OFFICE OF PROGRAM OF INTEGRITY AND COMPLIANCE
POLICY AND PROCEDURE #640
REFUSAL/FALURE TO COOPERATE POLICY
The TANF and CAPS programs require recipient (and CAPS providers) to cooperate with an OPIC
investigation. If a TANF or CAPS recipient fails to provide requested information necessary to determine
eligibility, the Investigator will notify DFCS to close the assistance case. The case will remain closed until
the recipient cooperates or the OPIC investigation is closed, whichever comes first. If a Provider fails or
refuses to cooperate with an OPIC investigation, the Provider is no longer eligible for CAPS vendor
payments, and eligible recipients must be notified to choose a new provider.
Although the application of this policy for TANF/CAPS recipients and CAPS providers are similar, this
section specifically addresses recipients. For Child Care Providers, see Policy #910.
For the purposes of this policy, cooperation with OPIC is defined as a response to correspondence
requesting information or an appointment to discuss an allegation of intentional program violation, in order
to resolve claims in a non-criminal venue. If the case is pursued for criminal prosecution, case closure for
failing to cooperate with the investigation will not be applied.
Basic considerations for the application of this policy regarding a client’s refusal to cooperate with an
investigation include the following standards:
Good service requirements must be met.
Recipients are expected to respond to appointment letters to discuss the allegation(s).
Investigators will make reasonable efforts to reschedule appointments upon request.
However, interviews will not be delayed indefinitely.
The client’s right to a hearing will not be abridged, and the right against self-incrimination
will be respected.
A recipient’s disagreement with the allegations or findings does not constitute a refusal to
cooperate with the investigation.
This policy will be applied prudently and uniformly. No investigation of program fraud is complete until
the recipient has had an opportunity to respond to the allegations. In the absence of a recipient response,
the Investigator will proceed with appropriate claim action.
Before initiating any adverse action to withhold benefits for refusal to cooperate, the OPIC Investigator
must assure receipt of the notification requiring cooperation with an investigation and the consequences of
refusing to cooperate. The Investigator will document the Case Review Checklist accordingly.
Good service can be achieved by first class mail to the address of record. The Investigator must allow 10
days notice for an appointment letter, or provide this notice by phone or face-to-face contact 7 days prior.
The Investigator will document the method of the notification as well.
Policy & Procedure #640 Released 01/09 Page 1 of 2
REFUSAL/FALURE TO COOPERATE (continued)
APPLICATION OF POLICY:
1. When a recipient fails to keep an appointment, a Request for Contact with OPIC will be sent to the
recipient. Good Service requirements must be followed.
2. If there is no response to the second letter and good service requirements have been met, the
Investigator will send DFCS a Disposition Letter requesting closure of the TANF/CAPS assistance
case, and document the request for case closure in SUCCESS.
3. The TANF/CAPS case will remain closed while the Investigator completes the
investigation/disposition of the referral/claim, until the client cooperates or final disposition, whichever
If the client contacts OPIC and indicates a willingness to cooperate, the procedures for Managing
Compliance will be observed.
The Investigator will obtain supervisory approval prior to requesting case closure for failure to cooperate.
The supervisor will assure good service requirements have been met and documented on the Case Review
Checklist. Supervisors will maintain a log of cases closed for refusal to cooperate.
If the client contacts the Investigator within 10 days of a request to close the case, and expresses a
willingness to cooperate, the Investigator will contact DFCS to suspend action and schedule a face-to-face
interview with the client. If the client fails to keep this final appointment, the Investigator will notify
DFCS via a Notice of Non-Compliance. The Investigator will not ask for any further delays in closure of
the TANF/CAPS assistance case until the client actually meets with the Investigator and cooperates to the
minimum degree required.
COMPLIANCE AFTER ASSISTANCE CASE CLOSURE:
Should the client cooperate with the investigation after the TANF/CAPS assistance case has been closed,
the Investigator will send DFCS a Disposition Letter and update documentation in SUCCESS citing
cooperation. This will ensure that future assistance is not denied for failure to cooperate with OPIC.
Policy & Procedure #640 Released 01/09 Page 2 of 2