Program Integrity
To maintain and improve program integrity for cash aid and CalFresh benefits, suspected fraud and other crimes must be reported to the Special Investigations Unit (SIU).
Definition of Program Integrity
Eligibility staff has the responsibility for making all determinations as to eligibility or ineligibility for assistance and for establishing the amount of overpayment/overissuance where ineligibility for any benefit is found.
Eligibility staff are also responsible for preventing and discovering fraudulent actions by recipients to the furthest extent possible. They are also responsible for taking prompt and decisive steps to investigate and establish the facts regarding any situation in which it appears possible that benefits are being received on the basis of incorrect, incomplete, or false data.
An investigation must be conducted when there are grounds to suspect that eligibility was established or an overpayment/overissuance, regardless of the amount, was due to fraud.
Priority on Program Integrity
Early Fraud programs provide the best opportunity to maximize limited county resources and avoid the higher costs associated with long-term investigations, prosecutions, and collections activities. By processing early fraud referrals and conducting necessary investigations during the application process, a county can determine whether an applicant is ineligible prior to granting benefits, which can result in cost avoidance savings.
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