Child Care Bureau: CCDF: Measuring Improper Payments in the Child Care Program

Second Error Rate Pilot Report

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APPENDIX K. Summary of Pilot Study States

Summary Topic	States Participating in First Pilot				States Participating in Second Pilot
Summary Topic	Arkansas	Colorado	Illinois	Ohio	Florida	Kansas	New Jersey	Oregon	West Virginia
State Structure	State administered	County administered, State supervised	State administered	County administered, State supervised	State administered	State administered	County administered, State TANF supervised	County administered, State supervised	State administered
Improper Payment Defined	Administrative Policy (Only misrepresentation in statute)	Administrative Policy	Administrative Policy	Policy (Only loosely defined)	General, not established in state policy	Administrative Policy	Administrative Policy	Administrative Policy	Administrative Policy
Improper Payments Processes	Complaints or calls to the agency Worker reviews Supervisory reviews Random provider reviews Unannounced visits Annual audits	Complaints or calls to the agency Counties investigate first Office of Program Improvement involved if necessary	Complaints or calls to the agency Program Integrity and Quality Assurance Unit conducts regularly - scheduled audits	Complaints or calls to the agency Some counties have regular supervisor reviews Counties conduct monitoring reviews, State follows-up	Technical assistance provided local staff Annual monitoring plan of all ELCs Monthly invoice reviews	Complaints from the public Review attendance sheets in the field Field staff review Inclusion of child care in QC review process	Case review of a sampling of cases Internal controls for monitoring vouchers	Hotline number Improper Payments staff Monthly desk audit of 200 randomly selected billing forms	Policy Specialist provides technical assistance to CCR&Rs Case review of a sampling of cases Two staff provide technical assistance to CCR&Rs
Assessment of Risk	Compliance Review Team Data mining Benchmark reporting Exception reporting	Office of Program Improvement Ad hoc studies Counties monitor improper payments Special studies	Reliance on exception reporting Ongoing training	State visits each county twice during a 15-month period Incident Tracking system of injury to a child in care	Field staff review local financial & program operations Exception reports Local Ad hoc report writing capability	Exception reports generated from automated systems Audits based on department request	Data Matching Exception reports generated from CARES and OMEGA systems Quality Assurance committee	Exception reports Monthly match with, Food Stamps and Medicaid files Child care reviews with Food Stamp reviews	FACTS edits identify anomalies Mandatory CCR&R Quality Assurance Plans
Automation	New system Up-front edits Interface with TANF, Food Stamps, child support	Mainframe statewide system that must be used Most counties have own systems	Mainframe system Interface with TANF, Food Stamps, child support Up-front edits Billing process is automated for CCR&Rs and will soon be for contract providers	Mainframe system Interface with TANF, Food Stamps, child support Up-front edits, but eligibility determination is not automated	Enhanced Field System (EFS) makes payments Eligibility determination module EFS has edits for age, atten-dance,and payment rate.	Mainframe system Interface with TANF, Food Stamps, child support Up-front edits, eligibility determination is not automated EBT for billing	Mainframe system Eligibility determination, subsidy and co-pay calculation, voucher generation, attendance, check write process	Mainframe legacy system Eligibility determination Interface with SAS payment system	Web based SACWIS system. Eligibility processing with eligibility and payment edits. Connectivity with the public assistance eligibility system (RAPIDS) Payment Processing

Summary Topic	States Participating in Discussions²²
Summary Topic	Arizona	California	Nebraska	New Hampshire
State Structure	State-administered	County-administered, State-supervised	State-administered	State-supervised
Improper Payment Defined	Statute	Statute	Policy (Only IPV in Statute)	State Plan
Improper Payments Processes	Complaints or calls to the agency Monthly supervisory-level case reviews Annual case reviews Audits of provider records	Complaints or calls to the agency Improper Payment Unit established Annual audits	Complaints or calls to the agency Issuance and Collection Center Unit audits child care	Complaints or calls to the agency Task Force for Improper Payments established across program areas
Assessment of Risk	Exception reports	Improper Payments Unit	Exception reports Attorney is assigned to child care	Developing queries for error-prone profiling Educating providers to encourage referrals Establishing Internet billing Developing automated exception reports
Automation	Mainframe system Interface with TANF, Food Stamps, child support	No State automated system, only aggregate data collected to meet Federal requirements Many counties have their own automated systems	Mainframe system Integrated with TANF, Food Stamps, child support Eligibility calculated off-line	New system Up-front edits System integrated with TANF, Food Stamps, child support Interfaces to most other systems

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²² In the first pilot, the team conducted telephone discussions with five additional States—Arizona, California, Kansas, Nebraska, and New Hampshire—to gather information about the States’ policies and practices regarding child care improper payments. Return to text.

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June, 2007