Cal. Unemp. Ins. Code § 320.4

Current through the 2023 Legislative Session.
Section 320.4 - Reports of overpayments; risk assessment; workload plan
(a) For the purposes of this part, upon appropriation by the Legislature, the department shall do all of the following:
(1)
(A) Report at least once every six months on its internet website all of the following information:
(i) The amount for which it has issued overpayment notices.
(ii) The amount of overpayments waived.
(iii) The amount repaid related to those overpayment notices.
(B) The reports shall encompass benefit payments made by the department from March 1, 2020, until January 12, 2021.
(C) The department shall publish the information required under this paragraph until the repayment period for all the notices has elapsed.
(2)
(A) Immediately perform a risk assessment of its deferred workloads, including deferred eligibility determinations and retroactive certifications.
(B) The department's risk assessment performed under subparagraph (A) shall take into account the relative likelihood that it issued payments to ineligible claimants by considering historic overpayment trends, as well as the new or altered eligibility requirements the federal government adopted in response to the COVID-19 pandemic. If necessary, the department shall either partner with another state agency or contract for assistance in performing the analysis in support of this assessment.
(3)
(A) Develop a workload plan that prioritizes its deferred workloads based on the risk assessment performed pursuant to paragraph (2) and determine the staffing and information technology resources needed to accomplish the work within expected timeframes.
(B) Hire and train staff as necessary in order to carry out the workload plan. Using the workload plan, the department shall process the deferred work in alignment with all of the following:
(i) The need to pay timely benefits to new or continued claimants.
(ii) Federal expectations about the urgency of the deferred work.
(iii) Any deadlines by which the department may no longer be allowed to recoup inappropriately paid benefits.
(4) Immediately begin modeling workload projections that account for possible scenarios that would cause a spike in unemployment insurance claims. The department shall plan its staffing around the likelihood of those scenarios, including having a contingency plan for less likely scenarios that would have a significant impact on its workload.
(5) By March 1, 2022, revise its public dashboards with regard to the number of backlogged claims in order to clearly describe the difference between those waiting for payment and those that are not, and to clearly indicate the number of claims that have waited longer than 21 days for payment because the department has not yet resolved pending work on the claim.
(6) By June 1, 2022, determine how many of its temporary automation measures for claims processing it can retain and by September 1, 2022, make those a permanent feature of its claims processing.
(7) By June 1, 2022, determine the reasons that claimants cannot successfully complete their identity verification through secure identity verification networked, including ID.me, and work with department vendors to resolve identified problems. The department shall thereafter regularly monitor the rate of successful identity verifications to ensure that it consistently minimizes unnecessary staff intervention.
(8) By June 1, 2022, identify the elements of the department's Benefit Systems Modernization process that can assist the department in making timely payments and that it can implement incrementally. The department shall then prioritize implementing the elements most likely to benefit Californians.
(9) Implement a formal policy per the recession plan, by May 1, 2022, that establishes a process for tracking and periodically analyzing the reasons why unemployment insurance claimants call for assistance.
(10)
(A) By May 1, 2022, implement a policy for tracking and monitoring its rate of first-call resolution. The department shall review first-call resolution data at least monthly to evaluate whether it is providing effective assistance to callers.
(B) To maximize the number of calls that department staff are able to answer, as soon as possible, the department shall add prerecorded message functionality to its phone system to advise claimants of their rights and responsibilities after they file their claim with an agent.
(C) To provide a more convenient customer service experience, as soon as possible, the department shall implement features of its phone system that allow callers to request a callback from an agent instead of waiting on hold for assistance.
(11) To prepare to respond to victims of identity theft who receive incorrect tax forms, the department shall, by February 15, 2022, provide information on its internet website and set up a separate email box for those individuals to contact the department and receive prompt resolution.
(12)
(A) To the extent consistent with federal law, the department shall immediately obtain from any federally chartered financial institution or other financial institution used by the department to make benefit payments a comprehensive list of claimants' accounts that are frozen. The department shall immediately thereafter evaluate the list, including considering using ID.me to verify claimants' identities, to identify accounts that should be unfrozen. By March 1, 2022, the department shall direct the institution to take action to freeze or unfreeze accounts as appropriate to ensure that it provides legitimate claimants with benefits but does not pay benefits related to fraudulent claims.
(B) To ensure that the department reviews each account that an institution reports to it as suspicious or potentially fraudulent, by February 2022, the department shall establish a centralized tracking tool that allows it to review and stop payment on claims, as appropriate. The department shall use this tool to monitor its own internal decisions and track whether the claimant responds to its requests for identity information and should, therefore, have their account unfrozen.
(b) Upon appropriation by the Legislature, by March 1, 2022, the department shall designate a unit as responsible for coordinating all fraud prevention and detection. The department shall assign that unit sufficient authority to carry out its responsibilities and align the unit's duties with the Government Operations Agency's framework for fraud prevention.

Ca. Unemp. Ins. Code § 320.4

Added by Stats 2021 ch 510 (AB 56),s 2, eff. 1/1/2022.