5653-S AMH CFS H2778.1

5653-S AMH CFS H2778.1

SSB 5653 - H COMM AMD ADOPTED 4/12/95

By Committee on Children & Family Services

Strike everything after the enacting clause and insert the following:

"NEW SECTION. Sec. 1. This act shall be cited as the "department of social and health services inspector general act of 1995."

NEW SECTION. Sec. 2. As used throughout this chapter:

(1) "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 (c) has not previously been disclosed in a public record.

(2) "Fraud or abuse" means acts and practices of fraud or abuse in programs administered by the department and fraud in the provision of the department's programs. This does not include provider fraud as it relates to the department's administration of funds pursuant to Title XIX of the social security act, medicaid.

(3) "Inspector general" means the inspector general of the department.

(4) "Office" means the office of the inspector general of the department.

NEW SECTION. Sec. 3. There is established in the department an office of inspector general in order to create an independent unit to:

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

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

(3) 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.

NEW SECTION. Sec. 4. (1) The head of the office is the inspector general, who shall be appointed by the governor solely on the basis of integrity and demonstrated ability in law enforcement management, public administration, and investigations. The inspector general shall report to and be under the general supervision of the secretary in all matters related to fraud and program integrity.

(2) The inspector general shall only be removed from office by the governor.

(3) If the inspector general 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 inspector general may report the improper governmental action to the auditor under chapter 42.40 RCW.

NEW SECTION. Sec. 5. (1) It is the duty and responsibility of the inspector general to:

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

(b) Review proposed legislation and rules relating to the detection and prevention of fraud 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 2 through 8 of this act, the inspector general shall refer all investigations in which the inspector general 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. 6. (1) The inspector general, jointly with the secretary, shall submit a report summarizing the activities of the office to the appropriate committees of the senate and house of representatives by January 1, 1996, and by January 1, 1997, and biennially thereafter. The report shall contain only disclosable information, including:

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

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

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

(d) 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;

(e) A summary of each report made to the secretary under section 7(2) of this act during the reporting period;

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

(2) The inspector general shall 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 inspector general to the legislature, the secretary shall make copies of the report available to the public upon request and at a reasonable cost.

NEW SECTION. Sec. 7. (1) In carrying out the provisions of sections 2 through 8 of this act, the inspector general is authorized to:

(a) 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 inspector general;

(b) Request such information or assistance as may be necessary for carrying out the duties and responsibilities provided by sections 2 through 8 of this act from any federal, state, or local governmental agency or unit of a governmental agency;

(c) Issue subpoenas for witnesses, documents, information, and other data necessary in the furtherance of an investigation conducted by the office. Such subpoenas are enforceable pursuant to RCW 34.05.588. Prior to issuing subpoenas to a state agency, the inspector general shall make a reasonable request to the agency for documents and information in possession of the agency;

(d) Administer oaths and take testimony, if necessary in the performance of the duties and responsibilities provided in sections 2 through 8 of this act, unless otherwise prohibited by law;

(e) Have reasonable access to the secretary or his or her designee when necessary in the performance of the duties and responsibilities provided by sections 2 through 8 of this act;

(f) Appoint not more than two deputies;

(g) To the extent and in such amounts as may be provided by appropriations, select, appoint, and employ such personnel as may be necessary to carry out the provisions of sections 2 through 8 of this act;

(h) To the extent and in such amounts as may be provided by appropriations, enter into contracts and other arrangements for audits, studies, analyses, and other services with public agencies and with private persons, and to make such payments necessary to carry out the provisions of sections 2 through 8 of this act, subject to compliance with civil service laws, collective bargaining agreements, and other applicable law; and

(i) To the extent and in such amounts as may be provided by appropriations, purchase or lease facilities, equipment, and supplies necessary to carry out the provisions of sections 2 through 8 of this act.

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

NEW SECTION. Sec. 8. (1) The inspector general may receive and investigate complaints or information from an employee of the department concerning the possible existence of an activity constituting a violation of law, rules, or regulations, or mismanagement, gross waste of funds, abuse of authority, or a substantial and specific danger to the public health and safety.

(2) The inspector general shall not, after receipt of a complaint or information from an employee, disclose the identity of the employee without the consent of the employee, unless the inspector general determines such disclosure is unavoidable during the course of investigation, except as otherwise provided by state law.

(3) Any employee who has authority to take, direct others to take, recommend, or approve any personnel action, shall not, with respect to such authority, take or threaten to take any action against any employee as a reprisal for making a complaint or disclosing information to the inspector general, unless the complaint was made with willful disregard for its truth or falsity.

NEW SECTION. Sec. 9. Sections 2 through 8 of this act are each added to chapter 43.20A RCW.

Sec. 10. 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 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 inspector general and deputy inspector generals; and all superintendents of institutions of which the average daily population equals or exceeds one hundred residents: PROVIDED, That 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. 11. 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 shall take effect July 1, 1995."

SSB 5653 - H COMM AMD

By Committee on Children & Family Services

On page 1, line 1 of the title, after "fraud;" strike the remainder of the title and insert "amending RCW 41.06.076; adding new sections to chapter 43.20A RCW; creating a new section; providing an effective date; and declaring an emergency."