Benefit Eligibility Assessment Process

Issued Date
May 28, 2014
Agency/Authority
New York City Human Resources Administration
Temporary and Disability Assistance, Office of

Purpose

To determine whether the New York City Human Resources Administration's (HRA) public assistance benefit eligibility assessment process is in compliance with applicable policies and procedures, and whether the Office of Temporary and Disability Assistance's (OTDA) Fair Hearing process is used only as necessary.

Background

OTDA oversees the State's public assistance programs (i.e., temporary cash assistance, health insurance and emergency food programs) administered by counties and local governments. HRA is responsible for administering these public programs in New York City. As such, its responsibilities include assessing new applicant and existing recipient (Client) eligibility, and when a Client is determined to be ineligible, denying, reducing or terminating the Client's benefits. As a last resort, Clients deemed to be ineligible are entitled to a Fair Hearing administered by OTDA. OTDA's Fair Hearing Process costs taxpayers more than $32 million annually to administer.

Key Findings

We found that HRA employees apply a comprehensive assessment process when determining a Client's eligibility, and that process is in compliance with governing regulations and procedures. However, procedural revisions are necessary to reduce the number of hearings held, and to reduce the number of HRA determinations that are reversed at hearings.

  • Fair Hearings have become routine with the number of hearings and associated costs growing each year even though many of the associated issues to be addressed at the hearings had either been resolved prior to the hearings or HRA had withdrawn its initial determination;
  • HRA eligibility determinations are often reversed at Fair Hearings due to insufficient case preparation or inaccurately prepared supporting documents; and
  • The current OTDA administrative codes assigned to closed cases do not adequately describe how or why the cases were resolved. In fact, the codes are often misleading.

Key Recommendations

To OTDA:

  • Work with HRA to reduce the number of Fair Hearings within the confines of the governing regulations.
  • Develop accurate outcome codes for all resolved cases.

To HRA:

  • Take action to reduce the HRA Fair Hearing case preparation deficiencies noted in this report.

Other Related Audit/Report of Interest

Office of Temporary and Disability Assistance: Fair Hearings Process (1997-S-42)

Frank Patone​​​​​​​

State Government Accountability Contact Information:
Audit Director: Frank Patone
Phone: (212) 417-5200; Email: [email protected]
Address: Office of the State Comptroller; Division of State Government Accountability; 110 State Street, 11th Floor; Albany, NY 12236