Home > KEESM 10-01-24 > 11000 Incorrect Benefits And Fraud Determinations > 11200 Determination Of Fraud > 11250 Making the Referral - Administrative Disqualification Hearing
11250 Making the Referral - Administrative Disqualification Hearing - When the decision has been made to request an Administrative Disqualification Hearing, a referral shall be sent to the Administrative Disqualification Hearing Officer (ADHO). The form, Referral for an Administrative Disqualification Hearing, ES-3112, shall be used for this purpose.
11250.1 Referral Form - The following information shall be provided on the ES-3112:
If the documentary evidence is available at the time the referral is made to the ADHO, it should be numbered (e.g., "Agency Exhibit #1") and submitted. If the agency's evidence is not ready at the time the referral is made, it should be submitted to the ADHO when ready.
11250.2 Time Limits
11250.3 Waived Hearings - Any individual who has been referred to the ADHO shall have the option of waiving his/her rights to an administrative disqualification hearing. In addition to sending the advance notification of a disqualification hearing as provided in 11250.7, the household member suspected of fraud shall also be informed of the fact that he/she may waive his/her right to an administrative disqualification hearing. The written notification provided to the household member which informs him/her of the possibility of waiving the administrative disqualification hearing shall be the Waiver of Right to an Administrative Disqualification Hearing form. This form will be mailed to the household by the Administrative Disqualification Hearing Officer. If the individual returns this form to the local DCF office, it shall immediately be forwarded to the Administrative Disqualification Hearing Officer. Persons who sign the waiver are to be disqualified for the appropriate time period and the claim on the system is to be changed from "client" error to "fraud".
11250.4 Publication of Rules of Procedure - The procedure for a disqualification hearing has been published as a brochure titled "Administrative Food Assistance Disqualification Hearing" and shall be made available to any interested party.
11250.5 Notification to Applicant Households - Applicants shall be informed in writing of the disqualification penalties for committing or attempting to commit fraud each time they apply for program benefits. The penalties are written in clear, prominent, and boldface lettering on the application form.
11250.6 Consolidation of Administrative Disqualification Hearing with Fair Hearing - A fair hearing and an administrative disqualification hearing may be combined into a single hearing if the factual issues arise out of the same, or related, circumstances and the household receives prior notice that the hearings will be combined. If the disqualification hearing and fair hearing are combined, the time frames for conducting disqualification hearings shall be followed. And, if the hearings are being combined for the purpose of settling the amount of the claim at the same time as determining whether or not fraud or attempted fraud has occurred, the household shall lose its right to a subsequent fair hearing on the amount of the claim. However, upon request from the household, the 30-day advance notice period required by 11250.7 shall be waived when the disqualification hearing and the fair hearing are combined. At the discretion of the Secretary of the Department of Administration, the same hearing official can be appointed to conduct both types of hearings.
11250.7 Advance Notice of Administrative Disqualification Hearing - The Administrative Disqualification Hearing Officer, or his/her designee, shall provide written notice to the household member suspected of fraud or attempted fraud at least 30 days in advance of the date a disqualification hearing is scheduled. The notice shall be mailed and shall contain at a minimum:
If the individual cannot be located and/or notified of the disqualification hearing, the hearing will be dismissed without prejudice by the ADHO. If the individual alleged to have committed fraud is subsequently found (either by reapplying for assistance or other means), the agency may re-refer the individual for an administrative disqualification hearing.
11250.8 Scheduling of Hearing - The time and place of the hearing shall be arranged so that the hearing is accessible to the household member suspected of fraud or attempted fraud. If the household member or its representative fails to appear without good cause at a hearing initiated by the local agency, the hearing shall be conducted without the household member being represented. The household member will have 10 days from the date of the scheduled hearing to present reasons indicating a good cause for failure to appear. Even though the household member is not represented, the ADHO is required to carefully consider the evidence and determine if fraud or attempted fraud was committed based on clear and convincing evidence. If the household member is found to have committed fraud or attempted fraud but the ADHO later determines that the household member or representative had good cause for not appearing, the previous decision shall no longer remain valid and the ADHO shall conduct a new hearing. The ADHO who originally ruled on the case may conduct the new hearing. The ADHO must enter the good cause decision into the record.
11250.9 Participation While Awaiting Hearing - A pending disqualification hearing shall not affect the individual's or the household's right to be certified and participate in the Program. Since a household member cannot be disqualified for fraud or attempted fraud until the ADHO finds that the individual has committed fraud or attempted to commit fraud, the eligibility and benefit level of the household shall be determined in the same manner it would be determined for any other household. For example, if the misstatement or action for which the household member is suspected of fraud does not affect the household's current circumstances, the household would continue to receive its allotment based on the latest certification action or be reviewed based on a new application and its current circumstances. However, the household's benefits shall be terminated if the review period has expired and the household, after receiving its notice of expiration, fails to reapply. The household's benefits shall be reduced or terminated if documentation exists which substantiates that the household is ineligible or eligible for fewer benefits (even if these facts led to the suspicion of alleged fraud and the resulting disqualification hearing) and the household fails to request a fair hearing and continuation of benefits pending the hearing. For example, the local office may have facts which substantiate that a household failed to report a change in its circumstances even though the local office has not yet demonstrated that the failure to report involved an intentional act of fraud.
11250.10 Criteria for Determining Fraud or Attempted Fraud - The ADHO shall base the determination of fraud on clear and convincing evidence which demonstrates that the household member(s) committed, and intended to commit, fraud as defined in 11200.
11250.11 Decision Format - The Administration Disqualification Hearing Officer's decision shall specify the reasons for the decision, identify the supporting evidence, identify the pertinent Kansas Economic and Employment Support Manual and FNS regulations, and respond to reasoned arguments made by the household member or representative.
11250.12 Notification of Hearing Decision