Revision 11-1; Effective June 27, 2011

 

Introduction

This section includes information applicable to the overall IHP/ONA program grant decision-making and processing, rather than to any particular grant category. In addition to casework guidelines, the section includes information on post-decision activities, such as applicant notification, appeal procedures, applicant claims of lost or stolen warrants, and audit procedures.

11100 Casework Documentation Guidelines

Revision 09-1; Effective July 20, 2009

 

 

11110 Change of Address

Revision 07-1; Effective May 1, 2007

The worker records changes in the applicant's mailing address in NEMIS. Updating NEMIS ensures that the current mailing address is entered in the Disaster Assistance Payment Program (DAPP).

 

11120 Explanation of Denials

Revision 09-1; Effective July 20, 2009

 

The worker should explain, in writing, as fully as possible, decisions to deny or grant awards. For example, if insurance or SBA meets serious needs in the personal property category, the worker documents the reason for disallowing grant funds in this category.

Cases marked with "IDV_FAILED," in the banner on NEMIS, indicates the applicant’s name and Social Security number do not match and will be sent an IDV_Failed denial letter and be given 60 days to comply with identification verification.

 

11130 Voluntary Withdrawal

Revision 07-1; Effective May 1, 2007

The applicant has the right to withdraw from consideration for a grant. The department will notify the applicant that his grant application is withdrawn based on his request. The letter acknowledging his request to withdraw from grant consideration will include notification of his right to request reconsideration of the grant decision.

If an applicant indicates, orally or in writing, that he wishes to withdraw from consideration for a grant, the worker records voluntary withdrawal as the grant decision in NEMIS.

 

11200 ONA Policy Interpretations

Revision 05-1; Effective October 1, 2004

 

The GCO or designee is responsible for interpreting policy for ONA staff. Eligibility workers and sign-off staff may encounter problems or have questions that are not clearly addressed in this handbook. If the problem cannot be resolved by supervisory staff, the eligibility supervisor submits the questions in writing to the IHP/ONA staff members assigned responsibility for policy clearance. The request for policy clarification should:

  • identify the case by name and number;
  • describe the situation (including enough information so that state office staff can answer the question);
  • identify the sections of the handbook that apply to the policy clarification, are difficult to interpret, or have ambiguous or unclear language; and
  • indicate the interpretation that he feels is most equitable.

The policy specialist responds in writing to the question. Some interpretations are applicable only to the referenced case. Others may represent a change of policy, making it necessary to revise the handbook.

 

11300 Notification

Revision 05-1; Effective October 1, 2004

 

Applicants are entitled to prompt notification of grant decisions. FEMA is responsible for notifying applicants by letter of the grant eligibility determination.

Letters approving grants include a grant approval statement, the grant amount, the purpose for which the grant is approved, and the notification of the right to request reconsideration of a grant decision. When applicable, grant approval letters include flood insurance requirements and conditions.

Letters disapproving grants include a statement that the application is denied, the reasons for denial, and the notification of the right to request reconsideration of a grant decision.

 

11400 Disbursements

Revision 07-1; Effective May 1, 2007

The ESP leader or designee transmits grant decision data to the Health and Human Services Accounting System (HHSAS) for processing. First, a vendor identification (VID) maintenance file is produced. This file is used by HHSAS to add disaster victims to the comptroller's VID file so that checks are printed with the correct name and address information. Once the data is uploaded on the HHSAS system, HHSAS staff then produce a payment file based on grant approvals. The file is to be processed by HHSAS. HHSAS staff submit the file to the state comptroller's office. The comptroller's staff print warrants and return them to HHSAS, where they are mailed to grant recipients. Disaster funds, by regulation, are exempt from garnishment.

 

11410 Lost or Stolen Warrants

Revision 07-1; Effective May 1, 2007

The applicant is responsible for notifying the ONA Program Office when he does not receive a grant warrant. ONA staff will notify the applicant of the required procedures for warrant reissue.

When an applicant notifies the ONA office that he did not receive a warrant, ONA staff must notify HHSAS of the applicant's claim. HHSAS coordinates with ONA to ensure that department procedures for resolving these claims are followed.

 

11420 Supplemental Grants

Revision 05-1; Effective October 1, 2004

 

Applicants may be entitled to a supplemental grant if the review and auditing process reveals that the initial grant amount has not adequately met the applicant's serious needs or necessary expenses. The total grant amount must not exceed the maximum grant allowed by federal law.

 

11500 Reconsiderations

Revision 05-1; Effective October 1, 2004

 

The applicant may request that the ONA provision of IHP reconsider a grant decision by writing a letter to the ONA grant coordinating officer (GCO) within 60 days of the date of the letter notifying the applicant of the decision. If the applicant files a request for reconsideration after the 60-day deadline, it will not be considered unless the applicant demonstrates good cause for failure to request consideration within that time period. The GCO or designee will be the sole determiner of whether good cause is shown. Good cause means circumstances beyond the applicant's control. The filing of a timely request for reconsideration is a prerequisite to an administrative appeal.

The applicant is notified of the ONA reconsideration decision by letter within 20 days of the reconsideration. The letter notifying the applicant of the grant reconsideration shall contain notice of the right to appeal the reconsideration decision by filing a written request for an appeal with ONA within 60 days of the date of the reconsideration decision letter. The appeal will be decided by the department's hearing officer in the appropriate region. Because FEMA pays for all housing repairs up to the maximum allowed under the Housing Assistance provision of the Federal Assistance to Individuals and Households Program, the applicant does not have appeal rights of FEMA's real property decision through the Texas Health and Human Services Commission.

 

11510 Reconsideration Procedures

Revision 08-1; Effective April 23, 2008

 

Upon receipt of the reconsideration request, the GCO or designee will review the case file to determine if needs have been met. The GCO or designee may request that a second inspection be conducted by FEMA.

If the request involves real property repairs and/or personal property, the request will be forwarded to FEMA for reverification. If additional real property repairs are allowed, FEMA will pick up these costs under the Housing Assistance provision of the IHP, up to the maximum allowed.

All requests for reverification by the state will be honored to ensure that the state meets the requirements published in the Texas Register. All results of FEMA's reverification will be forwarded to ONA via electronic transmission in NEMIS.

If ONA receives a request for personal property only, the reverification will be conducted by a FEMA verifier and ONA will pay the supplemental grant, if the applicant is eligible for additional funds.

 

11600 Appeals

Revision 08-1; Effective April 23, 2008

 

The applicant must direct any request for appeal in writing to the IHP/ONA within 60 days of the date of the reconsideration decision. The appeal hearing is held by a hearing officer in the region where the applicant is living at the time he files the appeal. The appeal hearing and the written hearing decision must be completed by the hearing officer within 90 days from the receipt of the Petition for Hearing within the IHP/ONA office.

The right to appeal is limited to eligibility and grant determinations. No appeal may be made if IHP has provided the maximum grant allowed by law.

Because FEMA pays for all housing repairs up to the maximum allowed under the Housing Assistance provision of the IHP, the applicant does not have appeal rights of FEMA's real property decision through the Texas Health and Human Services Commission.

The hearing is expedited if the disaster program is closing. All grant award activity, including eligibility determination, disbursement and disposition of appeals, must be completed within 18 months following the declaration of the disaster.

Before a case is submitted for a formal hearing, FEMA will perform a second inspection for personal property if the personal property items are available for an inspection.

As part of the hearing process, the ONA grant coordinating officer permits the applicant to examine any documents submitted by ONA to the hearing officer, if requested by the applicant, by sending copies of the documents to the applicant within five days of the applicant's request.

At the time a disaster declaration is made and the State Administrative Plan approved, ONA staff must deliver to the State Office Hearings Department a copy of the plan, any itemized price lists applicable to the disaster, and a list of regions affected by the disaster. The Hearings Department ensures that copies of this material are forwarded to the appropriate regional attorneys for use by the hearing officers.

In all procedural matters not superseded by this section, the fair hearings rules in Title 40 Texas Administrative Code, §79.1101- 79.1317, apply.

A record of all documents submitted and a tape recording of any oral testimony is prepared by the hearing officer and preserved for a period of two years following the ruling on the appeal.

 

11610 Appeal Procedures

Revision 09-1; Effective July 20, 2009

 

When ONA receives a request for an appeal, the following activities occur:

  • Within five days of the receipt of the written request for appeal, ONA staff complete Form H4800, Fair Hearing Request Summary, and Form H4800-A, Addendum, and forward the request for appeal to the regional attorney of the region where the applicant resides. The program completion deadline must be noted on Form H4800. Also, a copy of the State Administrative Plan (SAP) and the web address for the ONA online handbook is provided.
  • During the first five days from the appeal date, ONA staff may try to resolve any questions or concerns the applicant may have and, if applicable, reissue another reconsideration decision. If the applicant, prior to the time Form H4800 is sent to the regional attorney, decides to withdraw the appeal, ONA should obtain a written statement from the applicant that he wishes to withdraw the appeal before closing the file. It is not necessary to send Form H4800 to the regional attorney if the applicant makes clear his desire to withdraw the appeal.

Before the hearing, ONA staff will:

  • review the case,
  • write a summary of case processing and justification of decisions,
  • print the entire case record, including Form H4800-A, and mail a copy to the applicant and hearing officer in charge of the appeal, and
  • complete data entry processing to show that the request for appeal has been received.

When the hearing officer makes an appeal decision, the hearing officer:

  • notifies the applicant of the appeal decision in writing, and
  • sends a copy of the decision to the ONA office.

Upon receipt of the hearing decision, ONA staff:

  • file a copy of the decision in the case record,
  • complete data processing to show the appeal decision,
  • take appropriate action, if any is ordered by the hearing officer, and
  • complete Page 2 of Form H4807, Action Taken on Hearing Decision, and return it to the hearing officer to show that required action has been completed for cases in which the ONA grant decision was reversed.

 

11700 Sampling Grant Decisions

Revision 05-1; Effective October 1, 2004

 

A random sample of grant decisions must be conducted by the GCO manager or designee. This sample is to verify that:

  • grant funds are meeting applicants needs,
  • grant funds are not duplicating assistance from other means, and
  • grant decisions are meeting floodplain management and flood insurance requirements.

The sample must be conducted early in the disaster operation, prior to completion of 25 percent of the total decisions expected, and within 60 days after the presidential disaster declaration date.

Sample size must be five percent of cases received; however, at least 10 cases must be reviewed. It is not necessary to review more than 100 cases.

Actions are to be taken to correct problems. The random sample is not an audit. It is for the purpose of determining whether the program is meeting people's needs and the eligibility criteria.

When the sampling and analysis are completed, results are to be attached to the statistical report and made available to the state coordinating officer (SCO).

 

11800 Audits

Revision 05-1; Effective October 1, 2004

 

The SCO ensures that both program and financial audits are performed. Audit procedures are described in the State Administrative Plan submitted by Nov. 30 each year. All disbursements for which Texas requests federal funds are also subject to federal audits. Disaster Assistance staff provide reports to FEMA. These reports help FEMA monitor decisions to determine if benefits are being duplicated. Audits are made according to federal regulations in 44 CFR, Part 206.110-120, Subpart D, Federal Assistance to Individuals and Households.

 

11900 Recovering Grant Funds

Revision 05-1; Effective October 1, 2004

 

ONA must attempt to recover grant funds if it appears that these funds have been:

  • obtained fraudulently or misapplied, or
  • duplicated by assistance from other means, or
  • identified as overpayment because of administrative or data entry error.

Recovery procedures must be applied in accordance with the Office of Attorney General guidelines described in Title 1, Texas Administrative Code, §59.2 and §59.3.

However, ONA will not attempt recovery of overpayments that are automatically determined (Auto-D) by FEMA. These overpayments are FEMA's responsibility.

 

11910 Monitoring Methods

Revision 09-1; Effective July 20, 2009

 

The following monitoring methods and procedures are used to determine if recovery of funds is required:

  • Random sample of grant decisions (see Section 11700, Sampling Grant Decisions, for additional information).
  • Texas Division of Emergency Management (TDEM) audit.
  • Referral from other disaster assistance programs.
  • Referral from local, state or federal government, and other sources.
  • FEMA mid-program review.
  • Comparison of automated system reports on warrants issued with case records.
  • Automated tracking of requirements to purchase flood insurance.

 

11920 Offsets of Awards from Previous Disaster Assistance

Revision 09-1; Effective July 20, 2009

 

The state, including the Office of the Attorney General, does not have the authority to offset a debt owed by an ONA award recipient from an award made on one disaster against an award made to the same recipient on a subsequent disaster. The statedoes have the authority (44 CFR 13.43, Enforcement) to deny the award in full to an applicant who has not responded to recoupment requests on a previous award or is not meeting payment plan deadlines to the state's satisfaction. (Note: If the applicant contacts ONA and returns the funds owed from the previous disaster, or establishes a satisfactory payment plan, the award for the current disaster may be released.)

 

11930 Recovery Procedures – Fraud

Revision 09-1; Effective July 20, 2009

 

Criminal and Civil Penalties

In accordance with the applicable sections of Titles 18 and 31 of the United States Code, and Section 314 of the Robert T. Stafford Disaster Relief and Emergency Assistance Act, the government may impose criminal and civil penalties in cases of fraud, false claims and theft of funds awarded under the various provisions of the Stafford Act.

Because federal and state agencies are equally responsible for maintaining the integrity of the IHP, prosecutions also may be brought under the applicable state criminal and civil statutes.

The associate director, State and Local Programs, Support Program and FEMA will ensure that any reports of suspected criminal activity or civil fraud against the program are expeditiously referred to the Inspector General, FEMA.

Processing Reports of Suspected False Claims, Fraud and Theft of Funds

Any indication of criminal activity with respect to the ONA provisions of the IHP will be referred to the Inspector General, FEMA, immediately after it is discovered or reported. Referrals will be made in accordance with the following instructions:

  1. The grant coordinating officer (GCO) will notify the federal and state coordinating officers within 20 working days when a case of suspected fraud is discovered.
  2. Within 20 working days of the date of the GCO's notification of suspected fraud, the federal coordinating officer (FCO) will refer the matter to the Inspector General, FEMA. An information copy of this correspondence will be provided to the regional director.
  3. The FCO will maintain all documentation pertinent to the referral for use by investigators assigned to the case.
  4. The Inspector General will notify the FCO or the disaster recovery manager if the case will be investigated. An information copy of this correspondence will be sent to the regional director.
  5. The Inspector General will be responsible for liaison with state and local law enforcement authorities. The contact point for such liaison is:

Federal Emergency Management Agency
Office of the Inspector General
500 C Street, S. W.
Washington, DC 20472

US DHS OIG, Asst. SAC
5850 San Felipe Rd., Suite 300
Houston, TX 77057

Funds recovered from court order or other settlement will be received by the GCO, Emergency Services Program, and forwarded to HHSC Fiscal Management Services for accounting and appropriate disbursement to state and federal funding sources.

 

11940 Recovery Procedures – Other Than Fraud

Revision 11-1; Effective June 27, 2011

For cases identified as overpayments due to ONA administrative or data entry error, the recovery procedures outlined below begin upon discovery of the overpayment. As stated earlier in this section, ONA will not attempt recovery of overpayments due to FEMA processing errors.

Recovery Procedures

  1. Send a demand letter no later than 30 days after the obligation becomes delinquent. (All demand letters should be mailed in an envelope bearing the notation "address correction requested" in conformity with federal regulations.)

    Note: The notice must advise the recipient that he has a right to request an administrative review of the recovery effort within 20 days of receipt of the notice. If the recipient does not respond to the notice, the right to administrative review is waived, and collection efforts continue as described in Items 2 through 11 below.

    If the recipient does respond, an administrative review of the case record will be conducted by GCO or designee. The recipient is advised of the administrative review decision.
     
  2. Send a second demand letter no sooner than 30 days but no later than 60 days after the first demand letter. This letter also will advise the grant recipient that his case may be referred to the Attorney General's Office for legal action.
  3. If the grant recipient fails to return the funds, cases are prepared for referral to the HHSC Office of General Council (OGC). ONA removes all cases with owed amounts under $500. The OGC will not accept referrals less than $500.
  4. If the grant recipient owes more than $500 and fails to return the funds, ONA prepares a third demand letter for HHSC OGC approval and signature and mails the letter by certified mail.
  5. If there is no response to the third demand letter from OGC:
    • Remove all cases with owed amounts less than $2,000 and suspend from collection.
    • Remaining cases with debts more than $2,000 are reviewed to determine if debt appears to be collectible. The criteria used to make this determination include the applicant's age, income, assets and overall ability to repay as per the State of Texas Administrative Plan.
  6. The ONA office sends a memo to OGC listing the cases determined uncollectible with supporting documentation.
  7. OGC reviews the information and determines if further collection efforts are necessary. OGC then notifies ONA what action to take. If OGC approves ONA determination of "uncollectible," then these cases are suspended and no further collection action is taken. ONA does not have the authority to forgive any debt owed to the State of Texas. The applicants’ files in the state’s database (DAPP) will be put on permanent hold for any potential payments related to future disasters. Applicants will not be awarded any potential payments related to future disasters until debt has been paid or acceptable payment plan has been established.
  8. All other cases (collectibles more than $2,000) are listed in a memo from the ONA Program to OGC requesting that the case be referred to the Attorney General's office for handling. ONA makes two copies of each case record and sends them to OGC with the memo.
  9. A letter from HHSC to the State Attorney General's office is prepared by OGC for HHSC commissioner's signature.
  10. Attorney General's office notifies HHSC OGC of action taken.
  11. Attorney General's Collections Division notifies applicant that legal action may be taken if debt is not satisfied.

Recovery Reporting and Record-Keeping

  1. Not later than the 30th day after the department determines that normal department collection procedures for an obligation owed to the agency have failed, the department shall report the uncollected and delinquent obligation to the attorney general for further collection efforts.
  2. An annual delinquent obligations report is required to be submitted to the Attorney General's office of all outstanding delinquent obligations owed to each state agency.
  3. The ONA office will maintain record-keeping in order to apply appropriate penalties in future disasters in accordance with federal regulations.
  4. The ONA office will maintain an accounts receivable file. Any funds returned to ONA will be forwarded to the HHSC Accounts Receivable Tracking System (ARTS) to be credited to the appropriate disaster account.
  5. Returned funds will be handled as covered in Item 4 above.

 

11950 Outstanding Checks/Expired Checks

Revision 09-1; Effective July 20, 2009

 

A report on the status of outstanding checks/warrants will be provided by the Health and Human Services Accounting System (HHSAS) as part of the IHP (ONA) closeout package completed by the TDEM and submitted to FEMA. The state comptroller will provide HHSAS a listing of expired warrants and transfer the funds associated with the cancellation of warrants within 60 days after the warrant’s expiration date.

Once the disaster is closed for processing, HHSC will not reissue any warrants, including warrants that have been reported lost or stolen.

The federal share of the outstanding checks/warrants will be returned by HHSAS to FEMA within 90 days after the warrant's expiration date. Federal funds will be returned to FEMA via warrant with a listing, by federal disaster number, of clients who have cancelled checks/warrants.