Department of Health and Human Services
Departmental Appeals Board
AFDC QUALITY CONTROL REVIEW PANEL
SUBJECT: North Carolina Department
of Human Resources
Docket No. 91-88
DATE: August 9,1991
DECISION
The North Carolina Department of Human Resources (State)
appealed the
determination of the Acting Regional
Administrator of the Administration for
Children and
Families (Agency) dated May 13, 1991 that A.S. was
ineligible for a payment of $236 made by the State on
November 1,
1990. 1/ The payment was made under the
Aid to Families
With Dependent Children (AFDC) program
established by title IV-A of the
Social Security Act
(Act). 2/ As part of a quality control
system, a
sample of AFDC payments is reviewed on a monthly basis by
each
state to determine whether the payments were
correct. The Agency
reviews a sub-sample of the payments
and determines the state's error rate
for the fiscal
year, based on which title IV-A funds claimed by the
state may be disallowed.
The payment in question was included in the State's
quality control
review of payments for the month of
November 1990, and was found
correct. However, upon re-
review, the Agency found that the payment
was erroneous
because A.S. did not provide her child's social security
number (SSN) to the State agency which administered the
AFDC program
before the date of the payment, in
accordance with applicable
requirements.
For the reasons discussed below, we conclude that A.S.
furnished her
child's SSN as required and, accordingly,
we reverse the Agency's
determination.
The record on which this decision is based consists of
the State's appeal
request, the parties' responses to the
Panel's request for additional
information, and the
Agency's response to the State's appeal request.
Relevant Statutory and Regulatory Provisions and Agency
Interpretations
Section 402(a)(25) of the Act, as amended April 1, 1985,
requires that a
state's title IV-A plan "provide that
information is requested and exchanged
for purposes of
income and eligibility verification in accordance with a
State system which meets the requirements of section 1137
of this
Act." Section 1137 in turn provides that, as a
condition of
eligibility for title IV-A payments, a state
shall require that "each
applicant for or recipient of
benefits . . . furnish to the State his social
security
account number . . . ." Section 1137(a)(1). This
information is to be utilized primarily to obtain wage
information from
various state and federal agencies to
verify the applicant's eligibility and
the amount of
benefits to which the applicant is entitled. See section
1137(b). Section 408(c)(4) of the Act, which was added
by section
8004 of Public Law 101-239 and applies to
erroneous payments made after
fiscal year 1990, states
that "[n]otwithstanding any other provision of this
section, a payment shall be considered an erroneous
payment if the
payment is made to a family . . . (B) any
member of which is a recipient of
aid under a State plan
approved under this part and does not have a social
security account number (unless an application for a
social security
account number for the family member has
been filed within 30 days after the
date of application
for such aid)."
Regulations implementing the requirement for a SSN
(referred to by the
Agency as the "enumeration
requirement") appear at 45 C.F.R. 205.52, which
states in
pertinent part that a state title IV-A plan must provide
that
--
(a) As a condition of eligibility, each applicant
for or
recipient of aid will be required:
(1) To furnish to the State
or local agency a
social security account number, hereinafter referred
to as the SSN . . . ; and
(2) If he cannot furnish a SSN
(either because
such SSN has not been issued or is not known), to
apply
for such number through procedures adopted by
the State or local agency with
the Social Security
Administration. If such procedures are not in
effect, the applicant or recipient shall apply
directly for such number,
submit verification of
such application, and provide the number upon its
receipt. 3/
The AFDC Quality Control Manual issued by the Agency
also addresses
the enumeration requirement. The Manual
specifies that, to verify
compliance with the enumeration
requirement in states where there is no
agreement with
the Social Security Administration (SSA) for the local
agency to take SSN applications, the quality control (QC)
reviewer
--
must document that the individual: (1) applied
directly to
the SSA [District Office] for an SSN;
(2) furnished proof of application to
the local
agency; and (3) furnished the SSN when received, if
it was
received as of the review date.
Manual, Appendix W, p. 11. The Manual also addresses the
application of the enumeration requirement where a state
participates in
the "Enumeration at Birth Project," which
allows a mother to apply for a SSN
for her newborn child
while in the hospital. If the mother selects
this option
on the birth registration form, the state's vital
statistics
office transmits the necessary information to
SSA via magnetic tape, and SSA
automatically issues a
SSN. 4/ The Manual describes the
documents which
constitute acceptable proof of application for a SSN, and
goes on to state that "[i]n all cases, the SSN must be
provided to the
agency upon its receipt." Manual,
Appendix W, p. 13.
5/ There is no reference to any
documents which would establish
compliance with this part
of the enumeration requirement.
The enumeration requirement is also the subject of two
other Agency
issuances, FSA-IM-88-15 (November 28, 1988)
and FSA-AT-89-31 (July 20,
1989). Both indicate that
even where the enumeration at birth
procedure is used to
apply for a SSN, "verification of such application must
be submitted to the IV-A agency, with the number provided
upon its
receipt." FSA-AT-89-31, p. 1; FSA-IM-88-15, p.
2. 6/
FSA-AT-89-31 also elaborates on the requirement
that the applicant report
the SSN once received, stating
that --
Assigned SSN's issued through the "enumeration at
birth" process
will not be included on tapes
provided by SSA to States which list recently
enumerated AFDC recipients. Therefore, parents who
elect to
enumerate their newborn child(ren) through
this procedure must then furnish
the assigned SSN to
the IV-A agency when it is received. Even though
form 2853 [a form entitled "Message from Social
Security" which is given
to a parent who elects the
enumeration at birth option] contains a note to
the
parent to notify the caseworker when the SSN card is
received,
States will need to remind
applicants/recipients of this requirement.
FSA-AT-89-31, p. 3.
We refer to additional authorities in the Discussion
section of this
decision.
Factual Background
On May 1, 1990, A.S. applied for AFDC benefits for
herself and her child,
who was born on April 18, 1990.
An AFDC payment of $236 was
issued to A.S. on November 1,
1990. 7/ The State QC
reviewer determined the payment
to be correct, finding in particular that
the SSNs of
A.S. and her child had been provided as required. The
State QC review worksheet contains notations to the
effect that A.S.'s
case record included a copy of A.S.'s
social security card as well as
evidence that A.S. had
applied for a SSN for the child following enumeration
at
birth procedures. Agency Ex. 2. In addition, the
worksheet indicates that the State QC reviewer saw the
child's social
security card during a field review home
visit. 8/
Id. Finally, the worksheet refers to a
computer printout showing that,
prior to November 1,
1990, both the AFDC and the Food Stamp programs made
inquiries concerning this case to the "Master Client
Index," the
automated system used to validate SSNs. Id.
On re-review, the Agency determined that A.S. was totally
ineligible for
the $236 payment issued November 1, 1990.
The Agency noted that, in
response to an inquiry by the
federal QC reviewer, A.S. stated that she had
received
her child's SSN on June 27, 1990. 9/ The Agency
concluded that this SSN should therefore have been in the
case record on
November 1, 1990 in order for the payment
to be correct. The Agency
dismissed as irrelevant the
fact that A.S. had provided the State QC
reviewer with
the child's social security card at the time of the home
visit. Letter from Radon to Deyampert dated 3/12/91 and
enclosed
letter dated 3/5/91.
The State requested reconsideration of this determination
by the Regional
Administrator, FSA (now ACF), citing the
computer printout referenced in the
State QC review
records. Letter from Deyampert dated 3/25/91.
The State
also submitted a copy of one page (Part 2) of A.S.'s
application for Food Stamps dated May 30, 1990. 10/
The application includes, in a handwriting different from
that on the
rest of the application, a SSN for A.S.'s
child, with a notation that the
SSN was "rec'd by TC
after dt of application." 11/ The
State also asserted
that a copy of the child's social security card was in
A.S.'s Food Stamp file. Finally, the State submitted a
written
statement from A.S. dated April 8, 1991 to the
effect that she "reported"
her child's SSN "as soon as I
received it, to Department of Social
Services."
Memorandum from Proctor dated 4/8/91, and attachments.
Upon reconsideration, the Agency reaffirmed its initial
determination
that the case was ineligible. The Agency
stated that the computer
printout relied on by the State
did not show that the State validated the
SSN for A.S.'s
child since zeros appeared where the child's SSN would
have appeared had it been entered. The Agency also
stated that the
Food Stamp application and the client
statement had no probative value
because the notation on
the Food Stamp application regarding receipt of the
child's SSN was undated and the client statement did not
specify the
date when she reported the SSN. Letter from
Brooks to Deyampert
5/13/91.
On appeal to this Panel, the State indicated that it was
no longer
relying on the computer printout to establish
that A.S. provided her child's
SSN to the State agency.
Letter from Deyampert to Panel dated 7/9/91,
pp. 1-2.
However, the State continued to assert that the Food
Stamp application, in conjunction with A.S.'s written
statement,
established this fact. 12/ In response to
the appeal
request, the Agency took the position that,
even if (contrary to its belief)
A.S. provided the
child's SSN for the Food Stamp application before
November 1, 1990, she did not report her child's SSN to
the "State
agency" within the meaning of 45 C.F.R.
205.52(a)(2) and 201.1(h) since the
Food Stamp program
was administered separately from the AFDC program.
The
Agency also contended that Agency issuances require an
applicant's
eligibility for AFDC to be documented in the
case record and argued that the
Food Stamp application
was not a part of the AFDC case record. The
State
acknowledged that the "Department of Social Services"
referred to
in A.S.'s written statement contained both a
"Food Stamp Unit" and an "AFDC
Unit," but took the
position that the Department as a whole, and not the
individual units, was properly considered the "State
agency."
Letter from Deyampert to Panel dated 6/10/91,
p. 1.
Discussion
We conclude that the payment in question was not
erroneous. While
the record does not establish the
precise date on which A.S. reported her
child's SSN to
the Food Stamp unit, there is sufficient evidence to
support a finding that she reported the SSN prior to
November 1,
1990. We further find that A.S. complied
with applicable requirements
in reporting the SSN to the
Food Stamp unit since this unit was part of the
local
agency which administered the AFDC program.
1. The SSN was reported prior to November 1, 1990.
It is undisputed that A.S. received the child's SSN on
June 27, 1990 and
that she reported the SSN to the Food
Stamp unit. In a written
statement dated April 8, 1991,
A.S. asserted that she had reported the SSN
"as soon as"
she received it. While this statement does not specify
the date on which the SSN was reported, the words "as
soon as" clearly
indicate that this action was taken upon
receipt of the SSN or within a
short time thereafter.
This might have been a few minutes, hours, or
days after
A.S. received the SSN, but surely not as long as the
three
months which elapsed between the date of receipt
and November 1, 1990.
The Agency pointed out that A.S.'s statement was made
over nine months
after receipt of the SSN. In our view,
however, the age of the
statement does not render it
unreliable since A.S. had only to recall the
timing of an
action (reporting the SSN) in relation to an event
(receipt
of the SSN) the date of which was already
established. The Agency did
not contend that the
statement was unreliable on any other basis.
Thus, this
statement establishes that A.S. reported her child's SSN
prior to November 1, 1990.
Moreover, other evidence in the record suggests that A.S.
reported the
SSN no later than June 28, 1990, the day
after she received it. The
State asserted, and the
Agency did not dispute, that A.S.'s Food Stamp
application was denied on June 28, 1990. If A.S. had
already
received notice of the denial, there would have
been no reason for her to
call the Food Stamp Unit to
advise it of her child's SSN. In addition,
no reason
appears why the caseworker would have recorded the SSN on
A.S.'s Food Stamp application once the application was
denied. 13/ Thus, it is reasonable to infer that A.S.
reported the SSN before her Food Stamp application was
denied.
This inference is consistent with A.S.'s written
statement that she reported
the child's SSN as soon as
she received it, and further supports the
conclusion that
the SSN was reported before November 1, 1990.
2. A.S. reported the SSN to the local agency.
In North Carolina, the AFDC program is administered by
the Division of
Social Services within the State
Department of Human Resources and by the
county
departments of social services. Within the county
department of social services in question here, there was
an AFDC unit
and a Food Stamp unit, each of which
maintained its own case records on
applicants, who
submitted separate applications for each program. The
Agency took the position that, in order to comply with 45
C.F.R. 205.52,
A.S. should have reported her child's SSN
to the AFDC unit, while the State
maintained that it was
sufficient that A.S. had reported the SSN to someone
within the county department of social services. 14/
We agree with the State. Section 205.52 requires that an
applicant
for AFDC furnish a SSN "to the State or local
agency." The term "State
Agency" is defined in section
201.1(h) as the "State agency administering or
supervising the administration of the state plan . . .
under title
IV-A." This necessarily means that the
"local agency" (which is not
specifically defined) is the
local agency administering the title IV-A
program under
the supervision of the State agency. Thus, in order to
be considered a "local agency" within the meaning of
section 205.52, the
AFDC unit would have to be an
autonomous agency with individual
responsibility for
administration of the AFDC program. There is no
evidence
that this was the case, however. Instead, State law
authorizes the Department of Human Resources "to
establish and supervise
an Aid to Families with Dependent
Children Program . . . to be administered
by county
departments of social services. . . ." N.C. Gen. Stat.
�108A-27 (1989). Similarly, State law designates the
Department of
Human Resources as "the State agency
responsible for the supervision of a
statewide food stamp
program," with the boards of county commissioners
through
the county departments of social services responsible for
the
administration and operation of the program. N.C.
Gen. Stat. �108A-51
(1989). Thus, the separation of the
AFDC and Food Stamp programs
within the county department
was simply a matter of internal organization,
with the
county department as a whole retaining the responsibility
for
administering the AFDC and Food Stamp programs at the
local level. It
is clear, moreover, that federal law
does not require that a separate agency
administer each
program since the Agency itself noted that "the Title
IV-
A agency and Food Stamp agency may be one in the same
(DSS), and some
local staff may manage cases for both
programs. . . ." Letter from
Brooks to Panel dated
7/12/91, p. 6. We therefore conclude that the
county
department of social services was the "local agency"
within the
meaning of section 205.52 and that A.S.
complied with that regulation in
reporting her child's
SSN to the Food Stamp unit within that department.
The Agency argued that this was an unreasonable result
since the
reporting of the SSN served no purpose unless
it was known to "IV-A
staff." Id. (emphasis in
original). The Agency took the position
that in order
for A.S. to have been eligible for the payment in
question, her child's SSN had to have been in the AFDC
case record,
citing language in FSA-IM-88-15 and other
Agency issuances to the effect
that documentation of the
SSN must be in the case record.
We find no merit in the Agency's position. While the SSN
in
question here was not in the file for A.S. which was
maintained by the AFDC
unit, this does not mean that it
was not a part of the "case record" for
purposes of AFDC
quality control. The AFDC Quality Control Manual
defines
"Local Agency Case Record" as "[a]ll information
available to
the local agency for use in making an
eligibility and payment determination
including
information stored by automated systems." Manual,
section 3030. It appears from the record that
information in the
Food Stamp file was in fact available
for this purpose. The Food Stamp
application contains a
space for the county office to check off if a certain
form is "FILED IN AFDC RECORD." 15/ This indicates
that documents contained in an applicant's AFDC file were
used to make
Food Stamp eligibility determinations, in
which case documents in the Food
Stamp file were likely
available to make AFDC eligibility determinations.
Moreover, the AFDC Quality Control Manual specifically
states that "to
the extent allowed by State policy, the
reviewer can consult official data
sources of local
agency resource persons in various units to determine
facts and obtain documentary evidence needed to verify
elements such as
. . . enumeration . . . ." Manual,
section 3120 (emphasis
added). This clearly indicates
that the Agency did not view the case
record as
restricted to the file for a particular applicant
maintained
by AFDC staff. Accordingly, we conclude that
the SSN in question here
was in A.S.'s AFDC case record.
The Agency is of course correct that the SSN served no
purpose if AFDC
staff were not actually aware of it. As
noted previously, the SSN
provides a means of verifying
an applicant's income in order to determine
the
applicant's eligibility and benefit level. However, the
Agency
did not point to any authority for finding a
payment erroneous on the ground
that the applicant's
income was not verified in this manner.
Accordingly, the
only question before us is whether A.S. reported her
child's SSN to the local agency upon receipt. We
conclude that she
did.
Conclusion
For the reasons discussed above, we conclude that the
$236 payment made
to A.S. on November 1, 1990 was
correct. Accordingly, we reverse the
Agency's
determination.
________________________
Peggy McFadden Elmore
_____________________________
Carolyn Reines-Graubard
_____________________________
Leslie A. Weyn
* * * Footnotes * * *
1. We identify the
recipient by her initials in
order to protect her privacy. The State
quality control
review number is
811021.
2. The AFDC
program was previously administered
by the Family Support Administration,
which was one of
several agencies combined into the Administration for
Children and Families effective April 15,
1991.
3. These
regulations were published in 1986 and
have not been amended.
4. Another Agency
issuance describing this
process states that "[t]he total processing time
for the
parent(s) to receive the newborn's SSN ranges from about
3 to 13
weeks, depending upon the State." FSA-IM-88-15,
dated November 28,
1988.
5.
Appendix W of the Manual was issued by the
Agency to implement the
provisions of Public Law 101-239
pertaining to AFDC quality control.
However, the
language quoted above is identical to the language
appearing on pp. V-39 and V-40 of the Manual as
previously
issued.
6. Similar language is used in an Agency
issuance which
pre-dated the implementation of the
enumeration at birth project, AFDC
Quality Control
Memorandum No. 27, dated
11/15/84.
7. The dates
and amounts of any prior payments
are not shown in the record.
8. The home visit was
scheduled for January 7,
1991. Letter from Deyampert to Family Support
Administration dated 3/15/90, enclosed letter to A.S.
dated
1/2/91.
9. This
inquiry was made by letter dated
3/5/91, which A.S. returned to the Agency
after filling
in the date of receipt in the space indicated by the
Agency. Agency ex. 5.
10. According to the State, the Food Stamp
application was
denied on June 28, 1990 due to A.S.'s
failure to provide "required
verifications" other than
the child's SSN. Letter to Panel from
Deyampert dated
July 9, 1991, p. 2. In the Food Stamp program, which
is
administered by the U.S. Department of Agriculture, an
applicant's
failure to furnish a SSN is a technical error
which does not render the
applicant ineligible. Reform
of AFDC Quality Control: Hearing on
H.R. 2243 Before the
Subcomm. On Human Resources of the House Comm. on Ways
and Means, 101st Cong., 1st Sess. 16, 44 (1989)
(statements of Catherine
Bertini and Robert Greenstein).
11. We assume that
this means "received by
telephone conversation/contact after date of
application."
12.
At no point did the State argue that A.S.
was not required by law to report
her child's SSN after
she received it.
13. According to the
State, A.S. mailed a copy
of her child's social security card to the Food
Stamp
Unit after the telephone conversation in which she
reported the
SSN. The fact that the caseworker placed
this document in A.S.'s Food
Stamp file after the
application was denied is not inconsistent with our
conclusion that A.S. reported the SSN before the
application was
denied. Even if the caseworker ignored
the information reported by
telephone because it was no
longer relevant, the caseworker may have been
reluctant
to discard the copy of the social security card.
14. Although the
Agency framed the issue as
whether A.S. furnished her child's SSN to the
"State
agency" within the meaning of section 205.52, the issue
is
actually whether she furnished the SSN to the "local
agency" since the AFDC
and Food Stamp units in question
here were located within the county
department of social
services, not the State Department of Human
Resources.
15. Although the State
did not specifically
rely on this document, the State asserted that
"[i]nformation known to AFDC or Food Stamps is known to
the other
program." Memorandum from Proctor dated
4/8/91, p. 1.
(..continued)