Phase II Findings: Error Rate Methodology Pilot
Executive Summary, I. Introduction, II. Methodology, III. Measuring Improper Payments in Nine States, IV. Findings and Next Steps, V. Recommendations, Appendices: Appendix A: Arkansas, Appendix B: Colorado, Appendix C: Illinois, Appendix D: Ohio, Appendix E: Record Review Worksheet, Appendix F: Data Entry Form, Appendix G: Telephone Discussion Guide, Appendix H: Arizona, Appendix I: California, Appendix J: Kansas, Appendix K: Nebraska, Appendix L: New Hampshire
Appendix C: Illinois
SITE VISIT SUMMARY
Overview Illinois’s Child Care Program
The Illinois Department of Human Services Bureau of Child Care and Development (IDHS/BCCD) administers the Child Care Assistance Program (CCAP) in the 102 counties and 22 municipalities (populations greater than 30,000) that comprise the State of Illinois. In Federal Fiscal Year (FFY) 2004 the CCAP provided childcare assistance to over 300,000 children, 151,000 families, and 91,000 providers.
To be eligible for child care assistance, families must have income less than 50 percent of State Median Income (SMI) and live in Illinois, with children under the age of 13 years (or age 19 for special care needs) and be either employed or in an approved education and training activity, including teen parents. In Fiscal Year (FY) 2004, all eligible families applying for CCAP received services. There were no waiting lists in Illinois for FY 2004.
CCAP allows families the choice to select the childcare provider that best meets their needs. Parents may use licensed centers, licensed family childcare homes, and group homes as well as license exempt centers and homes. License exempt family childcare includes care supplied by relatives and friends that meet basic legal qualifications.
There are three provider reimbursement rate structures in the State. The rates have not increased in more than 4 years, and a recently conducted market rate survey may result in a rate increase in 2005 subject to budgetary considerations.
IDHS/BCCD contracts with 17 Child Care Resource and Referral (CCR&R) agencies that provide administrative service to more than 90 percent of CCAP clients. The CCR&R agencies are responsible for determining customer eligibility for CCAP and processing provider billings. CCR&R services also include outreach, information and referrals to families and providers, processing eligibility applications, determining eligibility and copayments, and processing provider payments.
One of the CCR&R’s, the McHenry County CCR&R, provides only resource and referral services to clients. The Community Coordinated Child Care CCR&R in DeKalb County processes applications, redeterminations, and certificates for their service delivery area.
The remaining ten percent of CCAP clients are serviced through the CCAP Site Administered program, which includes contracts with 90 agencies, including the City of Chicago’s Department of Children and Youth Services, to supply both administrative and direct services. Site Administered Program contractors provide slots for children of low-income families in licensed centers and homes, determine family eligibility, and calculate family copayments. Site Administered Program providers submit payment information to DHS for processing.
Improper Payment Process
CCR&Rs, Site Administered and State staff may identify inconsistencies when initially determining eligibility during the application process, or at the time of the redetermination. (Redetermination can occur at the every 3, 6, or 12 months depending on the case, or at anytime the CCR&R is aware of changes in the case status). IDHS/BCCD developed a Resource Guide to Determining Family and Provider Eligibility to provide assistance to staff in the determination of eligibility for difficult and challenging cases. Parents, neighbors, or the public will often notify the CCR&R or the State with an allegation of a suspected client or provider program violation. Reports generated from the Child Care Tracking System (CCTS) may also trigger a review or investigation of a client or provider. After investigation and supervisory review, referrals are made to IDHS/BCCD of any identified overpayments.
If client or provider overpayments occur, IDHS will pursue them through a variety of methods, including demand letters, tax intercepts, reductions in the CCAP payment for providers, and collection agencies. When a provider overpayment occurs, the IDHS notifies the provider and tries to arrange a repayment schedule. This can be a one-time repayment or, if the amount is too large, a negotiated repayment schedule.
The Program Integrity and Quality Assurance Unit monitors the CCAP program through regularly scheduled audits of the CCR&R CCAP units and the contracted Site Administered Program Providers.
CCAP’s automated computer program, the Child Care Tracking System (CCTS), generates numerous reports that can trigger further inquiry into a site or program. (A further explanation of these reports is contained later in this summary). The CCR&Rs are responsible for monitoring the performance of the providers that provide the actual childcare.
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