LIHEAP Program Integrity
In 2012 as part of the LIHEAP Program Integrity Working Group, NCAT surveyed a geographically diverse group of 22 larger and smaller LIHEAP tribal grantees on a variety of program integrity measures currently used, including identity and income verification, fraud reporting, vendor management, fiscal management, oversight and monitoring, benefit payments, etc. This was done because some program integrity (PI) issues identified by states did not apply to tribes, and some PI issues are unique to tribes.
Following are PI issues on which NCAT surveyed the sample of tribes.
1. Social Security number (SSN) requirements
Nearly all tribes require SSNs from some or all household members. Some require photo identification with SSN or only photo identification. Some of the small tribes don't require SSNs, and others began asking for them in FY 2011. Strategies are summarized below:
- 88 percent - require SSNs for at least 1 member of household
- 37 percent - require SSNs for all household members
- 4 percent - SSNs not required
- 12 percent - require SSN card or other SSA documentation
- 21 percent - accept copies of SSN cards for all household members
- 4 percent - require SSN card for applicant, SSNs for other household members
- 8 percent - SSN request is new for FY 2011
Tribal enrollment is not based on identification, but on documentation of tribal heritage. According to many tribal officials interviewed by NCAT, it is extremely rare if not unheard of for an applicant to try to assume another person's identity for the purpose of joining tribal rolls. Provided that SSNs are listed on the tribal enrollment records, these records could be valuable resources for identifying and verifying LIHEAP applicants.
Suggestions for improvement
- Include Social Security numbers (SSNs) as part of the information in tribal enrollment records
- Include photographs on tribal identification cards
- Require SSNs for LIHEAP applicant and all household members while allowing individual grantee exceptions, consistent with the group's recommendations to regarding state grantees (See Recommendations, Section IV.)
- If applications aren't reviewed after intake, institute additional review processes as appropriate to the size of tribal staff
- Create step-by-step guidelines or check-off lists for intake personnel operating in small communities where there is little chance for additional review or oversight
- Funding/resources: Including SSNs in enrollment records could involve revamping the tribal rolls; there is an expense to include photos on tribal identification cards; additional intake reviews, whether they are done on a regular or spot basis, would require staff time; developing guidelines for intake officers in small communities would take time and staff to develop.
- Privacy: Some tribal LIHEAP officials said some tribal members, especially older ones, were unhappy when the tribe began requiring SSNs or photo identifications. There could be some resistance to adding SSNs to the information in tribal enrollment records.
2. Verifying SSNs through third-party databases
A majority of tribes reported that they did not use third-party databases to check SSNs, citing expense and concerns over releasing information. Some intake personnel said the information obtained through cross-checking -- whether the SSN is active and corresponds to the applicant's name -- wouldn't necessarily confirm the applicant's identity.
Some tribes have their own databases, which are used to cross-check and verify client information (name, address, mailing address, age, SSN, and income) among tribally-administered assistance programs. Some tribes have other procedures, such as email, faxing, and telephone calls, to cross-check information with other tribally-administered assistance programs and, in a few cases, state-administered programs.
SSN verifications are summarized below:
- 76 percent - do not use third-party databases
- 8 percent - cross-check with tribal database
- 12 percent - cross-check manually with other programs
- 4 percent - check through state LIHEAP database
A majority of tribes, especially smaller tribes, said they rely on long-standing good relationships with other public assistance personnel, both tribal and state.
Alaska tribes have the option of entering into an agreement (see Resources, Appendix E) with the state Division of Public Assistance to gain viewing access to SNAP, TANF, and other public assistance programs. One Alaskan tribe said the state SSA and Unemployment Insurance charge a fee for verifications.
Effective FY 2011, the Lumbee Tribe of North Carolina had access to the state's Department of Health and Human Services, the LIHEAP grantee, application database to check for duplicate crisis applications. It also can access the state's online database for Supplemental Security Income, unemployment, TANF, and SNAP to verify household income, SSNs and birth dates. The parties signed an agreement outlining state and tribal responsibilities, the records access policies, funding allocations, reporting requirements, confidentiality, and liabilities. The state also provided training to the tribe.
A number of tribes said they would institute a check with SSA or other databases if it were required, but cited concerns due to their limited administrative budgets. Others said that negotiations to develop Memorandums of Understanding (MOUs) with state agencies in order to provide tribal access to databases had fallen through.
- Develop a model client database for tribal LIHEAP
- Identify and provide training on how tribes can share information among tribally-administered public assistance programs
- Help identify, develop and disseminate model agreements for states, tribes, and the federal government to use in negotiating MOUs and contracts
- Funding: developing a database would require time and staff, which most tribes would find too costly
- Expense: fees charged by other agencies to access client data
3. Verifying identity
The most consistent finding among the tribes was that they all rely on tribal enrollment status as their primary source of identity verification. As is the case with most program integrity issues, tribal enrollment procedures vary widely, depending on the size of the program and the size of the tribe or tribal association.
Many tribes require a tribal enrollment card or other documentation that proves enrollment. A third of the tribes stressed that intake staff reside in communities within the reservation and know applicants personally. Identity documentation is summarized below:
- 100 percent - tribal enrollment
- 33 percent - intake officers who are members of small communities
- 66 percent - Social Security numbers
- 16 percent - drivers license or other picture ID
4. Verifying income
Most tribes use pay stubs, income tax records, etc., to verify income. On some reservations, most of the employment is with the tribal government, which means the income is not available on state databases. Some tribes require proof that the applicant is registered with the tribal employment office or in school. Some reservations have seasonal employment, such as fishing, which often pay in cash and is hard to track. About one-third of tribes cross-check income information with other tribal or state public assistance programs, usually via telephone, email, or fax. A few cross-check information with other tribally-administered public agencies via a tribal database. Few tribal programs have made arrangements to track information through state and other third-party databases. Some can verify information with non-tribal employers, such as state unemployment offices, mostly through letters. Income verification is summarized below:
- 75 percent - pay stubs, tax returns, other documentation
- 33 percent - other tribal or state programs by telephone, email or fax
- 8 percent - tribal database
- 8 percent - state or other third-party databases
- 4 percent - contact non-tribal employers
- 4 percent - must show registration with employment agency or school
- Develop a database for each tribes' public assistance programs, or if one exists, make the database available to LIHEAP
- If databases aren't available, develop a list of contacts with tribal and state programs, including state LIHEAP, to verify information
- Expense: Any database development would require additional funding, time and staff.
- Lack of cooperation: Other tribal and state personnel may not agree to data exchanges with LIHEAP.
- Seasonal employment: Income is hard to track.
Methods of processing benefits vary widely based on tribal size and resources. Besides a few unregulated wood vendors, benefits are paid to vendors, not to clients. These wood-vendor benefits are paid only after the tribe receives a signed invoice from the vendor. Nearly half of the tribes report sending payments to vendors only after getting proof that an account has been credited with the benefit amount.
Some tribes send vendors information, including client names and account numbers, as the first step in the benefit-payment procedure.
Some tribes send account information both to clients and vendors. Some vendors receive program information at the beginning of the benefit cycle. A few say the program's relationship with the vendors, particularly regulated vendors, is long-standing and cooperative and the vendor notifies them if there is a questionable transaction, e.g., two payment requests for the same household.
Several tribes said they had identified fraudulent activity wherein a household had received duplicate benefits. This occurred because not all household members are members of the same tribe, and some households have non-tribal members; therefore more than one application may have been submitted from the same household. However, most tribal officials said such duplications usually result from misunderstanding of the program requirements. Some specifically help tribal elders and disabled members with applications in order to prevent such mistakes. However, none of the tribes reported officially tracking the various types of fraud that have occurred.
Materials sent with payments to vendors may include program information, for example, a household is entitled to one payment per season or may include details about tribal business ethics concerning client accounts.
Regarding fraud penalties, most tribes require benefit repayments when inappropriate benefits were issued, and some deny benefits for a specific amount of time if the error was deliberate. Some of the larger tribes pass the information on to tribal law-enforcement officials as soon as a potential problem is detected. Benefit payment policies are summarized below:
- 96 percent - payment sent to vendors
- 4 percent - payments sent to clients following receipt of wood delivery
- 46 percent - payments sent to vendor following proof of charges to account
- 21 percent - account information sent to both client and vendor
- 21 percent - vendors receive information at start of program
- 12 percent -vendors notified with letter containing client ID and account numbers
- 8 percent - vendors are aware of program details and help prevent fraud
- 4 percent - program information and/or tribal business ethics sent to vendor
2. Regulated vendors
Half of the tribes require a contract or agreement with vendors that includes the vendor's W-9 forms. Some say there are so few regulated energy vendors in their areas that all vendors are well known and trusted. A few require tribal business licenses or state business licenses. In some cases, the energy provider is a tribal enterprise. Status of regulated vendors and policies are summarized below:
- 51 percent - require contract or agreement and W-9
- 37 percent - no contract or agreement
- 8 percent - require tribal business license
- 4 percent - require state business license
- 8 percent - energy provider is tribal enterprise
- Require contracts or agreements with vendors that include W-9 or tax number information
- Include language outlining how benefits are paid in the vendor agreement and, if applicable, stating that LIHEAP payments are a one-time benefit
- Include confidentiality requirements in agreements
3. Unregulated vendors
A majority of tribes require a contract or agreement that includes W-9 or tax numbers. Because of the large number of unregulated vendors that do business on reservations -- particularly wood vendors -- some tribes choose which unregulated vendors may do business through LIHEAP. The wood vendor may also be a tribal enterprise. A few report that the program uses no unregulated vendors. Almost half require propane vendors to base their billing on a print-out showing the number of gallons delivered. A few tribes require unregulated vendors to submit complete itemized receipts for payments they have received at the end of the year. Some tribes report that they are developing new policies to deal with unregulated vendors. Both of the smaller territories have only one vendor that were established by the territorial government. Policies for unregulated vendors are summarized below:
- 75 percent - require agreement or contract with W-9s
- 41 percent - require delivery report for propane
- 12 percent - tribe selects unregulated vendors -- mostly wood
- 4 percent - vendor is tribal wood enterprise
- 4 percent - vendor provides itemized invoice to tribe
- 8 percent - require tribal business license
- 4 pecent - require state business license
- 8 percent - developing vendor policy
- 12 percent - no unregulated vendors
- Develop contracts or agreements with unregulated vendors that include requirements for W-9 or tax number information and the tribe's confidentiality requirements
- Expense: New vendor agreements take time and staff to develop.
Unlike states, most tribes do not have subgrantees to oversee, so compliance in this section refers to the LIHEAP program's compliance with federal and/or tribal regulations. Most tribes report some kind of oversight of the program's budget including administrative costs. In some cases, an individual does the oversight; in larger tribes, tribal finance offices provide oversight. Tribal officials who work with programs other than or in addition to LIHEAP view applications or conduct periodic spot reviews in a number of tribes. The program manager either reviews all applications or does spot reviews of applications in others. In some tribes, intake officials review each other's work. Most of these oversight efforts are identified as being new or under development. As might be expected, more workers review applications in larger tribes. Compliance strategies are summarized below:
- 83 percent - program budget, goals monitored
- 58 percent - program budget, goals monitored by other tribal departments
- 74 percent - client application monitored
- 21 percent - program manager reviews applications or conducts spot reviews
- 29 percent - tribal program officials other than LIHEAP check applications or conduct spot reviews
- 8 percent - peer review of applications
- 8 percent - audit by independent contractor
- 58 percent - new compliance measures
- Create step-by-step guidelines or check-off lists for intake personnel operating in small communities where there is little chance for oversight
- Ideally, applications should be reviewed by a supervisor or another staff person; if this is not possible, institute a review process appropriate to the size of tribal staff, e.g., reviewing all applications or doing spot reviews
- Lack of resources: Tribes stressed that new compliance strategies will require additional time and staff. Small tribes may not have adequate personnel to review applications.
A third of the tribes provide training for intake employees when hired. A few tribes with small communities have developed written guidelines to aid intake employees. Some tribes said their staff is too small to make training cost effective. Some are developing new fraud training, largely in response to the required LIHEAP program integrity supplements. Some managers or other tribal personnel attend annual LIHEAP training and pass information on to staff. A few reported monthly, bi-monthly or annual staff reviews of LIHEAP fraud and other policies. A number of the tribes have provisions for senior staff to help with intake if necessary. Some provide program details to vendors, including what constitutes fraud and how to report it, either in annual letters or on invoices. Training policies are summarized below:
- 29 percent - train new intake staff
- 8 percent - written guidelines for staff in small communities
- 12 percent - none, staff too small
- 12 percent - developing new fraud training
- 16 percent - staff attend annual training
- 4 percent - fraud discussed at public meetings
- 16 percent - periodic, monthly, bi-monthly or annual review of policies by staff
- 21 percent - supervisors help with intake if necessary
- Provide vendors with program information, including the one-time nature of payments, if applicable, and explanations of payment matrices
- Create step-by-step guidelines or check-off lists for intake personnel operating in small communities where there is little chance for oversight
- Expense: Developing guidelines and other training materials would require additional time and staff.
3. Fraud prevention and outreach/awareness
Most tribes have a specific policy concerning fraud. However, most tribal officials say that fraud has been identified only on rare occasions, if at all.
Regarding public awareness, some tribes have a website with fraud-reporting contacts and/or a published fraud hotline; a few have a website. Some tribes discuss public assistance fraud at tribal meetings and some post information at public places. Other tribes put information in newsletters and newspapers. A number said they were either beginning or developing new fraud awareness initiatives in FY 2011. Some have printed language concerning fraud on the application, or they began this practice in 2011. In general, the language warns of the potential loss of benefits and/or prosecution that could be incurred if applicants give incorrect information. Fraud policies are summarized below:
- 79 percent - specific policies
- 25 percent - have or will have website with fraud reporting information
- 46 percent - published fraud hotline
- 12 percent - discuss at tribal meetings
- 33 percent - post or will post information in media
- 20 percent - has or will have fraud language on application
- 29 percent - no policy
- 12 percent - no policy, small communities self-report
- Add language to applications that details the consequences of providing false information
- Add language to applications specifying that one household is eligible for only one LIHEAP payment, if applicable
- Develop websites and hotlines for reporting fraud
- Add information about reporting fraud, the possible penalties for fraud, to any information about LIHEAP, including publications, websites, and flyers posted in public places
- Expense: Creating or publicizing fraud-reporting strategies would require time and staff.
- Lack of resources: Smaller tribes may have limited resources for monitoring and prosecution.
Most tribes keep LIHEAP application materials under lock and key. Some of those tribes also reported using passwords to access LIHEAP electronic records. Some tribes have a written confidentiality policy and even more require employees to sign a confidentiality agreement. A smaller number includes information about the confidentiality policy on the application. Confidentiality policies are summarized below:
- 58 percent - information is under lock and key
- 25 percent - information under lock and key and passwords used for computers
- 46 percent - staff signs privacy agreement
- 4 percent - applicants separated as they fill out applications
- Develop a confidentiality agreement for employees
- Include information about confidentiality policy on application materials
- Create policies to place information under lock and key and/or under password protection
- Ensure that vendors are aware of confidentiality polices
- Expense: Developing new confidentiality materials would require time and staff
Click here to read the full LIHEAP Program Integrity Working Group Final Report