BP BHEAD INT S [atlas:bill]

AN ACT Relating to public assistance fraud; amending RCW 43.20A.020 and 41.06.076; adding new sections to chapter 43.20A RCW; creating a new section; providing an effective date; and declaring an emergency.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION. Sec. 1. The legislature finds that it is imperative that the limited resources dedicated to assist those in need be protected from fraud and abuse. While the legislature recognizes that it is a small percentage of the population that seeks to defraud the public assistance system, those who do defraud the public assistance system take millions of dollars from the needy.

The legislature also finds that one of the most effective ways to protect against these criminal acts is to have specific personnel whose focus is to discover and refer for prosecution individuals who receive assistance improperly. Currently, there is instability as to which state agencies are responsible for investigating the various types of fraud and abuse.

Therefore, the legislature intends to establish specific entities within the Washington state patrol and the department of social and health services whose purpose is to protect the state's limited resources by focusing on public assistance fraud.

Sec. 2. RCW 43.20A.020 and 1987 c 283 s 1 are each amended to read as follows:

((~~As used in this chapter, unless the context indicates~~)) The definitions in this section apply throughout this chapter unless the context clearly requires otherwise:

(1) "Chief investigator" means the chief investigator of the department.

(2) "Department" means the department of social and health services.

((~~(2) "Secretary" means the secretary of the department of social and health services.~~

~~(3) "Deputy secretary" means the deputy secretary of the department of social and health services.~~

(4) "Overpayment" means any department payment or department benefit to a recipient or to a vendor in excess of that to which the recipient or vendor is entitled by law, rule, or contract, including amounts in dispute pending resolution.

~~(5)~~)) (3) "Deputy secretary" means the deputy secretary of the department.

(4) "Disclosable information" means public information that:

(a) Is not exempt from disclosure under chapter 42.17 RCW;

(b) Does not pertain to an ongoing investigation; and

(5) "Fraud or abuse" means acts and practices of fraud or abuse in programs administered by the department, including criminal or administrative misconduct by clients or vendors. This does not include provider fraud as it relates to the department's administration of funds under Title XIX of the federal social security act, medicaid.

(6) "Office" means the office of the chief investigator of the department.

(7) "Overpayment" means any department payment or department benefit to a recipient or to a vendor in excess of that to which the recipient or vendor is entitled by law, rule, or contract, including amounts in dispute pending resolution.

(8) "Secretary" means the secretary of the department.

(9) "Vendor" means an entity that provides goods or services to or for clientele of the department and that controls operational decisions.

NEW SECTION. Sec. 3. (1) There is established in the department an office of chief investigator in order to create an independent unit to:

(a) Conduct and supervise investigations relating to allegations of fraud or abuse;

(b) Provide leadership and coordination in recommending policies and procedures designed to detect and prevent fraud and abuse; and

(c) Provide a method of informing the secretary and the legislature about vulnerabilities and deficiencies relating to the detection and prevention of fraud or abuse as may be discovered as a result of completed investigations conducted or coordinated by the office.

(2) The office of chief investigator is designated a criminal justice agency as defined in RCW 10.97.030 and 43.43.705.

NEW SECTION. Sec. 4. The chief investigator is the head of the office and is appointed by the secretary solely on the basis of integrity and demonstrated ability in law enforcement management, public administration, and investigations. The chief investigator reports to and is under the general supervision of the secretary in all matters related to fraud and program integrity.

NEW SECTION. Sec. 5. If the chief investigator discovers that improper governmental action, as defined in RCW 42.40.020, has occurred during an investigation with respect to an employee, such as an abuse of authority so as to impede or interfere with an investigation, then the chief investigator may report the improper governmental action to the auditor under chapter 42.40 RCW.

NEW SECTION. Sec. 6. (1) It is the duty and responsibility of the chief investigator to:

(a) Conduct, supervise, and coordinate fraud and abuse investigations and provide policy direction as it relates to program integrity and fraud and abuse;

(b) Review proposed legislation and rules relating to the detection and prevention of fraud and abuse in programs administered by the department, and make recommendations for improvement;

(c) Recommend policies for and coordinate activities carried out or financed by the department for the purpose of preventing and detecting fraud or abuse;

(d) Recommend policies for, and conduct, supervise, and coordinate, relationships between the department and federal, state, and local governmental agencies, and nongovernmental entities, with respect to: (i) Matters relating to the prevention and detection of fraud or abuse in programs and operations administered by the department; or (ii) the identification and prosecution of participants in such fraud or abuse; and

(e) Keep the secretary and the legislature informed by means of reports concerning the detection and prevention of fraud or abuse, and to make recommendations for improvement of the activities.

(2) In carrying out the duties and responsibilities established in sections 3 through 14 of this act, the chief investigator must refer all investigations in which the chief investigator has found substantial evidence supporting a finding of a violation of federal or state criminal law to the appropriate prosecuting authority for possible criminal prosecution.

NEW SECTION. Sec. 7. In addition to its other powers and duties, the office of the chief investigator has the power to enforce the penal provisions of sections 3 through 14 of this act, and as it may be amended, the penal laws of the state relating to programs administered by the department. The office of chief investigator has the authority to apply for and execute all warrants and serve process of law issued by the courts in enforcing the provisions of sections 3 through 14 of this act. The office of chief investigator has the power to issue and serve subpoenas under RCW 43.20A.110 and 43.20A.605.

NEW SECTION. Sec. 8. (1) The chief investigator must submit a report summarizing the activities of the office to the appropriate committees of the senate and house of representatives by November 30, 1997, and by November 30, 1998, and biennially thereafter. The report shall contain only disclosable information, including:

(a) A description of significant fraud or abuse, and of vulnerabilities or deficiencies relating to the prevention and detection of fraud or abuse, discovered as a result of investigations completed during the reporting period;

(b) A description of corrective action taken by the department regarding fraud and abuse discovered as a result of investigations conducted by the office of chief investigator;

(c) Recommendations for improving the activities of the office with respect to the vulnerabilities or deficiencies identified under (a) of this subsection;

(d) An identification of each significant recommendation described in the previous reports on which corrective action has or has not been completed;

(e) A summary of matters referred to prosecution authorities during the reporting period and the charges filed and convictions entered during the reporting period that have resulted from referrals by the office; and

(f) Any comments the secretary determines to be appropriate.

(2) The chief investigator must forward a draft of the report to the secretary not less than twenty days prior to the date that the report is to be issued.

(3) Within sixty days after the transmission of the report of the chief investigator to the legislature, the secretary must make copies of the report available to the public upon request and at a reasonable cost.

NEW SECTION. Sec. 9. (1) In carrying out the provisions of sections 3 through 14 of this act, the chief investigator is authorized to:

(a) Request information or assistance as is necessary for carrying out the duties and responsibilities provided by sections 3 through 14 of this act from a federal, state, or local governmental agency or unit of a governmental agency;

(b) Issue subpoenas for witnesses, documents, information, and other data necessary in the furtherance of an investigation conducted by the office. The subpoenas are enforceable under RCW 34.05.588. Prior to issuing subpoenas to a state agency, the chief investigator must make a reasonable request to the agency for documents and information in possession of the agency;

(c) Administer oaths and take testimony, when appropriate in the performance of the duties and responsibilities provided in sections 3 through 14 of this act, unless otherwise prohibited by law;

(d) Appoint not more than two deputies;

(e) To the extent and in the amount as may be provided by appropriation, select, appoint, and employ personnel as may be necessary to carry out the provisions of sections 3 through 14 of this act;

(f) To the extent and in the amount as may be provided by appropriation, enter into contracts and other arrangements for audits, studies, analyses, and other services with public agencies and with private persons, and make the payments necessary to carry out the provisions of sections 3 through 14 of this act, subject to compliance with civil service laws, collective bargaining agreements, and other applicable law; and

(g) To the extent and in the amount as may be provided by appropriation, purchase or lease facilities, equipment, and supplies necessary to carry out the provisions of sections 3 through 14 of this act.

(2) Whenever information or assistance requested under subsection (1)(a)of this section is, in the judgment of the chief investigator, unreasonably refused or not provided, the chief investigator must report the circumstances to the secretary without delay.

NEW SECTION. Sec. 10. (1) In carrying out the provisions of sections 3 through 14 of this act, the chief investigator is authorized to:

(a) Have reasonable access to the secretary or his or her designee when necessary in the performance of the duties and responsibilities provided by sections 3 through 14 of this act;

(b) Have prompt access to all individuals, records, electronic data, reports, audits, reviews, documents, and other materials available to the department that relate to operations of the office that is not otherwise prohibited from disclosure to the chief investigator.

(2) Whenever information or assistance requested under subsection (1)(a) or (b) of this section is, in the judgment of the chief investigator, unreasonably refused or not provided, the chief investigator must report the circumstances to the secretary without delay.

NEW SECTION. Sec. 11. (1) The chief investigator may receive and investigate complaints or information from an employee of the department or a citizen concerning the possible existence of an activity constituting a violation of law or rules, or mismanagement, gross waste of funds, abuse of authority, or a substantial and specific danger to the public health and safety.

(2) The chief investigator must not, after receipt of a complaint or information from a complainant, disclose the identity of the complainant without the consent of the complainant, unless the chief investigator determines that the disclosure is unavoidable during the course of investigation, except as otherwise provided by state law.

(3) An employee who has authority to take, direct others to take, recommend, or approve a personnel action, must not, with respect to the authority, take or threaten to take an action against an employee as a reprisal for making a complaint or disclosing information to the chief investigator, unless the complaint was made with willful disregard for its truth or falsity.

NEW SECTION. Sec. 12. (1) The chief investigator may be contracted by other state agencies to conduct investigations into allegations of fraud and abuse in those agencies. The requesting agency must reimburse the office of chief investigator for the cost of the investigation.

(2) The chief investigator must provide the requesting agency a report of findings and may also file the findings with the appropriate prosecuting attorney.

NEW SECTION. Sec. 13. (1) All powers, duties, and functions of the division of fraud investigation pertaining to the investigation of fraud and abuse and other duties set out under sections 3 through 14 of this act are transferred to the office of the chief investigator of the department of social and health services.

(2)(a) All reports, documents, surveys, books, records, files, papers, or written material in the possession of the division of fraud investigation pertaining to the powers, functions, and duties transferred shall be delivered to the custody of the office of the chief investigator of the department. All cabinets, furniture, office equipment, motor vehicles, and other tangible property employed by the division of fraud investigation in carrying out the powers, functions, and duties transferred shall be made available to the office of the chief investigator of the department. All funds, credits, or other assets held in connection with the powers, functions, and duties transferred shall be assigned to the office of the chief investigator of the department.

(b) Any appropriations made to the division of fraud investigation for carrying out the powers, functions, and duties transferred shall, on the effective date of this section, be transferred and credited to the office of the chief investigator of the department.

(c) Whenever any question arises as to the transfer of any personnel, funds, books, documents, records, papers, files, equipment, or other tangible property used or held in the exercise of the powers and the performance of the duties and functions transferred, the director of financial management shall make a determination as to the proper allocation and certify the same to the state agencies concerned.

(3) All employees of the division of fraud investigation engaged in performing the powers, functions, and duties transferred are transferred to the jurisdiction of the office of the chief investigator of the department. All employees classified under chapter 41.06 RCW, the state civil service law, are assigned to the office of the chief investigator of the department to perform their usual duties upon the same terms as formerly, without any loss of rights, subject to any action that may be appropriate thereafter in accordance with the laws and rules governing state civil service.

(4) All rules and all pending business before the division of fraud investigation pertaining to the powers, functions, and duties transferred shall be continued and acted upon by the office of the chief investigator of the department. All existing contracts and obligations shall remain in full force and shall be performed by the office of the chief investigator of the department.

(5) The transfer of the powers, duties, functions, and personnel of the division of fraud investigation shall not affect the validity of any act performed before the effective date of this section.

(6) If apportionments of budgeted funds are required because of the transfers directed by this section, the director of financial management shall certify the apportionments to the agencies affected, the state auditor, and the state treasurer. Each of these shall make the appropriate transfer and adjustments in funds and appropriation accounts and equipment records in accordance with the certification.

(7) Nothing contained in this section may be construed to alter any existing collective bargaining unit or the provisions of any existing collective bargaining agreement until the agreement has expired or until the bargaining unit has been modified by action of the personnel board as provided by law.

NEW SECTION. Sec. 14. (1) The department shall transfer to the Washington state patrol all administrative investigations focusing on department employees that concern:

(a) Alleged criminal conduct constituting a gross misdemeanor or a felony; or

(b) Administrative investigations involving allegations of willful or wanton disregard for the policies and procedures of the department. These include, but are not limited to, allegations of abuse of position and any other matter deemed necessary by the secretary of the department in consultation with the chief of the Washington state patrol.

(2) The Washington state patrol and management from the department shall develop specific procedures for referring matters from the department to the Washington state patrol. The Washington state patrol shall provide training for department staff regarding the implementation of the procedures. The department shall provide training for Washington state patrol investigators regarding unique issues relating to department employees, clients, programs, policies, or guidelines that will assist Washington state patrol investigators in conducting both criminal and administrative investigations.

(3) Investigations under this section are funded by the department of social and health services, division of fraud investigation budget.

Sec. 15. RCW 41.06.076 and 1993 c 281 s 22 are each amended to read as follows:

In addition to the exemptions set forth in RCW 41.06.070, the provisions of this chapter ((~~shall~~)) do not apply in the department of social and health services to the secretary; the secretary's executive assistant, if any; not to exceed six assistant secretaries, thirteen division directors, six regional directors; one confidential secretary for each of the above-named officers; not to exceed six bureau chiefs; the chief investigator and deputy chief investigators; and all superintendents of institutions of which the average daily population equals or exceeds one hundred residents((~~: PROVIDED, That~~)). However, each ((~~such~~)) confidential secretary must meet the minimum qualifications for the class of secretary II as determined by the Washington personnel resources board.

NEW SECTION. Sec. 16. Sections 3 through 14 of this act are each added to chapter 43.20A RCW.

NEW SECTION. Sec. 17. This act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and takes effect July 1, 1997.