0353_IPMOU_CURRENT_101800.PDF

Maricopa County — Formal (2020-05-06)

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INCENTIVE PAYMENT MEMORANDUM OF UNDERSTANDING 
(IPMOU) 
0 f-Oo ct- 
-00 
AGREEMENT BETWEEN 
TEE SOCIAL SECURITY ADMINISTRATION 
AND THE 
Maricopa County Sheriff's Office 
Article I, Purpose & Legal Authority 
The parties in accordance with sections 1611(e)(1)(I) and 
202(x)(3) of the Social Security Act (the Act) enter into this 
agreement. The agreement provides the terms and conditions under 
which the reporting entity (Reporter) will provide to the Social 
Security Administration (SSA) information about certain confined 
individuals, on its own behalf and/or on behalf of other 
facilities/institutions for whom it will report as identified in 
Article III B.1 of this agreement and under which SSA will pay 
facilities/institutions for information that results in the 
suspension of payments to certain confined individuals (see 
article II B) receiving Supplemental Security Income (SSI) 
payments under title XVI of the Act, 42 U.S.C. 1381 et seq., as 
well as suspension of benefits to individuals receiving 
Retirement Survivors and Disability '(RSDI) benefits under title 
II of the Act, 42. U.S.C. 402 et seq. The responsibilities of 
each party to the agreement are also provided. 
Title XVI of the Act sets forth the conditions under which 
individuals are eligible for SSI payments. 
Title II of the Act 
sets forth the conditions under which individuals are eligible 
for RSDI payments. 
Based on sections 202(x)(1), 202(x)(3), and 1611(e) (1)(A) of the 
Act (codified at 42 U.S.C. §§ 402(x)(1), 402(x)(3) and 
1382(e)(1)W respectively), the Social Security Administration 
is required to limit/deny the payment of benefits to: any 
individual for any month during which he/she is confined to a 
jail, prison, or other penal institution or correctional facility 
under a conviction of a criminal offense; certain individuals 
(see article II C) confined by court order in an institution at 
public expense in connection with certain verdicts or findings 
with respect to such offenses; and to certain individuals who, 
immediately on completion of confinement based on a conviction of 
an offense, an element of which is sexual activity, are confined 
by court order in an institution at public expense based on a 
finding that such individual is a sexually dangerous person or a 
sexual predator or a similar finding (title II of the Act); or to 
any individual for any month throughout which the individual is 
an inmate of a public institution (title XVI of the Act).

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Section 1611(e)(1)(I)(1) and section 202(x)(3) of the Act 
authorize SSA to enter into agreements described in those 
sections with a specified type of interested State or local 
institution (such as a jail, prison, or other 'penal institution 
or correctional facility or other institutions in which people 
are confined by court order at public expense). These sections 
of the Act provide the general terms and conditions under which, 
based on this agreement, the Reporter will provide information 
about confined individuals to SSA. SSA will also use the 
information provided by Maricopa County Sheriff's Office under 
authority of sections 205(j)(1)(A), 205(j)(5), 1631(a)(2)(A)(iii) 
and 1631(a)(2) (E) of the Act which require SSA to revoke 
certification for payment of benefits to representative payees 
under certain circumstances and investigate and monitor the 
performance of such representative payees. (See also 20 C.F.R. 
404.2050; 416.555). The incarceration or confinement of a 
representative payee is a circumstance that SSA will consider 
under the above referenced representative payee provisions. 
This agreement and any subsequent addenda supersede any similar 
agreement entered into previously under the above-cited statutory 
provisions by the reporter and SSA concerning disclosure of 
records of confined individuals or inmates of public 
institutions. 
Section 552a(a)(8)(B) of title 5, U.S.C., as amended by section 
402(a)(2) of Public Law 106 - 170 exempts this agreement, and 
information exchanged under this agreement, from certain 
provisions of the Privacy Act, i.e., those relating to computer 
matches. 
Article II, Definitions  
A. "Confined" refers to individuals who are confined to a 
facility/institution described in Article I of this 
agreement under authority of law at any time during the 
period covered by this agreement. 
B. "Other Confined Individuals" (Title XVI Beneficiaries) are 
individuals who are confined to a jail or similar facility 
throughout any month during the period covered by this 
agreement. This individual remains confined if transferred 
from one public institution to another or if temporarily 
absent from such an institution, or resides in the 
institution as of the beginning of a month and dies in the 
institution during the month. 
C. "Certain Other Individuals Confined at Public Expense" (Title 
II beneficiaries) are individuals confined by court order

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for more than 30 continuous days in any institution at 
public expense in .connection with: 
(1) A verdict or finding that the individual is not guilty 
of a criminal offense by reason of insanity; or 
(2) A finding that the individual is incompetent to stand 
trial under an allegation of a criminal offense; or 
(3) A similar verdict or finding with respect to such an 
offense based on similar factors (such as a mental 
disease, a mental defect or mental incompetence). 
Such an individual is considered confined until (1) he or 
she is released from the care and supervision of such 
institution; and (2) such institution ceases to meet the 
individual's basic living needs. 
D. "Sexually Dangerous Individuals" are individuals, who 
immediately upon completion of their prison sentence for a 
criminal offense (an element of which is sexual activity), 
are confined for more than 30 continuots days by court order 
in an institution at public expense. These individuals are 
confined in an institution based on a determination or 
finding that they are sexually dangerous persons, sexual 
predators, or similar determinations or findings. 
E, "Representative Payee" means the person, agency, 
organization or institution selected (by SSA) to receive and 
manage benefits on behalf of an incapable (SSA) beneficiary. 
This includes a parent who is receiving benefits on behalf 
of his/her minor child. 
F. "Record" means any item, collection, or grouping of 
information about an individual that is maintained by an 
entity including, but not limited to, the individual's 
criminal history, name, Social Security number (SSN), 
aliases, date of birth, gender, date of confinement, place 
of confinement and prisoner or inmate status. 
G. "Disclosure" mean 8 the release of information (data) with or 
without the consent of the individual(s) to whom the 
information pertains. 
H. "Reporter Identification code" means the four-character code 
assigned by SSA to the Reporter that is party to the 
agreement and that will report information on its awn behalf 
and/or on behalf of other facilities/institutions identified 
in this agreement.

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I. "Facility Identification Code" means the six-character code 
that SSA will assign to a facility or institution that 
confines individuals and is covered by this agreement. This 
code must be furnished with each submission of inmate data 
to SSA concerning the facility/institution's confined 
individuals in order for SSA to process any incentive 
payments due the facility/institution under this agreement. 
J. "Throughout a month" means that a title XVI individual is 
confined in an institution as of the first instant of a 
calendar month and stays through the last instant of the 
month. Suspension applies in any month throughout which an 
individual is confined as an inmate of a jail, prison, other 
similar facility or other such public institution. 
Example 1: If an individual enters an institution on April 
30 and is released on June 3, the individual would be 
confined throughout May. 
Example 2: If an individual enters an institution on May 1 
and is released on June 30, the individual would not have 
been confined in an institution throdghout either May or 
June. 
Under the SSI program, an individual who is confined in a 
public institution is considered as remaining confined in a 
public institution if he is transferred from one such 
institution to another or if he is temporarily absent for a 
period of not more than 14 consecutive days. Also, an 
individual is considered confined in an institution 
throughout a month if he is confined in the institution as 
of the beginning of a month and dies in the institution 
during the month. 
K. "More than 30 continuous days" means that a title II 
individual has been convicted and remains confined in an 
institution for a period of more than 30 continuous days 
following the conviction. Suspension applies in any month in 
any part of which the individual is convicted and confined. 
Example 1: Individual is convicted on April 28, enters an 
institution on April 30 and is released on June 3. The 
individual would be convicted and confined for more than 
30 continuous days. Benefits would be suspended for all 
three months, April, May, and June. 
Example 2: Individual is convicted on May 1, enters an 
institution on May 1 and is released on June 30. The 
individual would be convicted and confined for more than 
30 continuous days in an institution. Benefits would be 
suspended for both months, May and June.

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Article III, Description of Records to be Matched 
A_ General 
1. The Reporter will identify confined individuals for SSA. 
2. SSA will determine which of these confined individuals are 
receiving SSI payments, RSDI payments and/or acting as 
representative payees. 
B. Source of Reporter Records 
1. These records are compiled from the following 
facil.itie_sLinstitutions :  
Estrella Tent Facility (A20006) 
Towers Jail (A20007) 
Madison Street Jail (AZ0008) 
Maricopa County Hospital-Detention (A20009) 
Estrella Jail (A20010) 
First Avenue Jail (A20011) 
Durango Jail (AZ0012) 	
; 
Central Intake (A20040) 
Southeast Jail (AZ0041) 
Avondale Jail (AZ0042) 
2. A reporter may opt to qualify only for the payment of 
title XVI Incentive Payments. If the Reporter chooses 
that option, then the Reporter must provide the following 
data elements: 
a. Social Security number (provide all numbers the 
individual has been known to use); 
b. Name (provide all names the individual has been known 
to use); (Note: provide all known combinations of 
Social Security Number/Name identities); 
c. Date of birth (known or alleged); 
d. Confinement date, i.e., the date the inmate was 
admitted to. the facility or the date custody of the 
individual began; 
e. Facility identification code; and 
f. Other identifying information as required in the 
attached Enumeration Verification System (EVS) User 
Package for Correctional Institutions.

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3. A Reporter may opt to qualify for the payment of both 
title XVI incentive payments and title II incentive 
payments_ If the Reporter chooses that option, then, the 
Reporter must provide the following data elements: 
a. Social Security Number (provide all numbers the 
individual has been known to use); 
b. Name (provide all names the individual has been known 
to use) (Note: provide all known combinations of 
Social Security Number/Name identities); 
c. Date of Birth (known or alleged); 
d. Confinement date, i.e., the date the individual was 
admitted to the facility or the date custody of the 
individual began; 
e. Date of Conviction for the criminal offense; 
f. Facility identification code; 
g. Other identifying information as required by the 
attached Enumeration Verification System (EVS) User 
Package for Correctional' Institutions. 
4. All records will be prepared and transmitted as 
prescribed in Article IV with clear identification of the 
facility/institution that is the source of such records_ 
C. SSA Systems of Records 
SSA will match the data from the Reporter for the purpose 
described in the following systems of records. The data will 
be matched against the: 
1. Supplemental Security Income Record (SSR) SSA/OSR 09- 
60- 0103 
2. Master Representative Payee File (09-60-0222) 
3. Master Beneficiary Record (MBR)(09-60-0090) 
4. Master Files of Social security Number Holders and SSN 
Applications SSA/OSR 09-60-0058 (Alphident & Numident) 
Article TV, Functions to be Performed 
The information on confined individuals must be provided 
electronically (i.e., a computer tape, cartridge, diskette, or 
electronic transmission).

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A. Type of Report 
The Reporter agrees that it will furnish SSA with (check one 
of the reports below): 
Report(s) (electronic file or paper report, if 
appropriate) containing the data elements/reporting 
requirements listed in Article III.B.2.for individuals 
whose confinement commences on or after March 1, 1997 
for SSI recipients. (Title XVI Incentive Payment 
Agreement only.) 
Or 
XXX Reports (electronic file or paper report, if 
appropriate) containing the data elements/reporting 
requirements listed in Article III.B.3.for individuals 
whose confinement and/or conviction commences on or 
after March 1, 1997 for SSI recipients and the 
confinement and conviction for RSDI beneficiaries 
commences on or after April 1, 2000. (Title XVI and 
Title II Incentive Payment Agreement.) 
B. Reporting Protocol, 
Report data required to qualify for Title XVI and/or Title II 
Incentive Payments (See Article III B.2 or 3 for data to be 
reported to SSA on inmates.) 
1. The first submission of data, whether done electronically 
or by paper, will be a total inmate population report, 
commonly referred to as a census report. 
2. After census file is submitted to SSA, files are to be 
submitted monthly for the preceding calendar month. The 
monthly report should consist of: 
• data for those individuals who are admitted to the 
facility/institution at any time during the period from 
the first day of the reporting month to the last day of 
that month (e.g., newly admitted inmates)and/or, 
• data for those individuals already in the custody of 
the facility/institution who have subsequently been 
convicted since the facility/institution initially began 
reporting inmate data to SSA. 
C. 
SSA Actions on the Inmate Data Received 
After validating or locating the proper Social Security 
number, SSA will:

B 
1. Determine if the individual is receiving SSI or RSDI 
benefits. 
2. Verify that the individual has received an SSI or RSDI 
benefit in the month preceding the first month throughout 
which such individual is an inmate; 
3. Determine whether or not such individual is acting as a 
representative payee; 
4. Investigate and determine whether revocation of 
representative payee certification is appropriate under 
applicable law as cited in Article I. 
5. Verify that the individual has been confined throughout a 
calendar month for SSI or; convicted and confined for more 
than 30 continuous days for RSDI. 
6. Notify the individual of the suspension action and provide 
the individual with an opportunity to contest the planned 
action under applicable regulations. 
7. Suspend SSI and RSDI payments as required by law. 
B. Pay the appropriate facility/institution as specified 
under Article V. 
9. Provide the Reporter with a notice of the amount of the 
incentive payment, the payment date and the total number 
of suspended individuals, and a list of the individuals 
suspended. 
D. SSA Addresses for Submitting Data Files 
The Reporter agrees to send the data to one of the following 
addresses. If the Reporter prefers to ensure timely receipt of 
the data, files may be sent using FedEx. (Note: For diskette or 
large paper reporters, the address information for FedEx files 
differs from the regular mailing address since FedEx cannot be 
delivered to a P.O. Box. See below.) 
1. Send tapes or cartridges to: 
SSA 
Attention: Outside Agency 
2-F-9 National Computer Center 
6201 Security Blvd. 
Baltimore, MD 21235-6201

2. Send diskettes to: 
SSA 
Division of Employer Services, OCO 
Metro West Building 
P.O. Box 33004 
Baltimore, MD .21290-3004 
FedEx address for diskettes! 
SSA 
OCO, Division of Employer Services, ATTENTION: Prisoner 
300 North Greene Street, 5-E-10 North Building 
Baltimore, Maryland 21290-0300 
Contact Name: Dorthea Towson 
Telephone Number: (410) 966-9649 
3. Send paper listings that contain over 1000 names to: 
SSA 
Division of Employer Services, OCO 
Metro West Bldg. 
P.O. Box 33004 
Baltimore, MD 21290-3004 
FedEx address for paper reports: 
SSA 
OCO, Division of Employer Services, ATTENTION: Prisoner 
300 North Greene Street, 5-E-10 North Building 
Baltimore, Maryland 21290-0300 
Contact Name: Dorthea Towson 
Telephone Number: (410) 966-9649 
3. Establishing electronic transmission process: 
Contact Anita Cohen on (410) 965-5340 to establish 
electronic processes with SSA systems. 
Article V, Incentive Payment Process 
SSI (Title XVT) Incentive Palments  
In accordance with section 1611(e)(1)(I)(1)(II) of the Act, SSA 
will pay an incentive payment to a facility/institution covered 
by this agreement for information on a confined individual which 
the Reporter furnishes to SSA within the time periods specified 
below, provided that the confined individual is: 
9

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Receiving an SSI payment for the month preceding the first, 
• month throughout which the confined individual is in such 
facility/institution; and 
• Determined by SSA to be ineligible for a SSI payment for such 
first month as a result of the information provided by the 
Reporter under this agreement. 
NOTE: See article III, B.2. for data elements required to qualify 
for Title XVI incentive payments as described above. 
psnr (Title TT) Tn(1.1%%ntive Payments  
In accordance with section 202(X)(3) of the Act, SSA will pay an 
incentive payment to a facility/institution covered by this 
agreement for information on a confined and convicted individual 
which the Reporter furnishes to SSA within the time periods 
specified below, provided that the confined individual is: 
• Is receiving an RSDI payment for the month preceding the firsS, 
mauth in which the confined individual is in a 
facility/institution; and 
• Determined by SSA to be ineligible for an RSDI payment for any 
part of the first month as a result of the information 
provided by the Reporter under this agreement. 
NOTE: See Article III, B.3 for the data elements required to 
qualify for Title XVI and/or Title II incentive payments as 
described above. 
Payment of Incentives  
SSA will pay such facility/institution: 
• $400 if the Reporter furnishes the information on a confined 
individual described above to SSA within 30 days after the 
date the individualrs confinement in such facility/institution 
begins; and/or, 
• $200 if the Reporter furnishes such information to SSA after 
30 days after such date but within 90 days after such date. 
• The dollar amounts above will be reduced by 50 percent if the 
Commissioner is also required to make a payment to the 
reporter with respect to the same individual under an 
agreement entered into under section 202(x)(3)(8); and, 
conversely will be reduced by SO percent if a payment is made 
with respect to the same individual under section 
1611(e)(1)(I) (I). 	
.

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If SSA cannot validate the SSN of a confined individual, SSA will 
take no further action. 
SSA will not pay an incentive payment for information concerning 
a confined individual if, prior to SSA's receipt of the 
information, SSA has already determined that the individual is 
ineligible for SSI or RSDI payments or in cases in which SSA's 
only action is to suspend the individual from serving as a 
representative payee. 
Payments made by SSA under this agreement represent incentive 
payments accruing as a.result of SSA's efforts in processing the 
data provided under this agreement when such data results in the 
suspension of SSI payments to confined inmates or confined and 
convicted inmates for RSDI payments. The time required for SSA 
to complete the verification process, perform case development to 
determine whether suspension of an individual's SSI or RSDI 
payment is appropriate, and, complete the due process 
requirements that must be accorded an individual subject to a 
suspension action, may vary from case to case and may represent 
several months. 
SSA will pay incentive payments to a facility/institution on a 
monthly basis by electronic transfer' of funds. The facility/ 
institution will name a financial institution and provide the 
information required on the attached 	
oma 	
aor  
(ACH) Vendor/Miscellaneoua_payment Pairollment Zorm (SF 3881) to 
receive its incentive payments by electronic transfer of funds. 
SSA will provide the Reporter with a notice of the amount of the 
incentive payment, the payment date, the total number of 
suspended individuals, and a list of individuals suspended. 
Disputes involving these incentive payments will be considered by 
the Regional Prisoner Coordinator designated in Article IX. The 
Reporter should forward a written request describing the dispute 
in detail to the Regional Prisoner Coordinator designated in 
Article IX within 30 days of its receipt of the relevant 
incentive payment notice. 
Article VI, Records Usage, Duplication and 
Redisolosure Restrictions  
SSA agrees to use the information provided by the Reporter only 
to determine which of the confined/convicted individuals are 
receiving payments and to suspend these payments as required by 
law and to investigate and monitor the performance of 
representative payees under circumstances as described in Article 
I. SSA will adhere strictly to the provisions of section 
1611(e)(1) (I) and 202(x)(3) of the Act in any usage, duplication,

12 
or redisclosure of information provided by the Reporter under 
this agreement. 
As required by section 1611(e)(1)(ii)(II) and section 202(x)(3) 
of the Act, SSA will redisclose the information obtained pursuant 
to this agreement to any Federal or Federally assisted cash, 
food, or medical assistance program, for eligibility purposes. 
SSA will retire all identifiable records in accordance with 
the Federal Records Retention Schedule (44 U.S,C. 3303a). For 
records the Reporter wants returned, SSA will return the 
Reporter's electronic files (magnetic computer tapes, diskettes 
or other electronic media) to the Reporter within 12 months. 
Paper reports will not be returned. 
Article VII, Notice, Verification and Opportunity 
to Contest 
SSA agrees to verify information obtained under this agreement 
prior to initiating any adverse action against an individual. 
Pursuant to its applicable regulations, SSAwill inform the 
individual by written notice that it has received specified 
information indicating that the individual is confined under the 
jurisdiction of a named prison system or is an inmate of a public 
institution beginning (month/year) and that, by law, SSI payments 
and/or RSDI benefits must be suspended. SSA will afford the 
individual the opportunity to contest and submit information 
concerning the planned action and to appeal a determination by 
SSA to suspend payments in accordance with applicable 
regulations. 
SSA is responsible for determining the most suitable 
representative payee to receive title II and title XVI payments. 
For title II and title XVI actions under the representative payee 
provisions cited in Article I of this agreement, in addition to 
notices provided to any affected Social Security beneficiary or 
SSI recipient, that the representative payee receiving notice has 
30 days to contest the Agency's decision to change representative 
payee for the affected beneficiary or recipient based in part on 
the current payee's incarceration or confinement under applicable 
provisions of the Act and regulations requiring revocation of 
certification of payment to certain representative payees and 
monitoring of representative payee performance by SSA. 
NOTE: 
GSA's final decision on the representative payee issue 
does not affect the eligibility or entitlement of the individual 
to the continued receipt of Social Security benefits or 
supplemental security income payments. In the event that there 
is any adverse effect on the monthly benefits payments to the 
beneficiary or recipient as a result of this match, if a decision

13 
is made to change the representative payee, the beneficiary or 
recipient will receive notice of the change as provided in 
sections 205(j) (2) (E) (ii) and 1631(a) (2) (B) (xi) of the Act. 
Article VIII, Term of the Agreement 
This agreement supersedes any previous agreement(s) between SSA 
and the facility/institutions identified in this agreement 
effectuating the exchange of prisoner information for the purpose 
of enforcing section 2611(e)(1)(A), 205(j)(1)(A), 205(j)(5), 
1631(a) (2) (A) (iii),1631(a) (2) (E), and 202(x) (1) of the Act. 
This agreement shall be effective upon the signatures of both 
parties and shall remain in effect until terminated by either of 
the parties. The agreement may be terminated upon written 
notification by either party 90 days in advance of the 
termination date. 
Article IX, Persons to Contact 
A. The SSA contact for questions concerning this incentive 
payment agreement is the Regional Prisoner Coordinator in 
SSA's San Francisco Regional Office at the following address: 
Alan Follett 
Retirement and Survivors Insurance Team, 6 th  Floor 
P. O. Box 4206 
Richmond, CA 94804 
(510) 970-8245 
FAX (510) 9709-8101 
E-mail: alan.follett@ssa.gov 
B. The SSA contact for policy questions concerning the incentive 
payment provision is: 
William Browne 
Office of Program Benefits 
3-A-26 Operations Building 
6401 Security Boulevard 
Baltimore, MD 21235-6401 
(410) 965-7685 	
. 
FAX (410) 597-0146 
E-mail: bill.brownecOssa.gov

14 
C. 
For technical questions concerning the computer operation 
itself, contact: 
Anita Cohen 
Team Leader, Client Identification Branch 
3-L-16 Operations Building 
6401 Security Boulevard 
Baltimore, MD 21235-6401 
(410) 965-5340 . 
FAX (410) 966-4159 
E-mail: anita.m.cohen@ssa.gov 
 
D. The Reporter contact for the incentive payment provision is 
NAME 
ADDRESS 
TELEPHONE 
FAX 
E. The Reporter contact concerning technical questions regarding 
the electronic file process is: 
NAME 
ADDRESS 
TELEPHONE 
FAX 
F. The Reporter contact for questions concerning the incentive 
payment accounting information is: 
NAME 
ADDRESS 
TELEPHONE 
FAX

Article X, Signature 
In witness whereof, the parties execute this agreement, 
FOR THE SOCIAL SECURITY ADMINISTRATION 
BY 	
Marilyn Dreifus  
DATE  April_10, 2000  
District Mauager. 
(TITLE) 
FOR THE REPORTER 
BY nAil,u4.140-, 444,4A '5150-
0.2 
trn, c&X;a4. 
 
(TITLE) 
7 
DATE 
DATE  10//3/• -erlf-D 
15

Board of Supervisors 
ATTEST: 
Date: 	
/iS/1 a-6170 
LLA,L, 
frarricleCari-oll 
Clerk of the Board of Supervisors 
)20: 
Maricopa'County Attorney 
OD,. 2 
MARICOPA COUNTY BOARD OF SUPERVISORS 
ros ri+E 
Date:  /0 // 	
9-15-rr1  
Date: