RD674 - Annual Report on the Data Matches, Fraud Prevention Activities, and Application Processing During State Fiscal Year (SFY) 2020 – October 2020

Executive Summary:

The Code of Virginia (§ 63.2-503) requires the director of each local department of social services to conduct an investigation to determine the correctness and completeness of every application for public assistance. In conducting such an investigation, the local director shall ascertain all of the facts supporting the application to determine whether the individual is eligible to receive assistance.

The 2015 Virginia General Assembly approved changes to this requirement in order to clarify responsibilities of local departments and specify steps and information that must be verified. In determining eligibility, the Virginia Department of Social Services interfaces with a number of public and private databases to determine eligibility for assistance.

Currently, there are 14 databases local eligibility workers can access to determine eligibility for assistance. Some system matches are automatic, meaning the Department’s automated eligibility system, VaCMS, automatically queries these systems to verify statements made by the applicant/recipient. For information from other systems, the eligibility worker must request or “call" the service. Most of these requests are made through a system developed by the Department, the Systems Partnering in a Demographic Repository (SPIDeR), a web-based application, which benefits its users by effectively facilitating communication between applications (systems). It allows local workers to access multiple systems from a single source.

The Code of Virginia also requires local departments of social services to investigate allegations of public assistance fraud. Specifically, § 63.2-526 requires the establishment of a statewide fraud control program. Each local department of social services is required to have a fraud prevention and detection unit. These fraud units are responsible for: (i) developing methods to prevent the fraudulent receipt of public assistance administered by the local board and (ii) investigating whether persons who receive public assistance through the local board are receiving it fraudulently. The fraud unit must provide whatever assistance is necessary to attorneys for the Commonwealth in prosecuting cases involving fraud.

During State Fiscal Year 2020, these fraud units completed 7,739 investigations concerning allegations of fraudulent receipt of public assistance throughout the Commonwealth. Of these, 1,400 were founded and referred for prosecution or administrative disqualification.