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GCN : October 2015
24 GCN OCTOBER 2015 • GCN.COM children in a home setting. Kickbacks might flow from a provider to a care recipient or from provider to provider across large and small networks. Another common scheme is for a pro- vider to receive CalWORKs money when kids are actually in free after-school child care or at home. “ That person is really not providing child care,” Sylves- ter said. “Instead, they are taking the child care fees and divvying them up in many different ways.” More and more of the collusion is driven by fraud rings. Identifying the size and scope of those networks provid- ed an incentive to increase the county’s investment in an anti-fraud data-mining solution. “The rings can get pretty big,” Syl- vester said, adding that the county’s original goal was to find out how far the criminal networks extended. To do so, officials launched the Data Mining Solu- tion (DMS) for Child Care Welfare Fraud Detection. DPSS drew on the SAS Fraud Frame- work for Government to build a platform that ties together data mining, social network analysis and rules manage- ment applications. The county’s data is maintained in a secure cloud hosted by the company’s Advanced Analytics Lab for State and Local Government. The social networking analytics have helped the county drill down into pro- gram data and begin to identify fraud networks. Via a dashboard, investigators can pull up data on providers, families using the providers, the work locations Navy vessels are complicated places, and the learning curve for junior officers can be daunt- ing. Division officers, or DIVOs, are responsible for critical functions that include electrical maintenance or en- gineering — duties that require ready access to a vast array of manuals, books and other reference documents. Too of- ten, DIVOs on their first sea tour would discover that those materials were not accessible when and where they were most needed. When Lt. Charlie Hymen and Lt. John Harry came off sea duty, they were convinced there was a better way than relying on paper printouts, random PDF files and word of mouth. They approached Vice Adm. Bill Moran, chief of naval personnel, with an idea for a mobile application containing all the necessary information — and out of that discussion came eDIVO. The Sea Warrior Program — which manages IT systems to support a wide range of Navy missions — further ex- plored and developed the lieutenants’ idea into a fully operational solution in PUTTING A REFERENCE LIBRARY IN DIVISION OFFICERS’ POCKETS Two junior officers’ idea for making critical information more accessible at sea sparked the eDIVO mobile application, which is now used throughout the Navy AT A GLANCE PROJECT: Data Mining Solution for Child Care Welfare Fraud Detection ORGANIZATION: Department of Public Social Services, Los Angeles County Social networking analytics and targeted business rules allow investigators to dig into program data and reveal fraud rings. and the phone numbers of people tied to those locations. “You start to see how the linkages spawn off,” Sylvester said. “This lets our investigators really drill into the data, open it up and find out, my goodness, there are 10 others associated with that beneficiary.” The county also developed a triage unit to analyze alerts and funnel sus- pected fraud cases to investigators. The triggers are activated by business rules showing potential fraudulent activity, such as a person reporting income paid in cash or an unusually long distance between a beneficiar y’s home and the child care site. So far, the system has had a positive financial impact, said Sylvester, who estimates that the project has cut time to prosecute fraud investigations by 18 months and generated millions in annual cost savings. It has also led to hundreds of fraud referrals to county caseworkers, leading to cost avoidance savings throughout the department. Looking a few years down the road, Sylvester predicts that data mining and other tools will continue to improve investigators’ ability to find new data sources that will help them stay in front of their casework. Some of those sources might eventually include external pub- lic- and private-sector data. “Realizing you have huge data stores with information in them that can be pulled out and put together, it’s incumbent on all of us to find ways to put them in the budget and enable in- vestigators who are really working hard to catch perpetrators,” Sylvester said. — Paul McCloskey 1015gcn_020-038.indd 24 10/5/15 10:40 AM
January and February 2016