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The Office of Child Support EnforcementGiving Hope and Support to America's Children

Table of Contents

Office of Child Support Enforcement
FY 2009
Preliminary Report

May 2010

DEPARTMENT OF HEALTH AND HUMAN SERVICES
ADMINISTRATION FOR CHILDREN AND FAMILIES
OFFICE OF CHILD SUPPORT ENFORCEMENT

Program Highlights

The Office of Child Support Enforcement (OCSE) Preliminary Report highlights financial and statistical program achievements that occurred in fiscal year (FY) 2009. The information was compiled from State-submitted reports on program status sent to the Federal government on a quarterly and annual basis. The results indicate that $26.4 billion in child support payments was collected and distributed; $24.3 billion was distributed to families or Foster Care agencies; 1.8 million paternities were established and acknowledged; and 1.3 million child support orders were established. The downturn in the American economy, including an unemployment rate of over 9 percent, had an impact upon the child support collections contributing to a decrease in annual total collections for the first time in the history of the CSE Program.

Caseload. OCSE defines a child support case as a parent (mother, father, or putative father) who is now or eventually may be obligated under law for the support of a child or children receiving services under the Child Support Program, Title IV-D of the Social Security Act. A current assistance case is one in which the children are: (1) recipients of Temporary Assistance for Needy Families (TANF) under Title IV-A of the Social Security Act or; (2) entitled to Foster Care maintenance payments under Title IV-E of the Social Security Act. In addition, the children’s support rights have been assigned by a caretaker to the State and a referral to the State IV-D agency has been made. A former assistance case is a case in which the children were formerly receiving Title IV-A (AFDC or TANF) or Title IV-E (Foster Care) services. A never assistance case is a case in which the children are receiving services under the Title IV-D program, but are not currently eligible for and have not previously received TANF or Foster Care assistance. This includes cases in which the family is receiving child support services as a result of a written application (including cases in which children are receiving State, not Title IV-E, Foster Care services) or a case in which they are Medicaid recipients not receiving additional assistance.

There were 15.8 million cases in the Child Support Enforcement Program in FY 2009, an increase of 0.8 percent over the number of cases in the Child Support caseload in FY 2008. This represents the first increase in the caseload in two fiscal years. In FY 2009, there were 2.2 million current assistance cases, an increase of 6.4 percent from FY 2008; 6.9 million former assistance cases, a decrease of 2.8 percent from FY 2008; and 6.7 million never assistance cases reported, an increase of 2.9 percent from FY 2008 (Table P-3).

Paternities Established. Paternity establishment involves the legal establishment of fatherhood for a child. One way paternity can be established is by a voluntary acknowledgment signed by both parents as part of an in-hospital or other acknowledgment program.

In FY 2009, over 1.8 million paternities were established or acknowledged, of which 1.2 million involved in-hospital or other paternity acknowledgments. This represents a slight increase (.7%) over the number of paternities established in FY 2008.

Orders Established. In FY 2009, 1.3 million child support orders were established representing a 6.3 percent increase over the 1.2 million established in FY 2008 (Table P-3). This increase represents the largest increase in orders established since FY 1998 when the percentage was also 6.3 percent. In FY 2009, current assistance orders accounted for 18.0 percent of these orders, former assistance orders accounted for 32.0 percent, and never assistance orders accounted for 51.0 percent of the support orders established.

Collections Distributed. Total distributed child support collections amounted to $26.4 billion in FY 2009 (shown in Tables P-1, P-3, and P-4). This is a 0.7 percent decrease in comparison with the amount collected and distributed in FY 2008, which represents the first decrease in distributed collections in the history of the Child Support Program and also is attributed to the downturn in the American economy during FY 2009.

Collections Received. In FY 2009, child support continued to be received through different methods of collection, such as income withholding, unemployment compensation interception, and State or Federal tax refund offsets. Overall, 67.4 percent of payments were collected via income withholding; 5.3 percent from unemployment compensation; 6.9 percent from Federal and State tax offsets; 16.0 percent from other sources; 4.3 percent from other States, and 0.1 percent from other countries (Figure 6).

Collections per Full-Time Equivalent (FTE) Staff. There were 58,516 FTE staff working in the States and jurisdictions in the Child Support Enforcement Program in FY 2009 (Table P-2 and P-3), a 2.5 percent decrease in comparison with FY 2008. Nationally, the amount of child support collected per FTE was over $450,912 compared to the $443,000 per FTE in FY 2008.

Expenditures. Total administrative expenditures were $5.8 billion in FY 2009, a 0.4 percent decrease over those in the previous year (Table P-3). This is the first reduction in total administrative expenditures in the history of the Child Support Program. The Federal share of expenditures was $3.9 billion, and the State share was $2.0 billion (Table P-1).

Collections Due and Distributed. The total amount of current support due for FY 2009 was over $32 billion. About $20 billion or 62 percent of that amount was collected and distributed (Table P-17), an increase of 2.4 percentage points over the percentage of current support collected and distributed in FY 2008.

The total amount of arrearages reported for all previous fiscal years was over $107 billion and over $7 billion of these arrearages was collected and distributed in FY 2009, a decrease of 9.2 percent in comparison with the amount of arrears collected and distributed in FY 2008 (Table P-19). Over 11 million cases had arrears due and in FY 2009, over 7.2 million or 63 percent of these cases had collections (Tables P-20 and P-21). A slight increase was noted for total cases in which a collection was made. There were 8.9 million cases with collections, a 0.1 percent increase over cases with collections in FY 2008 (Table P-2 and P-3).

The number of cases with an order established in FY 2009 was 12.5 million, a 1.2 percent increase over the number of cases with orders established in the previous fiscal year (Table P-2 and P-3).

The number of children in the Title IV-D caseload in FY 2009 was 17.4 million, a 2.2 percent increase from the 17.0 million children in the Title IV-D caseload in FY 2008 (Table P-2 and P-3).

There were 36 comprehensive Tribal Child Support Enforcement Programs in FY 2009. These Tribes distributed over $19 million in collections in FY 2009 (Tables P-36 and P-37). This represented a 2.9 percent decrease from FY 2008. Collections sent to other States for Tribes in FY 2009 was over $4.9 million. Tribal total expenditures (outlays) were over $26 million in FY 2009, an increase of 48.9 percent over the previous year (Tables P-36 and P-39). There were 36,040 cases in the Tribal Program caseload (Tables P-36 and P-40), a 22.8 percent increase from FY 2008; over 19,000 children with paternity established (Tables P-36 and P-43), a 7.4 percent increase from FY 2008; and almost 18,000 support orders established (Tables P-36 and P-41), a 21.5 percent increase from FY 2008.

The attached tables and charts provide further preliminary detail regarding collections, expenditures, caseload, paternities, orders established, and other program statistics, related to both the Child Support Enforcement and Tribal Child Support Enforcement Programs for FY 2009 and for some prior years.

Note: The Child Support Performance and Incentive Act of 1998 (CSPIA) required the States to have complete and reliable data for purposes of computing incentives. Federal auditors begin their review of State data after the mandatory December 31st deadline for data submission. Readers should note that no determination or assumption has been made in this report regarding data reliability for each State for fiscal year 2009. The numbers are presented as submitted to OCSE.

SUMMARY TABLES FY 2009

NATIONWIDE, REGIONAL, AND STATE BOXSCORES FY 2009

Nationwide Boxscores
Nationwide Boxscores% change
from FY 08
Collections Distributed$26,385,592,827-0.7%
- Current Assistance$978,127,0900.0%
- Former Assistance$9,293,931,882-6.5%
- Never Assistance$11,936,424,5420.1%
- Medicaid Assistance$4,177,109,31312.2%
Total Expenditures$5,849,699,175-0.4%
Cost Effectiveness ($ Change)$4.78-$0.02
Paternities & Acknowledgements1,810,5640.7%
Orders Established1,267,4376.3%
Full Time Equivalent Staff58,516-2.5%
Total Caseload15,797,7680.8%
- Current Assistance2,179,6526.4%
- Former Assistance6,872,007-2.8%
- Never Assistance6,746,1092.9%
Net Undistributed Collections$588,520,419-16.4%
Arrears Amounts Due$107,638,651,6772.0%

Regional Box Scores

State Box Scores

CHARTS & GRAPHS FY 2009

Figure 1: The Child Support Caseload by Total, Current, Former, and Never Assistance and Percentages for Five Consecutive Fiscal Years

The data for figure 1 is after this graphic
Figure 1: The Child Support Caseload by Total, Current, Former, and Never Assistance and Percentages for Five Consecutive Fiscal Years
Year 2005 2006 2007 2008 2009

Source: Form OCSE-157 lines 1and 3

Total 15.9 15.8 15.8 15.7 15.8
Current Assistance 2.5 2.3 2.1 2.0 2.2
Former Assistance 7.3 7.3 7.2 7.1 6.9
Never Assistance 6.1 6.2 6.4 6.6 6.7
Current Assist. % 16% 15% 14% 13% 14%
Former Assist. % 46% 46% 46% 45% 43%
Never Assist. % 38% 39% 41% 42% 43%

In FY 2009, the total child support caseload increased to 15.8 million cases. This was due to an increase in current assistance and never assistance cases. Families formerly on public assistance and never assistance cases share an equal portion of the caseload.

Figure 2: Number and Percentage of Child Support Cases With and Without Support Orders Established for Five Consecutive Fiscal Years

The data for figure 2 is after this graphic
Figure 2: Number and Percentage of Child Support Cases With and Without Support Orders Established for Five Consecutive Fiscal Years
Year 2005 2006 2007 2008 2009

Source: Form OCSE-157 lines 1and 2

Total Caseload 15.8 15.8 15.7 15.6 15.7
With Orders 12.0 12.2 12.3 12.3 12.5
Without Orders 3.8 3.6 3.4 3.3 3.2
With Orders % 76% 77% 78% 79% 79%
Without Orders % 24% 23% 22% 21% 21%

Although the total child support caseload increased in FY 2009, the percentage of cases with and without orders remained unchanged.

Figure 3: Number of Cases for Which a Collection Was Made by Current, Former, and Never Assistance for Five Consecutive Fiscal Years

The data for figure 3 is after this graphic
Figure 3: Number of Cases for Which a Collection Was Made by Current, Former, and Never Assistance for Five Consecutive Fiscal Years
Year 2005 2006 2007 2008 2009

Source: Form OCSE-157 line 18

Total 8.3 8.5 8.7 8.9 8.9
Current Assistance 0.8 0.7 0.7 0.7 0.7
Former Assistance 3.9 4.0 4.0 4.1 4.0
Never Assistance 3.6 3.8 4.0 4.1 4.2

At 8.9 million, the number of IV-D cases for which a collection was made remained unchanged in FY 2009.

Figure 4: Paternities Established or Acknowledged for Five Consecutive Fiscal Years

The data for figure 4 is after this graphic
Figure 4: Paternities Established or Acknowledged for Five Consecutive Fiscal Years
Year 2005 2006 2007 2008 2009

Source: Form OCSE-157 lines 10 and 16

1 Includes in-hospital and other paternities acknowledged. Paternity acknowledgements include an unknown number of acknowledgements for children in the IV-D caseload.

Paternity Established 690 675 640 629 643
Paternity Acknowledged1 950 1,026 1,089 1,168 1,167
Total 1,639 1,701 1,729 1,797 1,811

In FY 2009, a total of 1.8 million paternities were established and acknowledged - largely through in-hospital and other acknowledgement programs.

Figure 5: Percentage of Collections Distributed to Current, Former, Never, and Medicaid Assistance Cases, FY 2009

The data for figure 5 is after this graphic
Figure 5: Percentage of Collections Distributed to Current, Former, Never, and Medicaid Assistance Cases, FY 2009
  Percentage Amount Collected

Source: Form OCSE-34A line 8

Medicaid 16% $4.2 billion
Current Assistance 4% $978 million
Former Assistance 35% $9.3 billion
Never Assistance 45% $11.9 billion

Most child support collections were made for families who were never on assistance. Former assistance and never assistance families combined received 80 percent of the child support collections in FY 2009.

Figure 6: Total Child Support Collections Received by Methods of Collections, FY 2009

The data for figure 6 is after this graphic
Figure 6: Total Child Support Collections Received by Methods of Collections, FY 2009
  Percentage Amount Collected

Source: Form OCSE-34A lines 2a thru 2h

2 Income withholding includes some collections from non-IV-D families.

3 Other sources include but are not limited to administrative enforcement in interstate (AEI) cases; payments received directly from non-custodial parents; collections received through the IRS' full collection process; collections received as a result of the administrative offset process; and collections received through the Financial Institution Data Match.

Other Countries 0.1% $242 million
Income Withholding2 67.4% $21.4 billion
Unemployment Intercept Offsett 5.3% $1.7 billion
Federal Tax Offset 6.2% $2.0 billion
State Tax Offsett 0.7% $221 million
Other Source3 16.0% $5.1 billion
Other States 4.3% $1.4 billion

Income withholding continues to be the most effective way of collecting child support.

Figure 7: Percentage of Net Undistributed Collections (UDC) by Category and Age, FY 20094

4 Net UDC is the amount of collections that remained undistributed at the end of the previous quarter.

The data for figure 7a is after this graphic
Figure 7a: Percentage of Net Undistributed Collections (UDC) by Category, FY 2009
Net UDC By Category Percentage

Source: Form OCSE-34A, Part 2, lines 3-7 and 9-13

Other 9%
Past 2 Business Days 8%
Tax Offset held up to 6 mos 32%
Held for Future 21%
Legal Dispute & other State 6%
Unidentified 2%
Location of CP or NCP 8%
Uncashed 4%
Missing info 10%
The data for figure 7b  is after this graphic
Figure 7b: Percentage of Net Undistributed Collections (UDC) by Category and Age, FY 2009
Net UDC By Age Percentage

Source: Form OCSE-34A, Part 2, lines 14-20

Greater than 5 years 4%
Less than or equal to 2 days 12%
Greater than 2 days and less than or equal to 30 days 30%
Greater than 30 days and less than or equal to 6 months 39%
Greater than 6 months and less than or equal to 1 year 5%
Greater than 1 year and less than or equal to 3 years 7%
Greater than 3 years and less than or equal to 5 years 3%

Tax offset held up to 6 months continues to be the largest component of the undistributed collections by category in FY 2009.

Figure 8: Total Administrative Expenditures for Five Consecutive Fiscal Years

The data for figure 8 is after this graphic
Figure 8: Total Administrative Expenditures for Five Consecutive Fiscal Years
Year 2005 2006 2007 2008 2009

Source: Form OCSE-396A line 9, column A, B, C, D
Beginning in FY 2008, Form OCSE-396A line 7, column A, B, C, D

Total $5.3 $5.6 $5.6 $5.9 $5.8
Federal Share $3.5 $3.7 $3.7 $3.7 $3.8
State Share $1.8 $1.9 $1.9 $2.2 $2.0

The Federal share of total administrative expenditures increased by 5.4% in FY 2009, while the State share of total administrative expenditures decreased by 9.0%.

Figure 9: Total Automated Data Processing (ADP) Expenditures for Five Consecutive Fiscal Years

The data for figure 9 is after this graphic
Figure 9: Total Automated Data Processing (ADP) Expenditures for Five Consecutive Fiscal Years
Year 2005 2006 2007 2008 2009

Source: Form OCSE-396A, lines 4, 5, and 6, column A+C

Total $835 $876 $862 $925 $773

Automated Data Processing (ADP) expenditures decreased 16.4% percent from FY 2008 to FY 2009.

Figure 10: Total Number of Children in the IV-D Program for Five Consecutive Fiscal Years

The data for figure 10 is after this graphic
Figure 10: Total Number of Children in the IV-D Program for Five Consecutive Fiscal Years
Year 2005 2006 2007 2008 2009

Source: Form OCSE-157, line 4

Total 17,173,286 17,261,575 17,121,013 17,031,940 17,413,972

In FY 2009, the number of children in the child support program increased by 2.2 percent over the previous year.

Figure 11: Number of Unique Persons Matched and Number of Persons in the Federal Case Registry by Participant Type for Five Fiscal Years

The data for figure 11a is after this graphic
Figure 11a: Number of Unique Persons Matched for Five Fiscal Years
Year 2005 2006 2007 2008 2009

5 The Number of Unique Persons (NCPs and PFs) Matched is derived by unduplicating SSNs located across all data types (W-4, QW, and UI).

Number of Unique Persons Matched5 (Millions) 4.7 5.0 (+6%) 4.9 (-1%) 4.9 (0%) 4.8 (-3%)
The data for figure 11b is after this graphic
Figure 11b: Number of Persons in the Federal Case Registry by Participant Type for Five Fiscal Years
Type of Participant6 Number of People (Millions)

6 The figures for the individual participant types are unduplicated within that category but not between them--i.e., an individual may appear in more than one category, but is only counted once within that category.

Noncustodial Parents 12.2 Million
Putative Fathers 1.3 Million
Custodial Parties 13.4 Million
Children 21.0 Million

The number of unique persons matched decreased by 0.3 percent between FY 2008 and 2009. Children make up the largest portion of the participant types.

Figure 12: Federal Offset Collections for Five Processing Years

The data for figure 12 is after this graphic

Figure 12: Federal Offset Collections for Five Processing Years
Processing Year Total Net Collections (Billions)

7 The Deficit Reduction Act of 2005 allowed States to certify nearly 1 million additional non-TANF debts in PY 2008 that were previously not eligible for tax refund offset. It is estimated that this resulted in at least an additional $200 million collected. The Economic Stimulus Act of 2008 provided economic stimulus payments of up to $600 ($1,200 if filing a joint return, plus additional amounts for each qualifying child), to be made to over 130 million American households. These payments were eligible for tax refund offset and resulted in an additional $863 million in collections in PY 2008.

8 The American Recovery and Reinvestment Act of 2009 provided one-time Economic Recovery payments (ERP) of $250 to an estimated 60 million recipients of Social Security (SSA), Supplemental Security Income (SSI), Railroad Retirement Benefits (RRB), and Veterans' Disability Compensation or Pension Benefits. These payments were eligible for administrative offset and resulted in an additional $111 million in collections in PY 2009.

2005 $1.58
2006 $1.60 (+1.0%)
2007 $1.69 (+5.8%)
2008 $2.85 (+68.4%)7
2009 $2.19 (-23.2%)8

Federal Offset collections for 2009 were $2.19 billion, a 23.2 percent decrease over the previous year.

Appendix

Incentive Formulas

CSPIA Incentive Measure Formulas
INCENTIVE MEASURE FORM AND LINE NUMBERS
PATERNITY ESTABLISHMENT PERCENTAGE (PEP): IV-D
Number of Children in the Caseload in the FY or as of the End of the FY Who Were Born Out-of-Wedlock with Paternity Established or Acknowledged
divided by
Number of Children in the Caseload as of the End of the Preceding FY Who Were Born Out-of-Wedlock
OCSE-157, Line 6
divided by
OCSE-157, Line 5a
PATERNITY ESTABLISHMENT PERCENTAGE (PEP): STATEWIDE
Number of Minor Children in the State Born Out-of-Wedlock with Paternity Established or Acknowledged During the FY
divided by
Number of Children in the State Born Out-of-Wedlock During the Preceding FY
OCSE-157, Line 9
divided by
OCSE-157, Line 8a
SUPPORT ORDER ESTABLISHMENT
Number of IV-D Cases with Support Orders
divided by
Number of IV-D Cases
OCSE-157, Line 2
divided by
OCSE-157, Line 1
CURRENT COLLECTIONS
Amount Collected for Current Support in IV-D Cases
divided by
Amount Owed for Current Support in IV-D Cases
OCSE-157, Line 25
divided by
OCSE-157, Line 24
ARREARAGE COLLECTIONS
Number of IV-D Cases Paying Toward Arrears
divided by
Number of IV-D Cases with Arrears Due
OCSE-157, Line 29
divided by
OCSE-157, Line 28
COST-EFFECTIVENESS
Total IV-D Dollars Collected
divided by
Total IV-D Dollars Expended
OCSE-34A, Lines 4b + 4c + 8 + 11 of column (G)
divided by
OCSE-396A, Line 7 columns (A) + (C)
less Line 1(c) columns (A) + (C)
STATE COLLECTION BASE
2 times (Current Assistance + Former Assistance Collections + Medicaid Assistance)
+ Never Assistance Collections
+ Fees Retained by Other States
OCSE-34A:
2 times ((Line 4b, columns A+B+C+D+E)
+ (Line 8, columns A+B+C+D+E))
+ Line 4b, column F + Line 8, column F
+ Line 4c + 11 of column G

How an Incentive Payment is Determined

Because of the complexity of the incentives formula set forth in section 458 of the Social Security Act, we have included an example of how the system would work in a particular year for State A. Let’s make the following assumptions regarding State A (See Table A):

Table A

Table A
Measure State A’s
Performance Level
Applicable Percent
based on
Performance
Weight State A’s
Collection Base
(assumed to be
$50,000,000)
Paternity Establishment 93% 100% 1.00 $50,000,000
Order Establishment 74% 88% 1.00 $44,000,000
Current Collections 59% 69% 1.00 $34,500,000
Arrearage Collections 60% 70% 0.75 $26,250,000
Cost-Effectiveness $4.40 80% 0.75 $30,000,000
State A’s Maximum Incentive Base Amount $184,750,000

Table B

Table B
State Maximum Incentive
Base Amounts
State’s Share
of $318,750,000
Incentive Payment
Pool $461,000,000
A $184,750,000 0.58 $267,199,216
B $84,000,000 0.26 $121,487,059
C $50,000,000 0.16 $72,313,725
Totals $318,750,000 1.00 $461,000,000

Table C[3]

If the Paternity Establishment or Support Order Performance Level Is:

Performance Levels
At Least: But Less
Than:
The Applicable
Percentage Is:
At Least: But Less
Than:
The Applicable
Percentage Is:
80% 100% 64% 65% 74%
79% 80% 98% 63% 64% 73%
78% 79% 96% 62% 63% 72%
77% 78% 94% 61% 62% 71%
76% 77% 92% 60% 61% 70%
75% 76% 90% 59% 60% 69%
74% 75% 88% 58% 59% 68%
73% 74% 86% 57% 58% 67%
72% 73% 84% 56% 57% 66%
71% 72% 82% 55% 56% 65%
70% 71% 80% 54% 55% 64%
69% 70% 79% 53% 54% 63%
68% 69% 78% 52% 53% 62%
67% 68% 77% 51% 52% 61%
66% 67% 76% 50% 51% 60%
65% 66% 75% 0% 50% 0%

Table D[4]

If the Current Collections or Arrearage Collections Performance Level Is:

Performance Levels
At Least: But Less
Than:
The Applicable
Percentage Is:
At Least: But Less
Than:
The Applicable
Percentage Is:
80% 100% 59% 60% 69%
79% 80% 98% 58% 59% 68%
78% 79% 96% 57% 58% 67%
77% 78% 94% 56% 57% 66%
76% 77% 92% 55% 56% 65%
75% 76% 90% 54% 55% 64%
74% 75% 88% 53% 54% 63%
73% 74% 86% 52% 53% 62%
72% 73% 84% 51% 52% 61%
71% 72% 82% 50% 51% 60%
70% 71% 80% 49% 50% 59%
69% 70% 79% 48% 49% 58%
68% 69% 78% 47% 48% 57%
67% 68% 77% 46% 47% 56%
66% 67% 76% 45% 46% 55%
65% 66% 75% 44% 45% 54%
64% 65% 74% 43% 55% 53%
63% 64% 73% 42% 43% 52%
62% 63% 72% 41% 42% 51%
61% 62% 71% 40% 41% 50%
60% 61% 70% 0% 40% 0%

Table E[5]

If the Cost-Effectiveness Performance Level Is:

Cost-Effectiveness Performance Levels
At Least: But Less
Than:
The Applicable
Percentage Is:
5.00 100%
4.50 4.99 90%
4.00 4.50 80%
3.50 4.00 70%
3.00 3.50 60%
2.50 3.00 50%
2.00 2.50 40%
0.00 2.00 0%

Table F

Incentive Pool Payment, FY 2000-2009

The incentive payment pool is:

The incentive payment pool after FY 2008 is the amount of the incentive payment pool for the preceding FY, multiplied by the percentage by which the CPI for that preceding FY exceeds the CPI for the second preceding FY.

The CPI for a FY is the average of the CPI for the 12 month period ending on Sept. 30 of the FY. The CPI means the last CPI for all-urban consumers published by the United States Department of Labor. The NOT seasonally adjusted CPI numbers are used.

The percentage increase between the preceding FY (FY 2008) and second preceding FY (FY 2007) is about 4.44%. So, $483 million (the FY 2008 incentive pool amount) plus 4.44% equals about $504 million (the FY 2009 incentive pool amount).


[1]Because the measure has less weight.

[2]Use this table to determine the maximum incentive levels for the paternity establishment and support order performance measures.

[3]Use this table to determine the maximum incentive levels for the current and arrearage support collections performance measures.

[4]Use this table to determine the maximum incentive level for the cost-effectiveness performance measure.


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