RD8 - Annual Report on the Data Matches, Fraud Prevention Activities, and Application Processing During State Fiscal Year (SFY) 2021 – December 2021

Executive Summary:

The Code of Virginia § 63.2-503 requires the director of each local department of social services (LDSS) 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 LDSS and specify the information that must be verified. In determining eligibility, VDSS 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 VDSS 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 VDSS and called Systems Partnering in a Demographic Repository (SPIDeR). SPIDeR is a web-based application, which benefits its users by effectively facilitating communication between applications and systems. It allows local workers to access multiple systems from a single source.

The Code of Virginia § 63.2-526 requires LDSS to investigate allegations of public assistance fraud and requires that a statewide fraud control program be established. Each LDSS 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 all assistance necessary to the Commonwealth in the prosecution of cases involving public assistance fraud.

During SFY2021, public assistance fraud units completed 8,088 investigations concerning allegations of the fraudulent receipt of public assistance throughout the Commonwealth. Of these investigations, 1,074 were founded and referred for prosecution or administrative disqualification.