SD4 - Welfare Fraud Study


Executive Summary:
This study was mandated by Senate Joint Resolution 356 which stated, “[t]he Secretary shall also study specific topics referred to it by the 1997 Session of the General Assembly, including Senate Joint Resolution No. 346 on welfare fraud.”

The Virginia Department of Social Services has oversight responsibility for all public assistance programs in the Commonwealth. Title I, § 402(a)(6) of the Personal Responsibility and Work Reconciliation Act of 1996, requires states to establish and enforce standards and procedures to ensure against program fraud and abuse. 7CFR273.16 of the Code of Federal Regulations places responsibility on the State agency to investigate cases of alleged intentional program violation, and to ensure that cases which have sufficient evidence to substantiate the commission of an intentional program violation are referred for disposition, either through an administrative disqualification hearing or in a court of appropriate jurisdiction.

Local departments of social services are responsible for identifying instances of fraud and taking appropriate steps for prosecution. §63.1-58.2 of the Code of Virginia gives authority to, but does not require, local boards of social services to establish fraud prevention and investigation units. The Commonwealth’s public assistance programs are state supervised and locally administered. Because the Code of Virginia does not require local boards to operate a fraud investigations program, the Department of Social Services is unable to enforce any standards for local fraud investigations activity.

This report provides an overview of the Department of Social Services' fraud control and collections program, and highlights the key findings from a study of this program.