlined below.

Upon receipt of a DPM, the SIU must seek verification from third parties such as county offices of vital statistics, coroners’ offices, and/or obituaries. If the information is not verified by a third party or the county cannot readily determine the effect of the death on the AU/HHs, the information is considered unclear and the county must follow the process summarized below under “Action on Unclear Information”.

If a third party does verify the death and the county can readily determine the effect on the AU/HH’s continued eligibility or benefit allotment, the information is considered clear and the EW does not need to send a notice of match results.

Note: SIU staff upon receiving the DMP verify reported deaths against the Public Records Database to fulfill the requirement of Third Party Verification.

Description of Deceased Person Match (DPM)

Section Description
RUN DATE The printing/processing date
PROCESS DATE The month and year of the match
INFORMATION SENT TO SSA Shows recipient information sent to SSA
INFORMATION RETURNED BY SSA Shows information returned from the SSA DMF record and indicates the source of the data. The "DMF" under source file indicates that the data came from the SSA DMF. This section gives the recipients SSN, name, sex, date of birth and date of death.
NOTE

This information will only appear for the following reasons:

  • If data was previously sent to the county
  • If the date of death has changed from the prior abstract.

This will not appear on a new abstract.

EW Actions for DPM

Once the information is verified and clear, the EW will take the following actions:

  • If the individual was verified as deceased, the EW must send a notice of action to remove the individual from the AU/HH and adjust benefits accordingly.
  • If the individual was deceased during a data month and the AU/HH did not report a household composition change, the EW must assess whether an OP/OI should be established and send a notice of action, as appropriate.
  • If the individual was verified as not deceased, the EW must mark the match as “no discrepancy.”
  • If the deceased individual was a minor in a CalWORKs AU, the county is not required to take any mid-period actions when it is not aware of the death. However, if the county becomes aware of the death of a child in the AU, benefits shall not be decreased in the month of death, or the following month.
  • For AR/CO cases, it is a requirement to report a death within 10 days. The EW is required to recalculate benefits based on the change effective the first of the month following the change. OPs are calculated according to the regulations for mid-period reports. 

Reminder: EW must case comment DPM death was verified by SIU against Public Records Database and verified the death, third party verification of death requirement has been met.

 

Action on Unclear Information

If the information in the DPM is NOT verified by a third party or the EW cannot readily determine its effect on the AU/HH’s continued eligibility or benefit allotment, the information is considered unclear and the EW must send a ‘Request for Verification Form’ (CW 2200) with the match results to the recipient. The notice must clearly explain what information the household must provide and the consequences of failing to respond to the notice. If the household does not respond to the notice of match results or does respond but fails to provide sufficient information to clarify its circumstances, the EW must remove the individual listed on the match from the household and adjust benefits accordingly. The EW must issue a notice of adverse action at least ten (10) days before the adverse action is taken.

Reminder: The 45-day processing rule does not apply to the DPM. Failure to remove a deceased individual from the AU/HH within 45-days is not considered a county error. OP/OI must be established by the quarter following the quarter in which the match was received. An OP/OI is only established if the AU/HH fails to report the change at initial application, SAR or RRR.