State Survey Analysis Report
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APPENDIX 20. MEASURES TAKEN TO PREVENT COLLUSION
20. What measure does your agency take to prevent collusion?
| 24 State agencies responded to Question 20 (Appendix 20: pp.123–126) | |
| State | Measures taken to prevent collusion |
|---|---|
| Alabama | Where possible the caseworker who interviews client and assign provider to child does not process payment to the provider. |
| Arizona | CCA has several safeguards in place concerning payment processes and providers. The AzCCATS (Arizona Child Care Automated Tracking System) assigns and tracks security levels in the automated system as controls for the administration. The security levels limit system access (examples would include a limited number of staff with access to load provider contracts, and limited number of staff with access to the payment module). In addition, the security levels separate any staff from having the ability to create a provider contract and the ability to reimburse the provider on that contract. There is a systematic separation between the eligibility, provider contract and payment modules. Security levels for the Child Care Administration are monitored and evaluated on an on going basis. CCA Policy Unit and Provider Contracts staff routinely define specifications for reports as needed to: • Compare information across program lines, • Identify suspect patterns of usage and billing, and • Identify inconsistencies in case processing that warrant further review. |
| California (DE) | The CCDF agency issued two reports in the last year recommending best practices for local agency internal controls designed to prevent local agency employees from colluding with clients and/or providers. The CCDF agency prevents successful collusion between parents and providers by establishing clear procedures for documenting the schedule of the parent’s work activity, updating that schedule as appropriate, and ensuring that payments cover only those hours of child care that correspond to the parent’s work activity schedule. |
| California (DSS) | Prevention of collusion measures are determined at the county level, but the definition and penalties are set out in statute (Penal Code §182). Please go to http://www.leginfo.ca.gov and click on “California Law” to access the code section. |
| Connecticut | Internal Program – Appropriate separation of duties to prevent eligibility staff from generating payments. Systems have multiple security levels and automatic log-off provisions. All system transactions are tracked. The assigned code of the individual completing the transaction is automatically recorded. Published rules prevent staff from working on cases of individuals known or related to them, or employees that may receive benefits from the program. Care is taken to avoid assigning cases from the area where the worker lives. Control reports and supervisory reviews. Clients/providers – Staff perform name checks and review selected data from on-line and matching data interfaces, including TANF, Medical Assistance, AABD and Food Stamps, Child Support, DMV and DOL records, DCF records, Public Health licensing data, NACCRRA. We look specifically for relationships, address and associations recorded in other databases. TIN matching and complaints resulting from filing W-2 forms have been particularly helpful in uncovering problems with unregulated providers. |
| District of Columbia | The ECEA has developed Attendance Policies and Procedures for the providers to follow for maintaining and reporting accurate attendance for the DHS children enrolled. The providers are trained on the policies and procedures. The program monitors complete an on site attendance review during each provider agreement period. NOTE: The agreement period is 12 months. The provider’s roll book/attendance sheets are compared to the pay statement for accuracy in payment for a designated month. The program monitor will share the findings with the provider and leave a deficiency list stating the out of compliance areas and timetable for correction. The program monitor will submit a copy of the attendance review to the ECEA Intake and Continuing Services Unit Supervisor to take appropriate action on all accurate payments. The Intake and Continuing Services Unit will provide a copy of the actions completed in the inaccurate payments to the Supervisory Program Monitor. The program monitor shall follow up on all deficiencies to ensure compliance with the ECEA Attendance Policies and Procedures. |
| Georgia | Red flag training for line staff to identify possible fraudulent activities, record reviews, identification of suspected collusion or fraud by our outside contractor that issues payments. |
| Kansas | Kansas requires hard copy verification of child care hours needed before a plan is written. This documentation is most often in the form of an employment verification which is filled out by an employer of the customer. For work program purposes the case manager knows the number of hours the client will be in the work program and sets child care hours according to that need. The State’s EBT payment system also dramatically reduces the potential for collusion as transactions must be done electronically and via direct deposit into the provider’s account. In addition, the State mandates that the parent establish a FEIN for all in-home care situations in order to pay Social Security taxes on behalf of the provider. |
| Kentucky | Contract Eligibility with review by Supervisor. Perform Payments internally with aid of 3 separate State Agencies/Department with review by supervisors in each Office. |
| Maryland | The informal relationship and location of care is declared prior to payment for informal providers. In the event that fraud is suspected, a request for investigation is forwarded to OIG. |
| Massachusetts | EEC maintains internal controls that have secondary review at all levels. Child care providers are required to implement and maintain internal controls in accordance with generally accepted accounting principles to ensure that Commonwealth funding is spent appropriately. |
| Minnesota | Minnesota Statutes 256.98 makes it a criminal offense and are subject to the same program disqualifications as others who wrongfully obtain public assistance. The act and penalty of collusion is included in the Rights and Responsibilities of the Child Care Application. |
| Mississippi | The MS Dept. of Human Services maintains penalty and debarment procedures in its standard Subgrantee/Contract Manual Revised March 2005. As this document is considerable in content, please refer to the official MDHS Web site: http://www.mdhs. State.ms.us/dpi_subman.htm |
| Montana | Each CCR&R is required by contract with ECSB to have an Internal Management Plan (IMP). Included in the IMP is specific language regarding conflict of interest and internal fraud. The contract requires that each agency adopt language in their IMPs that States: “Conflict of Interest - All staff who conduct any portion of their work for the Family Services section of the PMP, are not allowed to own, operate or work-in a licensed/registered child care facility or provide LUP/LUI services. All staff who work 20 hours or more per week for the Provider Services section of the PMP, are not allowed to own or operate a licensed/registered child care facility.” “Internal Fraud – Internal controls that include a system of checks and balances in areas of child care eligibility determination and payment processing, and contract management to protect against employee fraud. The Department requires that at least 10% of each eligibility worker’s case load is monitored and documented internally.” In addition to IMP procedures, the State has set up some controls in the payment of invoices (warrants) and in the approval of providers, in CCUBS. Payment of Invoices – In each CCR&R if a provider is requesting more than 110% on an Invoice (warrant), the CCUBS system will require a supervisor approval on the Invoice. This 2-person approval process, allows the CCR&R to be sure that the amount of the provider request is appropriate. Registered/Licensed Providers – For the CCUBS system to release a payment a provider must be approved and have a current registration/license. A Providers application is reviewed, imputed into the CCUBS system, and approved by licensing workers. The program supervisor then has final registration/licensing approval. Two approvals are always required and cannot be the same person. |
| Nebraska | When we have clear evidence that the provider and client/parent were in collusion, we pursue both for overpayments and sanctions. This sends a signal to the provider and client community that we monitor. |
| New Hampshire | There are currently no formal measures in place to prevent collusion between client and child care provider. There was a rule change in July 2005 regarding child care eligibility if the recipient/client is self employed as a child care provider. The adopted language is as follows: “When the individual is employed solely as a license exempt child care provider, there shall be no eligibility for child care assistance for his/her child(ren) who reside with him/her.” |
| North Carolina | All recipients and providers are given information about the consequences of misrepresentation to obtain services or payments, failure to provide accurate information, or notify the LPA of changes that may impact eligibility or payment rate. All recipients and providers are required to sign documents acknowledging they received and understand the information. Also, some LPA staff conduct intensive screenings prior to approving family for services. |
| Ohio | None, however, county agencies might have steps in place. |
| Oklahoma | Use of EBT system for child care time and attendance tracking and payments. Training of clients and providers |
| Puerto Rico | Segregation of Duties Creation of the Monitory Division |
| Utah | This is not actively pursued. If it is determined that collusion occurred, an overpayment will be looked at for both the parent and the provider. This may or may not be fraud. |
| Washington | There is a separation of duties. One group of staff authorize child care payments. Once authorized, there is a reconciliation process conducted by other staff. This lessens the possibility of collusion. |
| West Virginia | Please see the answers to questions 5, 13, 14, 17, and 21 |
| Wisconsin | I don’t know that we do a lot to prevent collusion other than our process to establish an eligible case requires that the people really exist. Providers are required to be regulated and their data comes from the regulatory databases – so we know that the providers are real. |
| Those that did not provide an answer: | |
| Missouri | |
Appendix 21 >>