[Code of Federal Regulations]

[Title 7, Volume 4]

[Revised as of January 1, 2006]

From the U.S. Government Printing Office via GPO Access

[CITE: 7CFR275.13]



[Page 857-859]

 

                          TITLE 7--AGRICULTURE

 

    CHAPTER II--FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE

 

PART 275_PERFORMANCE REPORTING SYSTEM--Table of Contents

 

                 Subpart C_Quality Control (QC) Reviews

 

Sec. 275.13  Review of negative cases.



    (a) General. A sample of households whose applications for food 

stamp benefits were denied or whose food stamp benefits were suspended 

or terminated by an action in the sample month or effective for the 

sample month shall be selected for quality control review. These 

negative cases shall be reviewed to determine whether the State agency's 

decision to deny, suspend, or terminate the household, as of the review 

date, was correct. Depending on the characteristics of individual State 

systems, the review date for negative cases could be the date of the 

agency's decision to deny, suspend, or terminate program benefits, the 

date on which the decision is entered into the computer system, the date 

of the notice to the client, or the date the negative action becomes 

effective. However, State agencies must consistently apply the



[[Page 858]]



same definition for review date to all sample cases of the same 

classification. The review of negative cases shall include a household 

case record review; an error analysis; and the reporting of review 

findings, including procedural problems with the action regardless of 

the validity of the decision to deny, suspend or terminate.

    (b) Household case record review. The reviewer shall examine the 

household case record and verify through documentation in it whether the 

reason given for the denial, suspension, or termination is correct or 

whether the denial, suspension, or termination is correct for any other 

reason documented in the casefile. When the case record alone does not 

prove ineligibility, the reviewer may attempt to verify the element(s) 

of eligibility in question by telephoning either the household and/or a 

collateral contact(s). Through the review of the household case record, 

the reviewer shall complete the household case record sections and 

document the reasons for denial, suspension or termination on the 

Negative Quality Control Review Schedule, Form FNS-245.

    (c) Error analysis. (1) A negative case shall be considered correct 

if the reviewer is able to verify through documentation in the household 

case record or collateral contact that a household was correctly denied, 

suspended or terminated from the program. Whenever the reviewer is 

unable to verify the correctness of the State agency's decision to deny, 

suspend or terminate a household's participation through such 

documentation or collateral contact, the negative case shall be 

considered incorrect.

    (2) The reviewer shall exclude a variance when the State agency 

erroneously denied, suspended or terminated a household's participation 

based on an erroneous verification of alien documentation by the 

Immigration and Nationalization Services (INS) Systematic Alien 

Verification for Entitlements (SAVE) Program. The reviewer shall exclude 

the variance only if the State agency properly used SAVE, and the State 

agency provides the reviewer with:

    (i) The alien's name;

    (ii) The alien's status; and

    (iii) Either the Alien Status Verification Index (ASVI) Query 

Verification Number or the INS Form G-845, as annotated by INS.

    (d) Reporting of review findings. When a negative case is incorrect, 

this information shall be reported to the State agency for appropriate 

action on an individual case basis, such as recomputation of the coupon 

allotment and restoration of lost benefits. In addition, the reviewer 

shall code and record the error determination on the Negative Quality 

Control Review Schedule, Form FNS-245.

    (e) Disposition of case review. Each case selected in the sample of 

negative cases must be accounted for by classifying it as completed, not 

completed, or not subject to review. These case dispositions shall be 

coded and recorded on the Negative Quality Control Review Schedule, Form 

FNS-245.

    (1) Cases reported as not complete. Negative cases shall be reported 

as not completed if the reviewer, after all reasonable efforts, is 

unable to locate the case record. In no event, however, shall any 

negative case be reported as not completed solely because the State 

agency was unable to process the case review in time for it to be 

reported in accordance with the timeframes specified in Sec. 

275.21(b)(2), without prior FNS approval. This information shall be 

reported to the State agency for appropriate action on an individual 

case basis.

    (2) Cases not subject to review. Negative cases which are not 

subject to review, if they have not been eliminated in the sampling 

process, shall be eliminated in the review process. In addition to cases 

listed in Sec. 275.11(f)(2), these shall include:

    (i) A household which was dropped as a result of a correction for 

oversampling;

    (ii) A household which was listed incorrectly in the negative frame.

    (f) Demonstration projects/SSA processing. A household whose 

application has been denied or whose participation has been suspended or 

terminated under the rules of an FNS-authorized demonstration project 

shall be reviewed following standard procedures



[[Page 859]]



unless FNS provides modified procedures to reflect the rules of the 

demonstration project. If FNS determines that information obtained from 

these cases would not be useful, then these cases may be excluded from 

review. A household whose application has been processed by SSA 

personnel and is subsequently denied participation shall be reviewed 

following standard procedures.



[Amdt. 260, 49 FR 6309, Feb. 17, 1984, as amended at 53 FR 39443, Oct. 

7, 1988; Amdt. 373, 64 FR 38296, July 16, 1999]