Item - 2008.AU8.10
Tracking Status
- City Council adopted this item on September 24, 2008 without amendments and without debate.
- This item was considered by the Audit Committee on July 10, 2008 and adopted without amendment. It will be considered by City Council on September 24, 2008.
AU8.10 - Managing the Risk of Overpayments in the Administration of Social Assistance, Toronto Social Services
- Decision Type:
- ACTION
- Status:
- Adopted on Consent
- Wards:
- All
City Council Decision
City Council on September 24 and 25, 2008, adopted the following motions:
1. The General Manager, Toronto Social Services, in the event that the Province does not amend its policy in relation to the recovery of certain benefit overpayments, be required to report to City Council on the following:
a. the amount of such non-recoverable overpayments; and
b. the administrative costs involved in determining the overpayment amounts.
2. The General Manager, Toronto Social Services, subsequent to any policy change by the Province, request the Province to amend the provincial information system such that it calculates overpayments consistent with provincial direction. The information system should exclude non-recoverable benefits from overpayments created by the system.
3. The General Manager, Toronto Social Services, give consideration to amending the extent of current participation reviews to include a component which addresses the financial status of all clients. Comprehensive participation reviews, which include a financial component review currently conducted by certain area offices, be expanded as a best practice to all area offices.
4. The General Manager, Toronto Social Services, as part of the joint venture agreement with the Province on the development of an on-line client application process, advise the Province of the need to expand this joint venture to include the on-line reporting of client financial information changes.
5. The General Manager, Toronto Social Services, revise the current reporting processes, in order to ensure that reports meet the requirements of the users. All such reports be developed in a manner which facilitates efficient and effective supervisory review. Evidence of such review be documented.
6. The General Manager, Toronto Social Services, continue ongoing deliberations with the Province in connection with the limitations of the provincial information system. These deliberations should reinforce the need for an efficient system that will reduce both the incidence of overpayments due to system error and the associated resources required to correct these errors.
7. The General Manager, Toronto Social Services, establish a case file standard in order to assist staff in preparing and retaining adequate documentation to support decisions concerning overpayments. The following minimum documentation requirements should be included in all files:
- the reason for the overpayment;
- the date the overpayment occurred;
- documents that were verified or retained in the file;
- any adjustments made and the amount; and
- details of the amount of recovery initiated or an explanation as to why the recovery of an overpayment was deferred.
8. The General Manager, Toronto Social Services assess the risk and extent of resources required to determine whether or not there is value in maintaining the current requirement to review all overpayments originating from other municipalities.
Background Information (Committee)
https://www.toronto.ca/legdocs/mmis/2008/au/bgrd/backgroundfile-14409.pdf
Appendix 1 - Managing the Risk of Overpayments in the Administration of Social Assistance, Toronto Social Services
https://www.toronto.ca/legdocs/mmis/2008/au/bgrd/backgroundfile-14410.pdf
Appendix 2 - Management's Response to the Auditor General's Review
https://www.toronto.ca/legdocs/mmis/2008/au/bgrd/backgroundfile-14411.pdf
AU8.10 - Managing the Risk of Overpayments in the Administration of Social Assistance, Toronto Social Services
- Decision Type:
- ACTION
- Status:
- Adopted
- Wards:
- All
Committee Recommendations
The Audit Committee recommends that:
1. The General Manager, Toronto Social Services, in the event that the Province does not amend its policy in relation to the recovery of certain benefit overpayments, be required to report to City Council on the following:
a. the amount of such non-recoverable overpayments; and
b. the administrative costs involved in determining the overpayment amounts.
2. The General Manager, Toronto Social Services, subsequent to any policy change by the Province, request the Province to amend the provincial information system such that it calculates overpayments consistent with provincial direction. The information system should exclude non-recoverable benefits from overpayments created by the system.
3. The General Manager, Toronto Social Services, give consideration to amending the extent of current participation reviews to include a component which addresses the financial status of all clients. Comprehensive participation reviews, which include a financial component review currently conducted by certain area offices, be expanded as a best practice to all area offices.
4. The General Manager, Toronto Social Services, as part of the joint venture agreement with the Province on the development of an on-line client application process, advise the Province of the need to expand this joint venture to include the on-line reporting of client financial information changes.
5. The General Manager, Toronto Social Services, revise the current reporting processes in order to ensure that reports meet the requirements of the users. All such reports be developed in a manner which facilitates efficient and effective supervisory review. Evidence of such review be documented.
6. The General Manager, Toronto Social Services, continue ongoing deliberations with the Province in connection with the limitations of the provincial information system. These deliberations should reinforce the need for an efficient system that will reduce both the incidence of overpayments due to system error and the associated resources required to correct these errors.
7. The General Manager, Toronto Social Services, establish a case file standard in order to assist staff in preparing and retaining adequate documentation to support decisions concerning overpayments. The following minimum documentation requirements should be included in all files:
- the reason for the overpayment;
- the date the overpayment occurred;
- documents that were verified or retained in the file;
- any adjustments made and the amount; and
- details of the amount of recovery initiated or an explanation as to why the recovery of an overpayment was deferred.
8. The General Manager, Toronto Social Services assess the risk and extent of resources required to determine whether or not there is value in maintaining the current requirement to review all overpayments originating from other municipalities.
Origin
Summary
In 2005, the City of Toronto Auditor General issued a report titled, “Recovery of Social Assistance Overpayments, Toronto Social Services”. The review focused on the administration, monitoring and recovery of inactive social assistance overpayments (cases not currently receiving any assistance) and contained 14 recommendations. As of May 2008, 10 of the 14 recommendations have been implemented and there are divisional plans to implement the other four in 2008. This current report relating to active social assistance overpayments was deferred to provide the Division adequate time to address the 2005 recommendations.
The integrity of the City’s social assistance program is contingent on ensuring that benefits are accurately paid and when overpayments occur they are effectively and efficiently administered.
The primary objective of this review was to determine why social assistance overpayments occur and to identify opportunities to prevent such overpayments. Further, we assessed whether the Division has adequate controls in place to ensure the effective and efficient administration of overpayments including compliance with legislative requirements and internal procedures and practices.
Our review found that Toronto Social Services has adequate processes in place to effectively administer overpayments. However, the implementation of the recommendations in this report will further improve existing controls and contribute to achieving administrative efficiencies.
Financial Impact
The implementation of recommendations in this report will improve the administration of overpayments related to providing social assistance. The extent of any resources required or efficiencies achieved from implementing the recommendations in this report is not determinable at the present time.
Background Information
https://www.toronto.ca/legdocs/mmis/2008/au/bgrd/backgroundfile-14409.pdf
Appendix 1 - Managing the Risk of Overpayments in the Administration of Social Assistance, Toronto Social Services
https://www.toronto.ca/legdocs/mmis/2008/au/bgrd/backgroundfile-14410.pdf
Appendix 2 - Management's Response to the Auditor General's Review
https://www.toronto.ca/legdocs/mmis/2008/au/bgrd/backgroundfile-14411.pdf