Department of Health and Human Servces

OFFICE OF

INSPECTOR GENERAL

AFDC PAYMENTS AFTER DEATH

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JU GmBS BROWN

Inspector General

NOVEER 1994

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. 

OFFICE OF EVALUATION AN 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, in 1988 the General Accounting Office (GAD) 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


EXECU SUMY PAGE 

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 

cases identified in the State). We selected the three States based on the average 

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.