5101:2-16-71 Child care improper payments.

(A) Improper child care payments may include:

(1) Child care benefits received by a caretaker for which the caretaker was not eligible, and for which the child care provider has been paid. The caretaker shall repay the county department of job and family services (CDJFS) for these improper payments.

(2) Child care payments made to a child care provider for which the provider was not entitled. The provider shall repay the Ohio department of job and family services (ODJFS) for these improper payments.

(B) Improper child care payments may occur as a result of any of the following:

(1) An error on the part of the caretaker and/or the provider or the caretaker's and/or the provider's intentional withholding or falsification of information or misuse of child care services.

(2) Misuse of the Ohio electronic child care (Ohio ECC) by the caretaker or provider as described in division (D) of section 5104.32 of the Revised Code:

(a) Provider's use or possession of an Ohio ECC card issued to a caretaker.

(b) Falsification of attendance records.

(c) Knowingly seeking payment for care not provided.

(d) Knowingly accepting payment for care not provided.

(3) Receipt of child care benefits by a caretaker pending the outcome of a state hearing or receipt of child care benefits by a provider pending the outcome of a county conference.

(4) An error by the CDJFS or ODJFS.

(C) The CDJFS shall include benefit repayment procedures for caretakers within its agency plan for the recovery of any identified improper payments pursuant to paragraph (B) of this rule, including category of authorization errors and determination of copayment errors. These procedures shall include all of the following:

(1) A requirement for sending the caretaker notice of the determined repayment amount using the JFS 01151 "Notice of Child Care Benefit Repayment Requirements for Caretakers" (rev. 2/2014).

(2) A requirement for when cases will be referred to the county prosecutor.

(3) The CDJFS shall report payments received from caretakers in the county finance information system (CFIS).

(D) The CDJFS shall propose termination of child care benefits if the caretaker fails to enter into or comply with an agreement to repay a child care improper payment , and shall issue the appropriate hearing notice pursuant to division 5101:6 of the Administrative Code . Ineligibility for child care benefits shall continue until the caretaker complies with an agreement to repay the determined amount.

(E) The CDJFS shall recover child care overpayments from providers if the overpayment is the result of CDJFS data entry errors for payment age-categories for publicly funded child care including manual claims or payment adjustments. The CDJFS shall:

(1) Send the provider notice of the determined overpayment using the JFS 01172 "County Notice of Child Care Overpayment and Repayment Requirements for Child Care Providers" (2/2014).

(2) Complete the payment adjustment process to recover the determined overpayment amount in accordance with ODJFS procedures.

(3) Refer all cases not able to be recovered through the payment adjustment process to ODJFS.

(F) The CDJFS shall initiate the following procedures if a provider fails to repay a child care overpayment within the time frame established in the JFS 01172.

(1) If the provider is certified by the CDJFS, the CDJFS shall revoke the provider's certificate according to rule 5101:2-14-35 of the Administrative Code. The provider shall not be eligible for certification for at least five years from the revocation date. Denial of certification shall continue after the five-year period, if necessary, until full repayment is made.

(2) If the provider is licensed by ODJFS or the Ohio department of education (ODE), is an out-of-state provider, or is an approved child day camp, the CDJFS shall notify ODJFS.

(G) The CDJFS, in cooperation with the county prosecutor, shall develop and implement procedures for the investigation and/or prosecution of alleged child care fraud and the recovery of child care overpayments from caretakers . The CDJFS shall update these procedures as necessary.

(H) If a provider does any of the following, the provider shall comply with all repayment requirements of ODJFS:

(1) Submitted inaccurate attendance data.

(2) Withheld information or provided false information to ODJFS or the CDJFS.

(3) Missused Ohio ECC as defined in divison (D) of section 5104.32 of the Revised Code and paragraph (B)(2) of this rule.

(I) Fraud is the willful withholding or falsification of information, or the misuse of child care services by the caretaker and/or the provider with an intent to deceive or defraud, resulting in the acceptance of or the delivery of services, and/or the receipt of payment for which the caretaker and/or provider are not entitled, as determined by a court of law.

(1) If the caretaker has been convicted of fraud, as determined by a court of law, or if the caretaker admits to the CDJFS to knowingly receiving child care benefits for which the caretaker was not eligible, the CDJFS shall terminate child care benefits. Ineligibility for subsidized child care shall continue until full repayment has been made. All appropriate provisions of the state hearing notice as required in division 5101:6 of the Administrative Code must be followed.

(2) The CDJFS shall notify ODJFS to request the termination of the provider agreement if a provider has admitted to committing fraud or has been convicted of fraud, as determined by a court of law.

(3) If a child care provider has pleaded guilty to committing fraud or has been convicted of fraud, as determined by a court of law:

(a) If the provider is a certified in-home aide, the CDJFS shall revoke the certificate according to procedures set forth in rule 5101:2-14-35 of the Administrative Code.

(b) If a provider is a licensed type B home, the CDJFS shall recommend revocation of the license to ODJFS pursuant to rule 5101:2-14-04 of the Administrative Code.

(c) If the provider is a licensed child care center or a type A home, or an approved child day camp, the CDJFS shall notify ODJFS.

Effective: 05/04/2014
R.C. 119.032 review dates: 02/11/2014 and 05/01/2019
Promulgated Under: 119.03
Statutory Authority: 5104.38
Rule Amplifies: 5104.37 , 5104.38
Prior Effective Dates: 6/3/96, 10/1/97 (Emer.), 12/30/97, 1/1/02, 2/1/07, 7/1/08, 3/28/2010, 8/28/11