Special Assistance SA-3410 RECIPIENT FRAUD

II. LEGAL RESPONSIBILITY

Both the state and the county departments of social services have a legal obligation to assure proper administration of public funds and an obligation to take necessary legal steps in cases of fraud and/or overpayments. This obligation rests on the efficiency, thoroughness and integrity of the processes by which initial and continuing eligibility are determined.

A. Designation of Fraud Staff

The county DSS director should designate at least one staff member to be responsible for suspected fraud investigation. The staff member need not have law enforcement authority but is responsible for thorough investigations, preparing the case for presentation to the county board of social services and assisting the district attorney as needed.

B. Confidentiality (10NCAC 24B, 10NCAC24B.0205, 10NCAC24B.0206)

All county DSS staff are bound by rules of confidentiality.

C. Legal Restrictions

1. The Privacy Act permits an individual to have some control over the accuracy and disclosures of records maintained by Federal Agencies. However the Privacy Act of 1947 (P.L. 93-579) Section 552 b(7) allows a caseworker/fraud investigator to obtain information necessary to conduct a civil or criminal investigation.

2. The a/r and legal counsel have the legal right to view and have a copy of the information in the eligibility or services record at anytime with the exception of:

a. Information that the county DSS is required to keep confidential by state or federal statute or regulation.

b. Confidential information originating from another source.

c. Information that would breach another individual's right to confidentiality. (Reference: 10 NCAC 24B.0306 and 20 NCAC.32S.0306)

d. Investigative records.







For questions or clarification on any of the policy contained in these manuals, please contact your local county office.