PD 24-14: Reminders for Making SIU Fraud Referrals

Date:	09/03/24
To:	DEBS and CalWORKs Employment Services (CWES) Staff
From:	Elizabeth Garay, SSA BPIS
Reference:	N/A

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Background

To ensure the integrity and enhancement of cash aid and CalFresh benefits programs, any suspected fraud or criminal activity should be reported to the Special Investigations Unit (SIU). Fraud happens when an applicant or recipient intentionally provides false information or conceals details to obtain aid or to avoid denial, discontinuation, or reduction of aid.

In Santa Clara County, the Eligibility Workers (EWs) assess and identify reasonable grounds for suspecting and referring cases of fraud. Guidance on relevant considerations and procedures is provided. The aim is to minimize fraudulently obtained benefits while upholding the rights of applicants and recipients. Refer to the topic, Fraud – General Information, in Chapter 13 of DEBS BP.

 

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Reminders

Before making a referral to SIU, the Eligibility Worker (EW) must consult the following sections in the topic for Fraud – General Information: 

• Pre-Referral Requirements, 
• When to Refer, and 
• Possible Criteria for FRED/General On-Going Fraud Referral. 

While the listed criteria do not always indicate fraud, they should prompt the EW to consider whether a referral is warranted based on reasonable suspicion of fraud and to prevent inappropriate referrals due to eligibility issues or administrative errors.

When evaluating a fraud referral, EWs should consider individual circumstances, such as domestic violence and trafficking, and ensure that bias and discrimination are not factors. If uncertain, the Eligibility Worker (EW) should consult with their supervisor or the SIU Supervising Welfare Fraud Investigator.

 

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