DPSS ePolicy

To convert existing policy to new writing style only – No concept changes.

Participation Problems

Participant is still attending assigned GAIN activity

When a participant has problems participating in GAIN, child care services are allowed through the compliance process, if the participant contiunes to attend the GAIN activity.  This is to enable the participant to attend the required compliance appointments and to continue participation in the GAIN activity.

Participant is not attending assigned GAIN activity

When the GAIN Services Worker (GSW) receives documentation or written/verbal notification that the participant is no longer attending their assigned GAIN activity, the GSW must close the activity and notify the Resource and Referral/Alternative Payment Program (R&R/APP) agency.

However, if the GSW is notified from a source other than the service provider or the participant, the GSW is responsible for validating the information by contacting the participant or the service provider.

If the participant is not particpating in a Welfare-to-Work/GAIN activity or employment,  (s)he is not eligible for child care services.

When there is suspicion that a participant intentionally provided false or misleading statements/information to obtain Stage 1 Child Care (S1CC) services, a referral shall be made to the DPSS Welfare Fraud Prevention and Investigations (WFP&I) Section.

Child Care Fraud

Child care fraud may include, but is not limited to, a CalWORKs participant receiving child care services to which (s)he knows that (s)he is not eligible or is no longer eligible to receive, and/or a child care provider who knowingly obtains or receives child care reimbursement for services that the provider did not render.

When the participant’s eligibility for child care benefits is questionable, GAIN staff, GAIN Contracted Case Managers (CCM), including Refugee Employment Program (REP), Cal-Learn, and R&R/APP Case Managers, and/or Eligibility Workers must submit a referral for investigation of suspected fraud for the S1CC Program.

There are two defined categories of Fraud Investigation conducted by Welfare Fraud Investigators (WFI):

1.  Early Fraud
2.  Historical Fraud
   
   

If the child care case is pending or recently approved and information is questionable, an Early Intervention referral can be initiated. GAIN, CCMs, and R&R/APP Case Managers initiate a referral in the California Statewide Automated Welfare System (CalSAWS) or complete an ST1-17, “Request for Investigation-Suspected CalWORKs Stage 1 Child Care Fraud”, and request it to be assigned as Early Intervention Child Care (EICC). However, that assignment is at the discretion of WFP&I. In instances where an emergency field call must be completed, the WFP&I Child Care Manager can be contacted prior to completion of the referral to discuss the feasibility of an emergency field call (emergency field calls are rare/seldom).

If fraud is suspected on a child care case that has ongoing authorizations, it is known as Historical Fraud. The process for Early Fraud does not replace existing procedures for initiating a fraud referral.

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Please refer to the Definition Template for a list of child care definitions.

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