Current through Register Vol. 47, No. 17, September 10, 2024
4.903.1
Information Available to the
Public
A. Federal regulations, federal
procedures embodied in Food and Nutrition Service (FNS) notices and policy
memos, the SNAP rules, and State Plans of Operation (including specific
planning documents such as corrective action plans) shall be available upon
request for examination by members of the public during office hours at the
State Department. Copies of materials are available to recipient organizations,
action centers, and other individuals for a minimal printing charge.
B. The SNAP rules shall be available for
examination upon request at each local office within each county. They are also
available online through the Secretary of State's official publication of State
Agency rules in the Colorado Code of Regulations, accessible at:
https://www.sos.state.co.us/CCR/Welcome.do.
4.903.2
Reporting
Lawsuits
FNS regulations require prompt notification from the State
Department of any lawsuits involving the administration of SNAP.
As SNAP is administered under the supervision of the State
Department, it is mandatory that all legal proceedings involving SNAP be
brought to the attention of the State Department immediately for notification
to the FNS.
4.903.3
Management Evaluations (ME)
The State Department is responsible for supervising the
administration of SNAP. To ensure compliance with program requirements, the
State Department is responsible for conducting ME reviews to measure compliance
with the provisions of these rules. The objectives of the ME review system are
to:
A. Provide a systematic method of
monitoring and assessing program operations in the counties;
B. Provide a basis for counties to improve
and strengthen program operations by identifying and correcting
deficiencies;
C. Provide a
continuous flow of information between the counties, the State Department, and
FNS to develop solutions to problems in SNAP policy and procedures;
and,
D. Provide a review of target
program areas as identified by USDA, FNS.
4.903.31
Frequency of ME Reviews
The State Department shall conduct an ME review of all SNAP
operations:
A. At least once annually
on each large project area containing more than twenty-five thousand and one
(25,001) participating households;
B. At least once every two (2) years on each
medium project area containing five thousand (5,000) to twenty-five thousand
(25,000) participating households; and,
C. At least once every three (3) years on
each small project area containing four thousand nine hundred and ninety-nine
(4,999) or fewer participating households.
The State Department may conduct ME reviews on an alternative
schedule with the written approval of the USDA, FNS. The State Department may
also perform reviews of specific local offices or program elements. The USDA,
FNS, or the State Department, may identify the need for a special review, or
the local office may request a special review.
Reviews will generally include all aspects of program
administration in the large project areas. The reviews may be more limited in
scope in the medium and small project areas. The USDA, FNS, generally
identifies target program areas that it requires for review each fiscal
year.
The State Department will complete the ME report for all
counties that are reviewed and will be responsible for monitoring the county
responses to any findings.
The county shall be responsible for submitting any factual
corrections to the ME review within twenty (20) state working days and shall
submit a final plan to correct all other cited deficiencies within twenty (20)
state working days of receiving the review. The response shall include specific
actions, persons responsible for implementation, and the date for completion.
When the review identifies ongoing problems in critical areas, the county
response shall also include a method for monitoring implementation of the plan
and reporting progress to the state department on at least a quarterly
basis.
4.903.32
Compliance Action for ME Reviews
The State Department is the designated entity responsible for
ensuring that corrective action is taken at the state and/or county level on
the deficiencies found by the ME Reviews.
The state may impose fiscal sanctions on counties that do not
make good-faith efforts to address ongoing problems in critical areas. Fiscal
sanctions may be imposed in accordance with Section 4.901.1, which requires
local offices to operate the program in accordance with state rules.
4.903.4
Quality Assurance
(QA) Reviews
QA reviews are conducted during the annual federal QA review
period, which is the twelve (12) month period from October 1 of each calendar
year through September 30 of the following calendar year.
A. QA reviews are federally mandated to
provide:
1. A systematic method of measuring
the validity of the SNAP caseload;
2. A basis for determining error
rates;
3. A timely and continuous
flow of information on which to base corrective action at all levels of
administration; and,
4. A basis for
establishing liability for errors that exceed the federal error rate target and
the State's eligibility for an increased share of federal administrative
funding and/or federal high-performance bonuses.
B. Reviews are conducted on:
1. Active cases to determine if the household
is eligible and, if eligible, whether the household is receiving the correct
SNAP benefits.
2. Negative cases to
determine if households that were denied or terminated were, in fact, not
eligible to participate in SNAP and that the household received an accurate,
timely notice as defined in sections 4.205.2, 4.209.1, and 4.608. The review of
a negative case includes:
a. A household case
record review;
b. An error
analysis;
c. Client notification;
and,
d. The reporting of review
findings.
4.903.41
QA Review Procedures
A. Each month a statistically random sample
of active and negative cases is selected for QA review. The sampling of both
active and negative cases is accomplished through the master file from the
automated system.
B. Case records
for the monthly selected sample may be reviewed by QA in the local office, or
the local office may be requested to forward the case recrods to the
appropriate state QA office for review prior to the field reviews and
verification of eligibility factors. Local offices shall make case records
available for review no later than seven (7) business days from the date that
the request is received by the local office.
C. When the local office receives a request
for one or more cases for QA review, the following steps shall be taken in
preparing the case record:
1. All documents
and notes supporting eligibility decisions and/or basis of issuance related to
the case and actions taken by the local office that apply to the sample/review
month shall be included in the case record.
2. Accomplishment of the objectives of QA
depends upon the successful operation of all aspects of the sampling system,
including the elimination of bias to prevent bias, the local office shall not
take any action that might alter the findings or misrepresent the household's
circumstance including, but not limited to:
a.
Making changes that would affect eligibility and payment;
b. Adding or removing
documentation/verification from the official case record; or,
c. Contacting the household sampled, the QA
reviewer, or making collateral contacts to obtain additional information to
clarify the household's circumstances, obtain statements or coerce the
household into saying or doing anything that might alter the findings or
misrepresent the household's circumstances for the review month.
D. These provisions do
not apply to routine case management such as acting on reported changes,
completing recertifications, or issuing a notice of expiration.
4.903.42
Refusal to
Cooperate with QA Review
Households selected for review are required to cooperate with
federal and state QA review processes.
Households that refuse to cooperate in a QA review shall be
declared ineligible for SNAP benefits in this section. The state QA reviewer
shall notify the local office of the household's refusal to cooperate in the
review process, including everyone who refused, and the local office shall
document the refusal to cooperate in the statewide automated system.
A. Within ten (10) calendar days from the
date of receipt of QA's notification of the household's refusal to cooperate,
the local office shall take action to disqualify or terminate the entire
household from participation in SNAP and each household member who refused to
cooperate shall be entered into the automated system to initiate a period of
ineligibility. The period of ineligibility is as follows:
1. For refusal to cooperate with a state QA
review, the period of ineligibility shall exist for the remainder of the
current federal fiscal year plus one hundred twenty-five (125) days and shall
expire on February 2 of that federal fiscal year.
2. For refusal to cooperate with a federal QA
review, the period of ineligibility shall exist for the remainder of the
current federal fiscal year plus nine (9) months and shall expire on June 30 of
that federal fiscal year.
B. If a member or members who refused to
cooperate with a QA review leaves the household, the ineligibility period shall
follow the household member(s) who refused to cooperate.
If a household is disqualified or terminated for refusal to
cooperate with a QA review, the household may reapply. The household cannot be
determined eligible until it cooperates with the QA review and provides
verification of all eligibility factors.
C. If a household that has refused to
cooperate with a state QA review reapplies more than one hundred twenty-five
(125) days after the end of the annual federal QA review period, or refused to
cooperate with a federal review and reapplies more than nine (9) months from
the end of the annual federal QA review period, the household shall not be
determined ineligible for its refusal to cooperate and is required to provide
verification of all eligibility factors before it can be approved for
benefits.
4.903.43
QA Findings and Required Responses
QA shall notify local offices on State-prescribed forms of
the review findings for each sampled active and negative case. Brief
descriptions of the review findings shall be given with references to
applicable rule sections.
A. When the
review findings document no error and/or only other observations have been
noted, a response is not required by the local office; however, any observation
that affects the payment accuracy must be corrected and a claim or restoration
established in accordance with Sections 4.801.2 and 4.702 . The report of
review findings shall be retained in the case record.
B. When the review findings document that an
error resulted in ineligibility, over-issuance, under-issuance, or an incorrect
negative action, the local office shall take action to correct any errors
discovered within ten (10) calendar days.
If the local office disagrees with a review finding then a
response should be sent to the State Department for further review.
C. Upon receiving the local
office's response to the QA review findings, the State Department shall review
the action taken by the local office and either concur with the QA findings;
concur with the local office rebuttal; or concur/disagree with the corrective
action taken by the local office.
1. The local
office shall be notified of the final QA review findings.
2. Upon receipt of final notification of the
results of the findings, the local office must take corrective action to
terminate ineligible households within ten (10) calendar days, restore lost
benefits, or establish a claim in accordance with Sections 4.801.2 and
4.702.
D. Local offices
are required by the State Department to report twice a year to the State
Department the status of all QA review findings that required case
corrections.
4.903.44
Federal QA Reviews
For purposes of validating the State's QA findings, the FNS
Regional Office will conduct a sub-sample re-review of the State QA sample. As
part of this re-review process, the Federal Regional Office will conduct case
record reviews to the extent necessary to determine the accuracy of state QA
findings. The FNS Regional Office may request case records and/or verify any
aspects of state QA findings. The local offices shall forward case records in
their entirety as outlined in Section 4.903.41 that are selected for FNS
regional office review within ten (10) calendar days of the
request.
