oversight

Eligibility for Aid for Families With Dependent Children in Mahoning County, Ohio

Published by the Government Accountability Office on 1977-06-17.

Below is a raw (and likely hideous) rendition of the original report. (PDF)

                  .-. ,                __       ~~~~~I61             7V7




                          DOCUMENT RESUME

02747 - :A1752779] (Restricted)

[EligibiLity for Aid for Families with Dependent Children in
Mahoning County, Ohio]. HRD-77-107; B-164031(3). June 17, 1977.
4 pp.

Report to Rep. Sam H. Gibbons, Chairman, House Committee on ways
and Means: Oversight Subcomuit+oe; by Robert P. Keller, Deputy
Comptroller General.

Issue Area: Health Programs (1200); Income Security Programs
     (1300).
Contact: Euman Resources Div.
Budget Function: Health: Health Care Services (551); Income
    Security: Public Assistance and Other Incore Supplements
     (604).
Congressional Relevrance: House Committee on Ways and ,eans:
    Cversight Subcommittee.

         A review of the certain procedures and practices of the
Mahoning County Welfare Decartment in approving and reviewing
eligibility for Aid to FaAilies of Dependent Children (AFDC)   and
Medicaid revealed that there had been AFDC overpayments and
potential Medicaid ove:payuerts.  Findings/Conclusions: In about
half of tte cases in a sample of 17 cases, AFDC overpayments
have resulted because unemployment compensation was not properly
considered and deducted from the AFDC benefits. Unemployment
compensation is considered by a declaration from the recipient,
and a periodic check of a state listing matching recipients of
AFDC and unemployment benefits. The matching program is a useful
tool, but to be effective, the State must improve its   efforts to
provide accurate data, and the county must act upon the
information provided, not always the case in the past. Ohio was
found to grant Medicaid coverage exceeding that allowed by
Federal law. AFDC recipients uso thus automatically get Medicaid
coverage, and who later become ineligible because of employment,
are entitled to four additional months of Medicaid. However,.
Ohio computes this from the effective date of AFDC termination,
often a month or more after the month of ineligibility.    (DJR)
          fSTCINrD.-       Wet to be released outside the Geweral
          Aems'sg Office except mn the basis of specific approval
           y the Offie, of Cngres       Relations.
                  cOMaTrOLrr   cr   AL OFr TH   UNITrD IrST




B-164031(3)
                                                       JUN 17
The Honorable Sam M. Gibbons
Chairman, Subcommittee on Oversight
Committee on Ways and Means
House of Representatives

Dear Mr. Chairman:

     In response to your subcommittee's requests of Decem-
ber 8, 1976, and January 13, 1977, we reviewed certain pro-
cedures and practices followed by the Mahoning County Wel-
fare Department (Ohio) in approving and reviewing eligibil-
ity for Aid to Families with Dependent Children (AFDC).
The results of our review were presented in oral briefings
to the subcommittee staff on February 9, 1977, and March 15,
1977. As requested, this report provides details on two
of the matters covered in the briefings. These are:

     -- AFDC overpayments because unemployment compensation
         was not properly considered in determining AFDC bene-
         fits.

     -- Potencial Medicaid overpayments due to the method used
        by Ohio to compute Medicaid eligibility.

We did not obtain written comments on this report; however,
we discussed our observations with State and county officials
who concurred with us.

AFDC OVERPAYMENTS

     Under current Fede-al law, individuals can receive both
AFDC assistance and unemployment compensation provided the
allowable APDC payment is reduced by the amount of unemploy-
ment compensation received. To qualify, AFDC applicants must
first apply for and accept unemployment compensation to which
they are entitled, and then apply for AFDC.

     There are two procedures to assure that the amount of
unemployment compensation is considered in determining AFDC
payments.  First, the Me&oning County Welfare Department
requires AFDC applicants to furnish a form completed by the
Ohio Bureau of Employment Services attesting to the amount
of unemployment compensation, if any, being received. Second,
the department is supposed to periodically check on the vali-
dity of AFDC payments being made by using State listings of


                                                                ARUD-77-t fl7
B-164031(3)



persons reportedly receiving both AFDC and unemployment
compensation. The State listings are the result of a com-
puter matching of social security numbers of persons shown
as AFDC and unemployment compensation recipients.
      We reviewed a sample of 17 Mahoning County AFDC cases
to determine the effectiveness of the two procedures in
preventing and/or detecting AFDC overpayments to individuals
receiving unemployment compensation. Our sample was selected
from a State listing of 63 Mahoning County AFDC and unemploy-
ment compensation matches for the months of June and July of
1976. The listing was forwarded to the county in September
1976.
     Eight of the 17 persons had received AFDC overpayments.
Payments for the other nine were proper either because they
did not actually receive AFDC and unemployment compensation
during the same period, or their AFDC payments were properly
reduced by the amount of unemployment compensation received.
At the time of our review in March 1977 county caseworkers
had taken appropriate action on six of the eight overpaid
cases through use of (1) the September 1976 listing, (2)
prior listings, or (3) other means, such as information
volunteered by recipients. However, in two cases the case-
workers did not detect the overpayments. One individual
received overpayments totaling $1,020 for the period February
through June.1976 and the other $2,214 for the period April
through August 1976.
      In each of the eight cases, the prescribed procedure
had been followed in approving the recipient's AFDC applica-
tion. Each file contained the required form completed by
the Ohio Bureau of Employment Services indicating the appli-
cant was not receiving unemployment compensation. However,
each recipient later became eligible for and began receiving
unemployment compensation without the AFDC caseworkers' knowl-
edge.
     In such instances, without the State matching program,
caseworkers would generally haveto rely upon recipients
voluntarily informing them that they are enrolled in both
programs. Therefore, the State matching program is a useful
means of detecting persons who do not inform the county of
their changed status. However, the Mahoning County Welfare
Department has no established procedures to insure that case-
workers use the State listings to detect erroneous payments.
The listings are handled informally, with little or no

                              2
B-164031(3)


documentation of action taken as a result of the information
provided.
     Also, the State has not been as responsive to the needs
of the counties as it could be. The State's January 1977
listing was inaccurate because of a computer programing error.
As a result of the error, many persons were listed as receiv-
ing benefits from both programs, even though they did not
actually receive unemployment compensation during the match-
ing period. The erroneous listing contained about 10,000
matches statewide, compared to a normal 2,000. The counties
were not notified of the error, which could result in unpro-
ductive efforts on their part. Future listings, according
to State personnel, will show the period and amount of un-
employment compensation, which should eliminate the problem
of erroneous matches.
     We believe that the State listing of individuals that
receive both AFDC and unemployment compensation is a useful
means of identifying overpaid or ineligible AFDC_recipients.
However, to be effective, the State must improve its efforts
to provide data that can be relied upon and the county must
act on the information provided.
POTENTIAL MEDICAID OVERPAYMENTS
     We noted a statewide practice that could result in over-
payments of Medicaid benefits. Ohio is granting Medicaid
coverage in excess of that allowable under Federal law.
     Under current Federal law, eligible AFDC recipients
are automatically given Medicaid coverage. Normally, when
they become ineligible for AFDC they also become ineligible
for further Medicaid coverage. However, AFDC recipients who
become ineligible because of employment are entitled to 4
additional months of Medicaid coverage.
      Under the law, the 4-month extended coverage period
begins with the month in which the individual becomes in-
-eligble for AFDC due to employment. However, in Ohio, the
4-month period is computed from the effective date of AFDC
termination, which is often a month or more after the month
of ineligibility. For example, one Mahoning County recipient
became ineligible because of employment in June, but the
effective date of AFDC termination was August 1. Therefore,
the recipient was granted extended Medicaid coverage through
November-a period of 6 months, beginning with the month of

                             3
B-164031(3)



ineligibility. To the extent that recipients take advantage
of Medicaid coverage, the additional time allowed in this case
and others will result in Medicaid overpayments.

     We trust the information in this report and that pro-
vided earlier in oral briefings will be helpful to the sub-
committee. As requested by your office, we are sending copies
of this report to the Secretary, Department of Health, Educa-
tion, and Welfare.

                                Sincerely yours,




                        DEPUTY Comptroller General
                               of the United States




                            4