N.J. Admin. Code § 10:90-12.5

Current through Register Vol. 56, No. 19, October 7, 2024

Section 10:90-12.5 - Evaluating county/municipal agency performance

(a) To ensure that WFNJ/GA program benefits are being provided to eligible individuals in an accessible and efficient manner, the performance of the county and municipal agency shall be assessed by the DFD through prescribed routine performance evaluation activities or, as warranted, through special performance evaluation activities. Assessable areas to be used by DFD for routine performance evaluation purposes shall correspond to the requirements set forth throughout this chapter in the following areas:

1. Procedures on the administration of the WFNJ/GA program are as follow:

i. Evaluation as to whether WFNJ/GA applications and interviews have been completed;

ii. Evaluation as to whether all necessary case file data has been maintained;

iii. Evaluation as to whether required verifications of eligibility factors have been completed as prescribed;

iv. Evaluation as to whether the case processing and redeterminations of eligibility and ongoing verifications have been completed as prescribed, including, but not limited to:

(1) Monthly reviews, where applicable; and

(2) Redeterminations of eligibility;

v. Evaluation as to whether individual responsibility plans are completed;

vi. Evaluation of the timeliness and adequacy of adverse action notifications;

vii. Evaluation of the timeliness and accuracy of the submittal of county or municipal budget for approval;

viii. Evaluation of the adequacy and correctness of the tracking mechanisms utilized to monitor compliance with the 60 month cumulative lifetime limit of receipt of cash assistance;

ix. Evaluation of the adequacy and correctness of the tracking systems in place to monitor and record required work activity and work requirements history and information;

x. Evaluation of the adequacy of the automated system; and

xi. Evaluation of the accuracy and timeliness of the transmittal of information to the automated client data base;

2. Rules on the administration of the Emergency Assistance component of the WFNJ/GA program are as follows:

i. Accuracy and detail of documentation of the client's emergency;

ii. Establishment and compliance with mutually developed Service Plans which includes:

(1) Provision of transportation;

(2) Assistance with recipient's search for permanent or alternative shelter; and

(3) Referrals to other appropriate services; and

iii. Securing authorization for granting of temporary rental assistance (TRA);

3. Fiscal procedures are as follows:

i. Timely and accurate transmittal of the following WFNJ/GA program documents:

(1) Report of Assistance Expenditures and Case Activity (WFNJ/GA-6), and Statistical Summary (WFNJ/GA-6A), shall be transmitted to DFD;

(2) Quarterly Financial Report (WFNJ/GA-535-Q) and the Annual Financial Report (WFNJ/GA-535-A); and

(3) Repayment of Interim Assistance Authorization Payment Verification (WFNJ/GA-31), shall be transmitted to DFD;

ii. Submittal of Social Security Administration Supplemental Social Security Income Notice of Interim Assistance Reimbursement (SSA-(L) 8125) to the New York Social Security Administration office;

iii. Reimbursement of assistance as follows:

(1) Completion and submittal of Authorization for Reimbursement of Initial Supplemental Security Income (SSI) Payment or Initial SSI Posteligibility Payment (WFNJ/GA-30); and, completion of Agreement to Repay Assistance from Initial SSI Payment (WFNJ/GA-30A);

iv. Accuracy of benefit payments verified through audits and Quality Assurance Reviews;

4. Fraud procedures are as follows:

i. Matched reports shall be completed and transmitted to DFD (see 10:90-14.7);

ii. WFNJ/GA cases identified as having sufficient evidence to support fraudulent activity shall be investigated for fraud, including referral for findings of intentional program violations (see N.J.A.C. 10:90-11); and

iii. Appropriate activity shall be initiated, as a result of local fraud investigative findings; and

5. Other evaluations, such as:

i. Status of county or municipal agency performance as determined by DFD from results of other evaluation findings; and

ii. A special performance evaluation shall constitute the undertaking of a statistically valid eligibility review in a specific county or municipal agency, when the DFD determines that a county or municipality cannot reasonably provide a legitimate reason for the following occurrences:

(1) At the end of each calendar quarter (March 31, June 30, September 30 and December 31), a county's or municipality's expenditures exceed its estimate to an extent proportionally in excess of other counties or municipalities of equal size; or

(2) A pattern of non-payment of WFNJ/GA exists in a specific county or municipality.

(b) County or municipal agency performance, as appropriate, shall be evaluated as follows:

1. When a routine performance evaluation is conducted, overall county or municipal performance shall be measured using no less than an 85 percent tolerance level for each of the evaluation categories identified at (a)1 through 5 above (that is, administration of WFNJ/GA program, emergency assistance, fiscal, fraud, and other evaluations).

i. Satisfactory performance shall mean that a county or municipality has achieved a rating of at least 85 percent in all of the evaluation categories.

(1) A satisfactory performance rating shall not be subject to county or municipal appeal.

ii. Below satisfactory performance shall mean a rating of below 85 percent in one or more of the evaluation categories.

2. When a special performance evaluation is conducted, county or municipal performance shall be measured in accordance with the DFD's established Quality Assurance review procedures. Review results indicating agency error shall be handled as follows:

i. If excessive county or municipal expenditures are identified and the review results in a finding of overpayments or payments made to ineligible individuals, audit exception shall be initiated against the agency based on individual cases found incorrect due to agency error.

ii. If a pattern of non-payment exists and the review results in a finding that a county or municipal agency is not providing eligible clients WFNJ/GA benefits, that county or municipality shall be advised that immediate corrective action measures shall be undertaken as described in (c) below.

(c) Rules governing a below satisfactory performance rating are as follows:

1. When a county/municipality's performance rating is below satisfactory, the Commissioner shall at any time, based on his or her discretion regarding the severity of the below satisfactory rating, exercise the right to assume direct administration of the county administered WFNJ/GA program or transfer the administration of the WFNJ/GA program from the municipality to the county.

i. Since WFNJ/GA shall be administered either by the county or municipal agency, (c)2 below governs "below satisfactory performance" for both county and municipal agencies.

2. Counties or municipalities whose overall performance rating results in a below satisfactory level shall be subject to the following corrective action measures:

i. State and county or municipal staff shall meet to identify possible causes of the deficiencies in operations.

ii. A corrective action plan to improve county or municipal WFNJ/GA operations shall be mutually developed and implemented within a reasonable period of time agreeable to both the DFD and the county or municipality.

iii. Upon implementation of the corrective action plan, county or municipal agency operations shall be monitored by DFD staff to ensure that planned corrective actions are taking place as stipulated in the mutually agreed upon manner.

iv. State staff shall reassess the county or municipality's WFNJ/GA operations at the end of the mutually designated period.

(1) Counties or municipalities whose WFNJ/GA operations have improved to at least a satisfactory level shall be deemed to have satisfied the terms of their corrective action plans.

(2) Counties or municipalities whose WFNJ/GA operations do not improve or which fail to show a good faith effort toward improvement shall be subject to the following:

(A) DFD shall arrange a meeting with the county agency director or the municipal agency director to discuss the unsatisfactory performance.

(B) When it is determined that, after meeting with the agency director, barriers for improvement remain and cannot be resolved, DFD shall advise the county or municipal governing authority, in writing, of its finding concerning the unsatisfactory performance of the county or municipality, as appropriate.

(C) If, after all contact with the county or municipal governing authority, the DFD determines that the situation cannot be resolved internally, DFD shall proceed to advise the county or municipal governing authority, in writing, of the unsatisfactory status of the county or municipal operation, and the necessity for the county or municipal agency to take immediate corrective action measures, subject to the consent and approval of the Commissioner to resolve the unsatisfactory situation.

(D) When it is determined that, in the case of a county administering the WFNJ/GA program, despite DFD's intervention efforts, barriers for improvement remain and cannot be resolved, the State shall notify the county, in writing, of its intent to assume direct administration of the WFNJ/GA program in accordance with provisions at 10:84-1.4.

(E) When it is determined that, in the case of a municipality administering the WFNJ/GA program, despite DFD's intervention efforts, barriers for improvement remain and cannot be resolved, the State shall advise, in writing, of its intent to require the municipality to transfer administration of the WFNJ/GA program to the county agency. Final notification from the Commissioner shall be made, in writing, within 30 days of the mailing date of DFD's initial communication to the municipal governing authority. The notice shall include the basis for the State action to transfer the program and the date the State's action to transfer is expected to commence.

N.J. Admin. Code § 10:90-12.5

Amended by R.1998 d.42, effective 1/20/1998.
See: 29 N.J.R. 3971(b), 30 N.J.R. 389(a).
Amended by R.2003 d.226, effective 6/16/2003.
See: 34 N.J.R. 2713(a), 35 N.J.R. 2670(a).
In (a), deleted former iii(1) and recodified former iii(2) as iii(1) in 3 and deleted former i and recodified former ii through iv as i through iii in 4.
Amended by R.2004 d.292, effective 8/2/2004.
See: 36 New Jersey Register 1695(a), 36 New Jersey Register 3545(a).
In (a)4i, amended the N.J.A.C. referenc