ACYF-CB-IM-01-11 - Title IV-E Foster Care Eligibility Review Guide

Glossary

Case Error Rate	The case error rate is the number of cases in error divided by the number of cases reviewed.
Disallowance	A payment disallowance is taken whenever a title IV-E eligibility criterion is not met and title IV-E funds are claimed for the ineligible occurrence. The payment disallowance includes all title IV-E foster care maintenance payments and applicable administrative costs of the error cases and non-error cases with ineligible payments that occurred during the period beginning with the first month of ineligibility and continuing through the date that is the earlier of the end of the service month that immediately precedes the month of the on-site review, or when the ineligibility ceases for the most recent foster care episode. For States found not to be in substantial compliance during the primary reviews, a disallowance will be assessed on the basis of payments associated with error cases and non-error cases with ineligible payments for the total of the title IV-E foster care maintenance payments made during the entire period that the payments are ineligible. Administrative costs associated with the ineligible payments will be disallowed. For secondary reviews, an extrapolated disallowance will be assessed in addition to a case specific disallowance on the basis of maintenance payments and administrative costs associated with error and non-error cases for ineligible payments that occurred before and after the period under review (PUR).
Dollar Error Rate	The dollar error rate is determined by dividing the maintenance and administrative dollars associated with the ineligible payments during the PUR by the total dollar value claimed during the PUR for the maintenance payments and administrative costs associated with the case records reviewed.
Error Case	A case is determined to be in error when a review of the sample case indicates that a title IV-E payment for a maintenance or administrative cost is made during the PUR on behalf of a child determined not to meet the criteria for title IV-E eligibility during the foster care episode.
Improper Payment	An improper payment is considered to have occurred in an error and non-error case whenever a title IV-E maintenance payment or administrative cost is not claimed for an allowable title IV-E activity or is claimed for an unallowable title IV-E activity. Improper payments include underpayments and ineligible payments.
Ineligible payment	An ineligible payment is considered to have occurred in an error and non-error case whenever a title IV-E maintenance payment or administrative cost is claimed for an unmet eligibility criterion; for a duplicate payment; for an overpayment; or for any other unallowable program cost.
Initial Primary Review	The initial primary review is the first title IV-E foster care eligibility review conducted in a State following the publication of the final rule in the Federal Register on January 25, 2000. A sample of 80 foster care cases is reviewed. (All States, as well as the District of Columbia and Puerto Rico, have undergone their initial primary reviews.)
Most Recent Foster Care Episode	If a child has had multiple entries into foster care, the most recent foster care episode begins with the date that the child is last removed from the home and placed in foster care before the end of the PUR and continues to the date the child is discharged for such removal. If a child has remained in foster care since his or her original removal from the home, the duration of this foster care event is considered the most recent episode.
Noncompliance	If a State is noncompliant, it is not in substantial compliance. For primary reviews, five or more of the title IV-E cases reviewed must be determined to be in error. For secondary reviews, noncompliance means both the case error rate and the dollar error rate exceed 10 percent.
Non Error Case with Ineligible Payment	A case is determined to be a non-error case with ineligible payments when a review of the sample case indicates that a title IV-E payment for a maintenance or administrative cost is made solely outside the PUR on behalf of a child determined not to meet the criteria for title IV-E eligibility. A non-error case with ineligible payments is included in the assessment of payment disallowance and calculation of the dollar error rate in the secondary review. It is excluded in the determination of substantial compliance for the primary reviews and in the determination of the case error rate for the secondary review.
Period Under Review	The period under review (PUR) is the 6-month reporting period of the Adoption and Foster Care Analysis and Reporting System (AFCARS) from which the sample of cases is drawn for the eligibility review. The AFCARS data are transmitted semi-annually by the State agency to the ACF Central Office.
PIP Completion Date	The PIP completion date is considered to be the date that is earlier of the latest completion date of an action item in the approved PIP or 12 calendar months from the approval date of PIP implementation.
Primary Review	The primary review is the first review in the title IV-E foster care eligibility review process. A sample of 80 foster care cases is reviewed. These cases, plus at least a 10 percent oversample, are selected from AFCARS data utilizing a probability sampling methodology. No alternate data source may be substituted for the AFCARS for sampling selection.
Program Improvement Plan (PIP)	The PIP is a plan developed by the State child welfare agency, in collaboration with the ACF Regional Office that, when implemented, is intended to correct the areas determined not to be in substantial compliance. The State agency must submit its PIP to the ACF Regional Office for approval within 90 calendar days from the date the State agency receives written notice from the ACF Regional Office that it is not operating in substantial compliance. This deadline may be extended an additional 30 calendar days when the State agency submits additional documentation to the ACF Regional Office for approval in support of cases determined to be in error as a result of the on-site eligibility review.
Review Oversample Plan (PIP)	The review oversample refers to the additional cases that are randomly selected for potential review to ensure that the required number of sample cases is examined for a primary or secondary review. At a minimum, a 10 percent oversample will be selected from the State's most recent AFCARS submission to the ACF Central Office. A case from the oversample is reviewed in lieu of a case from the original sample when the original sample case is included in the sample erroneously.
Review Sample Plan (PIP)	The review sample refers to the number of cases initially selected for a review and consists of the cases of children who received at least one title IV-E maintenance payment during the 6-month reporting period reflected in the State's most recent period of AFCARS data submission. A sample of 80 cases is selected for review during the primary review and a sample of 150 cases is selected for examination during the secondary review.
Secondary Review	The secondary review is conducted during the AFCARS reporting period that follows the PIP completion date. A sample of 150 cases is reviewed in a secondary review. These cases, plus at least a 10 percent oversample of 15 cases, are drawn from the State's most recent AFCARS data. No alternate data source may be substituted for the AFCARS for sample selection.
Secondary Review Extrapolation	When both the case error rate and dollar error rate of a secondary review exceed 10 percent, a disallowance will be based on extrapolation from the sample to the universe of claims paid for the duration of the AFCARS reporting period under review. The extrapolated disallowance is equal to the lower limit of a 90 percent confidence interval for the population's total dollars in error for the amount of time corresponding to the AFCARS reporting period.
Substantial Compliance	For the primary reviews, if the total number of error cases does not exceed four, the State will be considered to be in substantial compliance. For the secondary review, substantial compliance means that either the case error rate or dollar error rate does not exceed 10 percent.
Three-Year Cycle of Reviews	States that are determined to be in substantial compliance must undergo a subsequent review after 3 years. The cycle begins at the completion of the primary review. States that are not in substantial compliance also must undergo a subsequent review after 3 years. The cycle begins at the completion of the secondary review.
Underpayment	An underpayment is considered to have occurred when a title IV-E payment is not claimed, but may be claimed, for an allowable title IV-E activity or a period of eligibility.
Universe of Claims Paid	The universe of claims paid is the Federal share of title IV-E foster care maintenance payments and administrative costs for the period of the time that a case is in error. All title IV-E funds expended during the period of time the case is in error will be subject to disallowance, including funds for related administrative costs.
When Payments May Begin	Federal financial participation may begin the first day of placement in the month in which all required eligibility factors are satisfied. If eligibility is attained within a portion of the month, title IV-E payments may be claimed retroactive to the first day of the month. If a child is placed with a foster care provider on a date other than the first of the month, title IV-E funds must be claimed from the actual date of placement with the foster care provider.