LAW
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Ohio Laws and Rules
(A) Child care providers and caretakers are responsible for making an accurate, complete and timely disclosure of all information necessary for the county department of job and family services (CDJFS) to determine the following:
(1) The caretaker’s eligibility for child care benefits, which includes authorized hours for child care services, and a copayment.
(2) Reimbursement for the provider.
(B) A child care improper payment is:
(1) Child care benefits received by a caretaker but for which the caretaker was not eligible, and for which the CDJFS has reimbursed the child care provider. Child care benefits include child care services received by the caretaker, the caretaker’s monthly child care copayment, and other fees paid erroneously by the CDJFS but owed by the caretaker. The caretaker is responsible for repayment of the overpayment to the CDJFS.
(2) Child care payments made the CDJFS to a child care provider for which the provider was not entitled. The provider is responsible for repayment of the overpayment to the CDJFS.
(C) Child care overpayments may occur as a result 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 of falsification of information or misuse of child care services.
(2) Billing for inappropriate services by the provider.
(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.
(D) The CDJFS is responsible for ensuring that the caretaker receives a complete written explanation regarding the following:
(1) Procedures for application and determination of eligibility.
(2) Factors which determine eligibility such as, family income, family size, ages of family members and the caretaker’s hours of employment, training or education.
(3) The caretaker’s responsibility for reporting changes of information which affect eligibility, in accordance with rule 5101:2-16-35 of the Administrative Code.
(4) The consequences to the caretaker of failure to accurately and completely report information or changes. These consequences may include:
(a) An overpayment of child care benefits which the caretaker received but for which the caretaker was not eligible.
(b) Termination or denial of child care benefits.
(c) Penalty of fine and/or imprisonment if a court action renders a finding that the caretaker fraudulently received child care benefits for which the caretaker was not eligible.
(E) The CDJFS is responsible for ensuring that child care providers receive a complete written explanation regarding the following:
(1) The CDJFS requirements and procedures for correct and timely reimbursement of child care services.
(2) The provider’s responsibility for reporting to the CDJFS knowledge of a caretaker’s withholding or falsification of information or misuse of child care services.
(3) The provider’s responsibility for billing of appropriate services.
(4) The consequences of improper payments which may result in:
(a) Repayment by the provider of an overpayment which the provider received but for which the provider was not entitled.
(b) Revocation of the provider’s certificate.
(c) Penalty of fine and/or imprisonment if a court action renders a finding that the provider fraudulently received payments from the CDJFS for which 5101:2-16-71 2 the provider was not entitled.
(F) The CDJFS shall include procedures for the recovery of child care overpayments within its agency plan for the recovery of overpayments. These procedures shall include all of the following:
(1) A requirement for a repayment agreement between the CDJFS and the caretaker using the JFS 01151 “Notice of Child Care Overpayment” (rev. 1/2007).
(2) A requirement for repayment agreement between the CDJFS and the child care provider.
(3) A requirement that cases will be referred to the county prosecutor.
(G) The CDJFS shall provide notice to a caretaker or a provider that an overpayment has been identified using the JFS 01151.
(H) The CDJFS shall propose termination of child care benefits if the caretaker fails to repay in full a child care overpayment or fails to enter into or comply with an agreement with the CDJFS to repay a child care overpayment. The appropriate hearing notice pursuant to division 5101:6 of the Administrative Code shall be followed. Ineligibility for child care benefits shall continue as long as:
(1) Repayment of an overpayment is owed to the CDJFS.
(2) The caretaker fails to enter into or comply with an agreement with the CDJFS to repay a child care overpayment. The agreement shall be satisfactory to both the caretaker and the CDJFS.
(I) The CDJFS shall revoke the provider’s certificate if the provider fails to repay a child care overpayment. The provider shall not reapply for certification for at least one year from the revocation date. Denial of certification shall continue until the repayment in full is made to the CDJFS.
(J) The CDJFS shall report overpayments which are identified as required on the JFS 02827 “Monthly Financial Statement” (rev. 11/2000) and the “Child Care Information System” (CCIDS/3299).
(K) The CDJFS, in cooperation with the county prosecutor, shall develop and implement procedures that the CDJFS shall follow for the investigation and/or prosecution of alleged child care fraud and the recovery of child care overpayments. The CDJFS shall update these procedures as necessary.
(L) 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) When the caretaker has been convicted of fraud, as determined by a court of law, or when 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 and 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) When the child care provider has pleaded guilty to committing fraud or has been convicted of fraud, as determined by a court of law, the CDJFS shall promptly take the following actions:
(a) Revoke the type B family child care home certificate or in-home aide certificate according to the procedures set forth in rule 5101:2-14-06 of the Administrative Code.
(b) Terminate the JFS 01224 “Contract for Purchase of Publicly Funded Child Care Services” (rev. 01/2008).
(c) Terminate the JFS 01140 “Certificate for Authorization for Payment of Publicly Funded Child Care Services (COAP)” (rev. 1/2007).
(d) Notify the Ohio department of job and family services (ODJFS) child care licensing section or the Ohio department of education (ODE) district licensing section in writing of any findings of fraud, determined by a court of law, involving a licensed child care facility.
Effective: 07/01/2008
R.C. 119.032 review dates: 02/01/2012
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