N.J. Admin. Code § 10:69-9.17

Current through Register Vol. 56, No. 21, November 4, 2024

Section 10:69-9.17 - County welfare agency responsibility; administrative plan

(a) The role of the CWA is limited to responsibility for determining whether there is a basis in fact for believing that fraud may have been committed so that referral to the county prosecutor, other proper law enforcement official, or Division of Medical Assistance and Health Services for legal action is justified. The action taken by the law enforcement official following referral determines what further legal action shall be pursued. Whether fraud has actually occurred is a question for the courts.

1. The CWA director may utilize the power of subpoena given him or her by N.J.S.A. 44:7-20 to secure testimony and records pertinent to the investigation and needed to determine true facts.

(b) Each CWA shall develop an operational method to carry out its responsibility that is best suited to its administrative structure and to local conditions and resources. There must be clear allocation of duties and functions in the total process of including investigation, reporting, evaluation, and the decision to refer. In respect to the function of investigation, the CWA may select one or a combination of the following plans:

1. Cooperative arrangements with other county agencies:

i. The CWA may arrange for special investigation of cases of suspected fraud by another appropriate agency or official such as office of the county adjuster, the probation department, or the office of the county prosecutor, without cost to the CWA.

2. The CWA may appoint a "special investigator(s)" whose duty shall be to give special attention to case situations involving suspicion of fraud (and other related situations requiring special investigating skills), to prepare the necessary reports, and to function in a liaison capacity for the director and CWA to the law enforcement authorities. Such special investigator(s) shall have no law enforcement authority, and shall not engage in activity which is properly the responsibility of the eligibility worker.

3. The CWA may elect to have staff carry the responsibility for the necessary special investigation in instances of suspected fraud, relying upon consultation with CWA counsel for the technical aspects of establishing adequate evidence on which to base a decision.

4. Whatever administrative plan is adopted, there will be instances where discussion should be arranged with CWA counsel and/or the county prosecutor's office as to the nature and conduct of the investigation.

(c) The CWA shall file with the Division of Medical Assistance and Health Services a detailed description of the administrative plan, and shall advise the division of any subsequent proposed change in the plan before it becomes effective.

N.J. Admin. Code § 10:69-9.17

Amended by 49 N.J.R. 3729(a), effective 12/4/2017