April 19, Enclosed is a copy of the decision resulting from the hearing held in the above-referenced matter. Sincerely,

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1 STATE OF WEST VIRGINIA DEPARTMENT OF HEALTH AND HUMAN RESOURCES OFFICE OF INSPECTOR GENERAL Bill J. Crouch Board of Review M. Katherine Lawson Cabinet Secretary PO Box 1247 Inspector General 433 Mid Atlantic Parkway Martinsburg, West Virginia Nathan Walters, Esq. Walters & Heishman P.O. Box 119 Moorefield, WV RE: SUPRENIA VANCE v. WV DHHR BOR Action #17-BOR-2965 Dear Mr. Walters: April 19, 2018 Enclosed is a copy of the decision resulting from the hearing held in the above-referenced matter. In arriving at a decision, the State Hearing Officer is governed by the Public Welfare Laws of West Virginia and the rules and regulations established by the Department of Health and Human Resources. These same laws and regulations are used in all cases to assure that all persons are treated alike. You will find attached an explanation of possible actions you may take if you disagree with the decision reached in this matter. Sincerely, Encl: Appellant s Recourse to Hearing Decision Form IG-BR-29 Lori Woodward State Hearing Officer Member, State Board of Review cc: Debra Carey, IFM, Lewis Co. DHHR

2 WEST VIRGINIA DEPARTMENT OF HEALTH AND HUMAN RESOURCES BOARD OF REVIEW SUPRENIA VANCE, Defendant, v. ACTION NO.: 17-BOR-2965 WEST VIRGINIA DEPARTMENT OF HEALTH AND HUMAN RESOURCES, Movant. DECISION OF STATE HEARING OFFICER INTRODUCTION This is the decision of the State Hearing Officer resulting from an administrative disqualification hearing for SUPRENIA VANCE requested by the Movant on December 12, This hearing was held in accordance with the provisions found in Chapter 700 of the West Virginia Department of Health and Human Resources Common Chapters Manual and Federal Regulations at 7 CFR The hearing was convened on February 21, The matter before the Hearing Officer arises from a request by the Movant for a determination as to whether the Defendant has committed an Intentional Program Violation (IPV) and therefore should be disqualified from the Supplemental Nutrition Assistance Program (SNAP) for 12 months.* *It is noted that the Defendant had not requested a fair hearing on the issue of the amount of possible repayment; therefore, that issue was not consolidated with this Administrative Disqualification Hearing (ADH). At the hearing, the Movant appeared by Debra Carey with Investigations and Fraud Management (IFM). The Defendant appeared through her counsel, Nathan Walters. The parties were sworn and the following documents were admitted into evidence: Movant s Exhibits: M-1 Hearing Summary M-2 Written statement from Malissa Teter, LSW, Family Child Care Regulatory Specialist, dated December 11, 2017 M-3 Malissa Teter s notes from a telephone conversation reporting allegations of fraud, dated April 18, 2017 M-4 Debra Carey s notes from a telephone conversation with the Defendant, dated April 20, 2017 M-5 Screen print of Benefit Recovery Referral (BVRF) # BOR-2965 P a g e 1

3 M-6 Screen print of Provider Information from Family and Children Tracking System (FACTS) M-7 SNAP CSLE review form signed and dated July 15, 2013; SNAP CSLE review form signed and dated January 28, 2014; SNAP CSLE review form signed and dated July 16, 2014; Supplemental Nutrition Assistance Program (SNAP) 6 to 12 month contact form (PRC2) signed and dated January 27, 2015; Supplemental Nutrition Assistance Program (SNAP) 6 to 12 month contact form (PRC2) signed and dated July 22, 2015; Supplemental Nutrition Assistance Program (SNAP) 6 to 12 month contact form (PRC2) signed and dated January 29, 2016; Supplemental Nutrition Assistance Program (SNAP) 6 to 12 month contact form (PRC2) signed and dated July 20, 2016; West Virginia Health and Human Resources Application for Benefits signed and dated July 21, 2016; West Virginia Health and Human Resources Application for Benefits signed and dated October 26, 2016 M-8 Advance Notice of Administrative Disqualification Hearing and Waiver (ig-ifm- ADH Ltr) dated November 29, 2017 M-9 Waiver of Administrative Disqualification Hearing (ig-ifm-adh-waiver) M-10 West Virginia Income Maintenance Manual (IMM), Chapter 1, M-11 West Virginia Income Maintenance Manual (IMM), Chapter 3, A M-12 West Virginia Income Maintenance Manual (IMM), Chapter 3, A.4 M-13 West Virginia Income Maintenance Manual (IMM), Chapter 3, M-14 West Virginia Income Maintenance Manual (IMM), Chapter 11, 11.1, 11.2 M-15 Code of Federal Regulations, 7 CFR M-16 Screen print of West Virginia Department of Health and Human Resources (DHHR) Bureau for Children and Families (BCF) Child Care Provider Regulatory Requirements page; West Virginia Code of State Regulations, 78 CSR 19, et seq. M-17 Screen print of SNAP Issuance History - Disbursement (IQFS) M-18 Screen print of case member history (AQCM) M-19 Case comments from Defendant s erapids case from April 18, 2011 to September 6, 2017 M-20 Employee Wage Data Match for Jeremy Riggleman M-21 Unemployment Compensation Claimant Profile Data and Benefit Payment History for Jeremy Riggleman M-22 Food Stamp Claim Determination (es-fs-5) from April 7, 2011 to September 2011; BVRF # ; Food Stamp Calculation Worksheets (es-fs-5a); Screen print of Food Stamp Allotment Determinations (EFAD) M-23 Food Stamp Claim Determination (es-fs-5) from October 2011 to January 2012; BVRF # ; Food Stamp Calculation Worksheets (es-fs-5a); Screen print of Food Stamp Allotment Determinations (EFAD); Wage Worksheet M-24 Food Stamp Claim Determination (es-fs-5) from February 2, 2012 to January 2013; BVRF # ; Food Stamp Calculation Worksheets (es-fs-5a); Screen print of Food Stamp Allotment Determinations (EFAD); Wage Worksheet M-25 Food Stamp Claim Determination (es-fs-5) from February 2013 to July 2013; BVRF # ; Food Stamp Calculation Worksheets (es-fs-5a); Screen print of Food Stamp Allotment Determinations (EFAD) 17-BOR-2965 P a g e 2

4 M-26 Food Stamp Claim Determination (es-fs-5) from August 2013 to January 2014; BVRF # ; Food Stamp Calculation Worksheets (es-fs-5a); Screen print of Food Stamp Allotment Determinations (EFAD); Wage Worksheet M-27 Food Stamp Claim Determination (es-fs-5) from February 2014 to July 2014; BVRF # ; Food Stamp Calculation Worksheets (es-fs-5a); Screen print of Food Stamp Allotment Determinations (EFAD); Wage Worksheet M-28 Food Stamp Claim Determination (es-fs-5) from August 2014 to July 2015; BVRF # ; Food Stamp Calculation Worksheets (es-fs-5a); Screen print of Food Stamp Allotment Determinations (EFAD); Wage Worksheet M-29 Food Stamp Claim Determination (es-fs-5) from August 2015 to July 2016; BVRF # ; Food Stamp Calculation Worksheets (es-fs-5a); Screen print of Food Stamp Allotment Determinations (EFAD); Wage Worksheet M-30 Food Stamp Claim Determination (es-fs-5) from November 7, 2016 to April 2017; BVRF # ; Food Stamp Calculation Worksheets (es-fs-5a); Screen print of Food Stamp Allotment Determinations (EFAD); Wage Worksheet; Data Exchange FACTS Income Details M-31 West Virginia Department of Health and Human Resources Instruction Sheet and Applications to Operate a Registered Family Child Care Home, Informal Family Child Care Home or Relative Family Child Care Home forms, signed and dated April 1, 2010; April 17, 2012; April 2, 2014; and March 2016 M-32 Cover letter to Jeremy Riggleman dated January 24, 2018; ig-fm-ag questionnaire signed and dated January 28, 2018 Defendant s Exhibits: D-1 Pendleton Community Bank Checking and Savings Account Statements from January 2010 to August 2017 After a review of the record, including testimony, exhibits, and stipulations admitted into evidence at the hearing, and after assessing the credibility of the witness and weighing the evidence in consideration of the same, the Hearing Officer sets forth the following Findings of Fact. FINDINGS OF FACT 1) The Investigations and Fraud Management (IFM) unit of the West Virginia Department of Health and Human Resources (DHHR) alleged that the Defendant intentionally committed a program violation by concealing her physical residence and the fact that the father of her child lived in the household, on all her SNAP applications and/or reviews from April 2011 through April ) The Defendant was a recipient of SNAP benefits. (Exhibits M-22 through M-30) 3) The Defendant and her daughter resided at 155 Tower Drive, Petersburg, WV (hereinafter referred to as Tower Drive ), with Jeremy Riggleman, her daughter s father. (Exhibits M-1 through M-4, M-31 and M-32) 17-BOR-2965 P a g e 3

5 4) The Defendant did not list Mr. Riggleman, as a household member on any of her SNAP applications and/or renewals, or inform any of the workers who interviewed her for SNAP benefits as to this fact. (Exhibits M-7 and M-19) 5) On all the Defendant s SNAP renewal and/or application forms, she only listed 21 Central Avenue, Petersburg, WV (hereinafter referred to as Central Avenue ), never indicating the Tower Drive address as her actual physical address. (Exhibits M-7) 6) The Defendant was a registered Child Care Provider (CCP). (Exhibit M-31). 7) On her CCP renewal forms under the Directions to My Home section, she provided directions to the Tower Drive address. (Exhibit M-31) 8) On her 2010 and 2012 CCP renewal forms, the Defendant listed Jeremy Riggleman as a household member. (Exhibit M-31) 9) Jeremy Riggleman received earned and/or unearned income from April 2011 to April 2017, which should have been considered in processing the Defendant s SNAP benefits. (Exhibits M-20 and M-21) 10) The Defendant intentionally concealed the fact that she was residing with the father of her child, Jeremy Riggleman, who had earned and/or unearned income, which resulted in the Defendant receiving SNAP benefits for which she was ineligible. (Exhibits M-22 through M-30) APPLICABLE POLICY IMM 1.2(E) states that it is the client s responsibility to provide information about his/her circumstances so the worker is able to make a correct decision about his/her eligibility. Failure to fulfill this obligation may result in one or more of the following actions: denial of the application, closure of the active Assistance Group (AG), removal of the individual from the AG, repayment of benefits, and/or a reduction in benefits. IMM A.4, explains that natural or adopted children and stepchildren who are under 22 years of age and who live with a parent must be in the same AG as that parent. Code of Federal Regulations, 7 CFR 273.1(a) General household definition: A household is composed of one of the following individuals or groups of individuals, unless otherwise specified in paragraph (b) of this section: (ii) A person under 22 years of age who is living with his or her natural or adoptive parent(s) or step-parent(s). Code of Federal Regulations, 7 CFR , establishes that an individual making a false or misleading statement, or misrepresenting, concealing or withholding facts, violating the Food Stamp Program (SNAP), or any State statute for the purpose of acquiring, receiving, possessing or 17-BOR-2965 P a g e 4

6 trafficking of coupons, authorization cards or reusable documents used as part of an automated benefit delivery system has committed an Intentional Program Violation (IPV). IMM 20(C)(2) defines an IPV and establishes that IPVs include: making false or misleading statements, misrepresentations, concealing or withholding information, and committing any act that violates the Food Stamp Act of 1977, SNAP regulations, or any State statute related to the use, presentation, transfer, acquisition, receipt, or possession of SNAP benefits. Once an IPV has been established, a disqualification period must be imposed on the Assistance Group (AG) member who committed the violation. IMM 9.1(A)(2) sets forth the penalties for individuals found guilty of an IPV as follows: First Offense, twelve (12) month disqualification; Second Offense, twenty-four (24) month disqualification; Third Offense, permanent disqualification. Common Chapters, , Consolidation of Administrative Disqualification Hearing with a Fair Hearing Requested by the Household, an Administrative Disqualification Hearing may be consolidated with a fair hearing requested by the household member if the factual issues arise out of the same or related circumstance. [Emphasis added] This includes the issue of the amount of over-issuance associated with the alleged Intentional Program Violation. If the hearings are consolidated, the household must be notified in advance of this fact, and the time frames for Administrative Disqualification Hearings will be observed. However, the household may waive the 30-day advance notice of the hearing as required in disqualification hearings. If the household member or his or her representative fails to appear at the consolidated hearing, the only issue that may be considered shall be that of an alleged Intentional Program Violation. Common Chapters, K, Decision The Hearing Official shall base the determination of Intentional Program Violation on clear and convincing evidence that demonstrates that the Defendant committed, and intended to commit, an Intentional Program Violation as defined in Section (D) of this Chapter. The Hearing Official shall weigh the evidence and testimony presented and render a decision based solely on proper evidence given at the hearing. In rendering a decision, the Hearing Official shall consider all applicable policies of the Department, state and federal statutes, rules or regulations, and controlling court orders. The decision shall include reference to all pertinent law or policy. If the Hearing Official rules that the Defendant committed an Intentional Program Violation, he or she shall include the length and the beginning date of the disqualification penalty. The Department shall then take action to ensure that the disqualification takes effect within 45 days from the date of the hearing decision. DISCUSSION Federal and state regulations define an Intentional Program Violation (IPV) as making false or misleading statements, misrepresentations, concealing or withholding information related to the acquisition of SNAP benefits. The Movant alleges that the Defendant intentionally concealed the fact that she was residing with the father of her child, Jeremy Riggleman, who had earned and/or unearned income, on her SNAP applications and/or reviews, which resulted in the Defendant receiving SNAP benefits for which she was ineligible. 17-BOR-2965 P a g e 5

7 The Movant must show by clear and convincing evidence that the Defendant intentionally committed a program violation as defined by federal and state statutes. The Defendant, by and through her counsel, stipulated to the Movant s facts of the case and evidence submitted into the record. The Defendant contended, however, that the she did not intentionally withhold the fact that she lived with her daughter s father at a different address on all of her SNAP applications and/or reviews. The Defendant proffered several reasons why she did not consider Mr. Riggleman as a member of her household -- he was often out of town working, they kept their finances separate, they filed separate income tax forms, he did not give her any money, and she maintained a separate address at Central Avenue. She contended because of those reasons, she did not report him as a member of her household for her SNAP benefits. However, the Defendant s contention is questionable due to the fact that she clearly identified Mr. Riggleman as a household member on some of her CCP review forms and to the CCP worker who updated her case in the computer, and also by reporting living at the Tower Drive address. Additionally, the evidence showed that the Defendant listed Mr. Riggleman as her fiancé on her CCP review form. Interestingly, not once does the Defendant on all of the SNAP applications/reviews in evidence reveal that her physical address is Tower Drive, although those forms clearly require information as to whether there was a different physical address than the mailing address. Moreover, at no time did the Defendant disclose to a worker interviewing/processing her SNAP benefits, that she was living at another address or that the father of her daughter was in the household. As a matter of fact, the Defendant actually returned verifications that she lived at the Central Avenue address on February 28, 2014 when there was a report to the local DHHR that she was not actually living at that address. This is especially demonstrative of the fact that the Defendant intentionally provided the Movant with false and/or misleading information, especially in light of the fact that she admitted she had lived with Mr. Riggleman since In the absence of any indication that the Defendant was forthright with the information regarding her circumstances in applying for or reviewing her SNAP benefits, especially when she had the opportunity to present her actual living circumstances, her contention that she did not intentionally withhold this information is not plausible. The Defendant proffers that she had no idea the amount of income Mr. Riggleman earned because they kept their finances separate. Although she may not have been aware of the exact amount of Mr. Riggleman s income, she was aware that he was receiving income. Had she not concealed her actual circumstances and provided the correct information on her SNAP applications and/or reviews, then an accurate determination could have been made regarding the Defendant s SNAP eligibility. Instead, the evidence shows that she chose not to truthfully disclose her living circumstances in applying for and/or reviewing of her SNAP benefits. The Movant provided clear and convincing evidence that the Defendant s act was intentional she knowingly provided false or misleading statements, misrepresentations, concealed and/or withheld information related to the acquisition of her SNAP benefits by not reporting her physical residence and the fact that the father of her child was in the household. 17-BOR-2965 P a g e 6

8 CONCLUSIONS OF LAW 1) The act of making false or misleading statements, misrepresentations, concealing or withholding information related to the acquisition of SNAP benefits constitutes an Intentional Program Violation. 2) The Movant provided clear and convincing evidence that the Defendant intentionally concealed and/or withheld the fact that she lived at a different address with the father of her child, in the acquisition of SNAP benefits. 3) The penalty for a first offense Intentional Program Violation is exclusion from participation in SNAP for twelve (12) months. DECISION It is the ruling of the State Hearing Officer that the Defendant committed an Intentional Program Violation. The Defendant will be disqualified from participation in SNAP for a period of twelve (12) months to begin effective April 1, ENTERED this 1 st day of March Lori Woodward, State Hearing Officer 17-BOR-2965 P a g e 7