Department of Health and Human Servces
OFFICE OF
INSPECTOR GENERAL
AFDC PAYMENTS AFTER DEATH
.. SERVIQ'
+t-\ JU 
GmBS BROWN
Inspector General
NOVEER 
1994
cii/a OEI-0491- OFFICE OF INSPECfOR GENERA

The mission of the Offce of Inspector General (DIG), as mandated by Public Law 95-452, as 
amended, is to protect the integrity of the Department of Health and Human Servces' (HHS)
programs as well as the health and welfare of beneficiaries served by those programs. This 
statutory mission is carried out through a nationwide network of audits, investigations, and 
inspections conducted by three DIG operating components: the Offce of Audit Servces, the 
Offce of Investigations, and the Office of Evaluation and Inspections. The DIG also informs 
the Secretary of HHS of program and management problems and recommends courses to 
correct them. 
OFFICE OF AUDIT SERVICE 
The DIG's Offce of Audit Servces (OAS) provides all auditing servces for HHS, either by 
conducting audits with its own audit resources or by overseeing audit work done by others. 
Audits examine the performance of HHS programs and/or its grantees and contractors in 
carryng out their respective responsibilties and are intended to provide independent 
assessments of HHS programs and operations in order to reduce waste, abuse, and 
mismanagement and to promote economy and efficiency throughout the Department. 
OFFICE OF INTIGATIONS 
The DIG's Offce of Investigations (01) conducts criminal, civil, and administrative 
investigations of allegations of wrongdoing in HHS programs or to HHS beneficiaries and of 
unjust enrichment by providers. The investigative efforts of 01 lead 
to criminal convictions 
administrative sanctions, or civil money penalties. The 01 also oversees State Medicaid fraud 
control units which investigate and prosecute fraud and patient abuse in the Medicaid program. 
AN 
OFFICE OF EVALUATION  INSPECTONS 
The DIG's Office of Evaluation and Inspections (DEI) conducts short-term management and 
program evaluations (called inspections) that focus on issues of concern to the Department 
the Congress, and the public. The findings and recommendations contained in these inspection 
reports generate rapid, accurate, and up-to-date information on the effciency, vulnerability, 
and effectiveness of departmental programs. 
DEI's Atlanta Regional Offce prepared this report under the direction of Jesse J. Flowers 
Regional Inspector General and Christopher Koehler, Deputy Regional Inspector General. 
Principal DEI staff included: 
ATLA 
REGION  HEQUARTES 
Joe Townsel Project Leader  Wm. Mark Krushat, Sc. 
Betty Apt  Team Leader  Linda Moscoe 
Jacqueline Andrews  Ann O'Connor  EXECUTIVE  SUMMAR 
PUROSE 
To determine if AFDC assistance is improperly paid on behalf of deceased persons. 
BACKGROUN 
Responding to Congressional concern (GAD)
, in 1988 the General Accounting Office 
reviewed the possibilty that public assistance benefits might be improperly continued 
after a recipient's death. The GAO concluded that Aid to Families with Dependent 
Children (AFDC) and other public assistance may have continued for up to 2 years or 
more after the death of some recipients. 
METHODOLOGY 
To determine if States were stil issuing AFDC benefits after death, we analyzed a 
probe sample of 54 cases with dates of death in 1992. We identified the 54 
cases by 
matching Social Security numbers for State public assistance cases with numbers that 
Social Security Administration files showed to have been assigned 
to deceased persons. 
We then matched the date of death for sample 
cases with the date that States 
terminated public assistance. 
FIING 
NO AFC ASISTANCE WAS PAI ON BEHA OF DECEED PERSONS IN 
OUR PROBE SAMLE 
None of the deceased persons in our probe sample were receiving AFDC at the time
of their death. Therefore, no improper AFDC payments were made. 
CONCLUSION 
Based on our limited analysis of a probe sample, we could not conclusively show 
whether or not public assistance payments were being made on behalf of deceased 
AFDC recipients. However, we believe the universe of AFDC recipient deaths is too 
small to warrant further review. We therefore closed our inspection.  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
TABLE OF CONTENTS

PAGE 
EXECU SUMY 
INODUCI0N................................................. 
FIING 
. No AFDC Payments Made to Deceased Persons in Our Probe Sample. . . . . . . 3

CONCLUSION  . . . . . . . . . . . . . . . . 4
 INTRODUCTION

PUROSE 
To determine if AFDC assistance is improperly paid on behalf of deceased persons. 
BACKGROUN 
During the 1980s, Congress became concerned that federally-funded public assistance 
benefits may be improperly continued after a recipient s death. In 1988, Congress 
asked the General Accounting Office (GAO) to determine if federally-funded benefits 
were paid on behalf of deceased recipients. GAO concluded that Aid to Familes with 
Dependent Children (AFDC), Food Stamps, and General Assistance may have 
continued for up to 2 years or more after the death of some 
recipients. That finding 
was based on a review of 229 cases in Maryland, Pennsylvania, and the District of 
Columbia. Although GAO was unable to get complete information on the majority of 
sampled cases, the agency estimated that about $72 000 in public assistance benefits 
were paid after recorded dates of death of sampled recipients. 
Of the three public assistance programs GAO reviewed, AFDC is the only one 
financed and managed by the Department of Health and Human Servces (HHS). 
Medicaid was not included in the GAO review, but it is also a federally-funded 
assistance program. Both AFDC and Medicaid are funded jointly by HHS and States. 
AFDC agencies are responsible for terminating benefits to any recipient who dies. 
Local caseworkers normally become aware of a death through sources such as funeral 
directors and survving family members. If, however, a death of a recipient does not 
become known to local AFDC agencies, improper AFDC benefits would likely 
continue. 
States currently match public assistance records with some Social Security 
Administration (SSA) fies, such as the Number Identification fie. However, a match 
is not made with SSA death records because of an SSA agreement with many States 
prohibiting redisclosure of death information those States provide SSA. States are 
required to verify applicants' Social Security numbers (SSNs) with SSA before issuing 
initial public assistance payments. After eligibilty is established, States submit SSNs to 
SSA every 6 months to verify Social Security 
benefits received by a public assistance 
recipient. 
METHODOLOGY 
To identify the number of deceased people to whom States potentially were stil 
issuing AFDC benefits, we first identified all States sending verification queries to 
SSA. Then, we randomly selected 12 States from that group of States. The 12 States 
submitted 1.5 milion recipient queries to SSA in November 1992. Of the 1.5 milion  queries, SSA identified 25 686 SSNs which had been assigned to persons shown 
SSA' s files to be deceased. SSA provided us the dates of death for those persons. 
We calculated the number of months between November 
1992 and the reported dates 
of death for the 25 686 cases, and decided to initially focus on cases in which death 
occurred in August 1992. We selected this 3-month timeframe (August to November) 
assuming that within 3 months, State AFDC agencies should have taken administrative 
action to discontinue public assistance to the deceased individual. The subgroup of 
August death cases, from the 12 sample States, consisted of 5 620 cases. 
To determine if AFDC payments were in fact being issued on behalf of deceased 
recipients, we conducted a probe sample of the 5 620 death cases. For the probe, we 
randomly selected 55 cases in 3 of the 12 sample States. The three States we selected 
were New Jersey (20 cases), California (20 cases), and Florida (15 cases--all the death 
We selected the three States based on the average 
cases identified in the State). 
volume of SSN queries they submitted during a 6-month period, from September 1991 
through February 1992. Specifically, we selected New Jersey and Florida because they 
submitted the most queries, and California because it ranked near the middle of the 
12 States. Those 3 States had a total of 2 381 death cases in August 1992. 
We asked AFDC agencies in the three selected States to review their files and tell us 
what kid of assistance the deceased individuals had received and when that assistance 
was terminated. We reduced our probe sample from 55 to 54 cases because the New 
Jersey agency had no record of 1 case. We then matched the date of death with the 
date public assistance was terminated to ascertain if any improper payments were 
made. 
We used the results of the probe sample to determine if a complete study was 
warranted. If our probe sample had shown improper AFDC payments were issued on 
behalf of deceased persons, we would have continued our analysis to determine the 
amount of benefits being paid improperly nationwide. 
In addition to discussions with officials in New Jersey, California, and Florida, we 
intervewed officials in three other States and four local AFDC agencies about the 
potential for AFDC payments continuing after death, and how those deaths usually 
become known to AFDC agencies. 
This inspection was conducted in accordance with the  Quality Standard for Inspections
issued by the President s Council on Integrity and Effciency.  FINDING

NO AFC ASISTANCE WAS PAI ON BEHA OF AN DECEED 
PERSONS IN OUR PROBE SAMLE 
None of the 54 deceased persons in our probe sample were receiving AFDC at the 
time of their deaths. Although the computer match of State and SSA records included 
both young and old people who received public assistance, the vast majority of 
recipients in our sample of deceased recipients turned out to be of advanced age--not 
children or young parents who tyically would receive AFDC. To ilustrate, the 
average age of our sample members was 
76. Only four people were under age 50 
and their ages ranged from 32 to 41. 
State and local officials we intervewed said the incidence of mortality among AFDC 
recipients is quite low. They said that when such deaths do occur, AFDC staff usually 
learn of the deaths timely. Therefore, payments rarely continue after the death. 
ilustrate, survvors and funeral directors have an incentive to report deaths because 
some States pay burial benefits. Also, when an AFDC payee dies, survvors frequently 
report the death in order to have a new AFDC payee selected. The survvors 
assuming responsibilty for deceased recipients' children need the AFDC check issued 
in their names. Since banks and stores usually will not cash checks without 
identification, it is difcult for someone other than a payee to cash AFDC checks. 
Also, post offices sometimes return checks addressed to a deceased person. At least 
one State identifies deaths of AFDC recipients through periodic computer matches 
with its bureau of vital statistics. 
It is true that State agencies did not close all 54 cases during the month of death. Ten 
were closed one or more months after death, one 12 months after death. Therefore 
it is possible that States could have continued some public assistance other than 
AFDC on behalf of some deceased persons. For example, prior to their deaths, all 54 
deceased persons had received SSI-related Medicaid. Five of the 54 had also received 
food stamps. However, it is unlikely that States actually continued such benefits after 
the death of any of our probe sampled recipients. 
First, the States closed all five food stamp cases during the month of death. Second 
Medicaid funds are spent only when claims for medical servces are fied. Therefore 
an agency s failure to close a Medicaid case during the month of death does not 
necessarily result in an overpayment.  CONCLUSION

Based on our limited analysis of a probe sample, we could not conclusively show 
whether or not public assistance payments were being made on behalf of deceased 
AFDC recipients. However, not even one family in our probe sample was found to 
have received such payments. Furthermore, the universe of AFDC deaths is so small 
that widespread payments after death are unlikely. We believe that if payments occur 
after death, the frequency is not significant enough to continue with a full inspection 
which would require research on a significantly larger number of cases. Such research 
is particularly labor intensive and costly since the computer match with SSA does not 
distinguish between AFDC and other tyes of public assistance cases. We are 
therefore, closing our inspection without further review.