Definitions 448-01-10

(Revised 10/16/2024 ML #3873)

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Alien - an individual who is still a subject or citizen of a foreign country and who has not been granted U.S. citizenship.

 

Alternative Work Site – is an extension of the official work site at another location other than the employee’s official work site. The alternative work site will be used on an on-going basis, rather than just an occasional basis, includes telework.

 

Appeal - a specific request for Departmental review, by a dissatisfied, applicant, recipient, provider or their representative concerning a decision made by a Human Service Zone (HSZ) office or by a division of the Department.

 

Appeals Supervisor – an official of the Legal Advisory Unit of the Department who oversees the appeal process.

 

Authorized Representative - A responsible adult non-household member authorized in writing by the household to act on behalf of the household.

 

Beneficiary and Earnings Data Exchange System (BENDEX) Wage – annual earnings data received from SSA through IEV interface.

 

Beneficiary Earnings Exchange Record (BEER) – an interface record that matches information received from SSA with information in TECS and Vision systems to generate the BENDEX WAGE hits for IEVS.

 

Collateral Contact - knowledgeable individuals or sources who can support or verify information.

 

Department - the North Dakota Department of Human Services.

 

Disclosure - communication of any information from the applicant or recipient’s record to anyone other than the recipient. It does not include the transfer or exchange of information between or among units within the Economic Assistance or Medicaid Programs for the purpose of administration of a program.

 

Ex Parte – Decision made without requiring a recipient to provide a specific form.

 

Fair Hearing - an administrative review of a decision considering evidence and arguments presented by an applicant, recipient, their representative, a Human Service Zone (HSZ) or division of the Department.

 

Federal Tax Information (FTI) – Consists of return information provided from Internal Revenue Services (IRS) records. FTI includes taxpayer identity information, filing status, family size, Modified Adjusted Gross Income (MAGI), and tax year to which information relates. FTI excludes information provided by the taxpayer or their legal representative (even if it is a copy of their tax return or W-2), information obtained from public information files, and information from a source other than the IRS, such as state wage data. If the Department independently verifies FTI provided by the IRS or a secondary source (i.e., SSA, BFS) with the taxpayer or a third-party source (linked to the taxpayer), the verified information is no longer FTI as long as the IRS source information is replaced or overwritten with the newly provided information.

 

Household - an individual or group of individuals receiving or applying for benefits.

 

Improper Disclosure - Exposure of information to an unauthorized person. Improper disclosure occurs when PII, FTI or individually identifiable information is disclosed to another person who does not have a need to know.

 

Income Eligibility Verification System (IEVS) – income and asset data received through an interface from the Internal Revenue Service, Social Security Administration and Job Service.

 

Individually Identifiable Information - means information collected from an individual that is created or received by the Department and relates to:

 

1. The past, present, or future assistance or services applied for or received by an individual under any program administered by or under the supervision and direction of the Department, that identifies the individual or with respect to which there is a reasonable basis to believe the information can be used to identify the individual; or

2. A report or any other information obtained, concerning an applicant or a provider of or an individual applying for or receiving assistance or services under any program administered by or under the supervision and direction of the Department.

 

Intentional Program Violation Hearing (IPV) - a hearing conducted for individuals or households accused of intentional program violations, who do not waive their rights to such a hearing, to determine if the individuals or household members committed, and intended to commit, intentional program violations.

 

Mandated Reporter - An individual who holds a professional position (as of licensed social worker, physician, teacher, or counselor) that requires him or her to report to the appropriate state agency cases of child abuse that he or she has reasonable cause to suspect.

 

Mobile Device - is a computing device that (i) has a small form factor such that it can be easily carried by a single individual (made for portability); (ii) is designed to transmit and receive voice, data, video, or text communications without a physical connection (e.g. wirelessly) which includes mobile/cell phones; smartphones; personal digital assistants (PDAs); laptops computers; notebooks; tablets including Apple iPad, Microsoft Surface, or any other tablet computer; Apple iPods or other MP3 players; and cameras and video cameras; (iii) possesses a local, nonremovable, or removeable data storage; and (iv) includes a self-contained power source.

 

Need-to-Know - means access to information by Economic Assistance and Medicaid program workforce members, whose official duties or responsibilities require them to have access to the information.

 

NUMIDENT – a system interface with SSA that verifies social security numbers, identity, age and sex.

 

Participant - An individual who is currently, or was previously, eligible for an Economic Assistance program.

 

Personally Identifiable Information (PII) - refers to information that can be used to distinguish or trace an individual's identity. This could be information that identifies a person directly, or when combined with other personal or identifying information that is linked or linkable to a specific individual (indirect).

 

Protected Health Information (PHI) – means individually identifiable health information including demographic and genetic information created or received by a health care provider, health plan, or health care clearinghouse that relates to the past, present, or future physical or mental health or condition of an individual; the provision of health care to an individual; or the past, present, or future payment for the provision of health care; and identifies the individual or there is a reasonable basis to believe the information can be used to identify the individual. The confidentiality of PHI is protected under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). PHI falls under the category of personally identifiable information (PII).

 

Prudent Person Concept – A process in which an individual consistently exhibits good judgment in requesting, reviewing, and weighing information provided by an applicant or recipient, or a person representing an applicant or recipient.

 

Individuals must use this concept to:

 

• Exercise judgment in requesting, reviewing, and weighing information provided by an applicant, recipient, or any source of verification.
• Be attentive, vigilant, cautious, perceptive, and governed by reason and use common sense.
• Quickly and accurately determine that the information is adequate for making an eligibility decision or that further exploration of the circumstances is necessary.

The decision arrived at when applying this concept must be documented.

 

Recipient - an individual who is receiving or has received benefits under Economic Assistance or Medicaid Programs.

 

Release of Information – a signed statement by an applicant or recipient authorizing disclosure of any kind of information the household has provided for the purpose of determining eligibility for Economic Assistance and Medicaid Programs.

 

Return - means any tax or information return, estimated tax declaration, or refund claim (including amendments, supplements, supporting schedules, attachments, or lists) required by or permitted under the IRC and filed with the IRS by, on behalf of, or with respect to any person or entity."

 

Return Information – means:

1. Information that IRS obtained from any source or developed through any means that relates to the potential liability of any person under the IRC for any tax, penalty, interest, fine, forfeiture or other imposition or offense;

2. Information extracted from a return, including names of dependents or the location of business;

3. The taxpayer’s name, address, and identification number;

4. Information collected by the IRS about any person’s tax affairs, even if identifiers, such as name, address and identification number are deleted;

5. Status of whether a return was filed, under examination or subject to other investigation or processing, including collection activities; and

6. Information contained on transcripts of accounts.

 

Safeguarding Information - The act of protecting confidential information entrusted to the Department by applicants, participants, members and other agencies..

 

Short Name - A short name is a numerical number assigned based on the document type. The list of short names can be located in the Economic Assistance Reference materials.

 

State Data Exchange (SDX) - a system interface with Social Security Administration that verifies Supplemental Security Income (SSI).

 

State Verification and Exchange System (SVES) – an interface with the Social Security Administration (SSA) that matches information in the TECS and Vision systems. These include SDX, BENDEX, NUMIDENT, TPQY and Citizenship.

 

Systematic Alien Verification for Entitlement Program (SAVE) - The system is used to verify immigration status of applicants and recipients who are not U. S. Citizens.

 

Telework - is an alternative work site located at a home location or other non-traditional work site.

 

Third Party Query Procedure (TPQY) - the on-line method of requesting verification of Social Security, SSI and Medicare benefits, and US citizenship verification.

 

Tolerance – Established variance levels for matches received through the Income Eligibility Verification System (IEVS).

 

Unidentified Financial Object (UFO) - an interface record that matches information received from IRS with information in TECS and Vision systems to generate the UFO hits for IEVS.

 

USCIS – United States Citizenship and Immigration Services.