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

(A) Child care providers and caretakers are responsible for making accurate, complete and timely disclosures of all information necessary 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) Payment to the provider.

(3) Attendance data.

(B) A child care improper payment includes:

(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.

(2) Child care payments made to a child care provider for which the provider was not entitled. The provider is responsible for repayment of the overpayment.

(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 or falsification of information or misuse of child care services.

(2) Submitted or received inappropriate attendance data.

(3) Misuse of the child care electronic swipe card.

(4) 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.

(5) 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.

(4) The consequences to the caretaker for failure to accurately and completely report information or changes 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 shall include procedures for the recovery of child care overpayments from caretakers and providers within its agency plan for the recovery of overpayments. These procedures shall include all of the following:

(1) A requirement for a repayment agreement using the JFS 01151 "Notice of Child Care Overpayment" (rev. 8/2011).

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

(F) 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 to repay a child care overpayment. The appropriate hearing notice pursuant to division 5101:6 of the Administrative Code shall be issued. Ineligibility for child care benefits shall continue as long as:

(1) Repayment of an overpayment is owed.

(2) The caretaker fails to enter into or comply with an agreement to repay a child care overpayment.

(G) The CDJFS shall initiate the following procedures if a certified provider fails to repay a child care overpayment within the time frame established in the JFS 01151. .

(1) Revoke the provider's certificate according to rule 5101:2-14-06 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 repayment in full is made.

(2) Notify the Ohio department of job and family services (ODJFS) if the provider is a licensed or out of state provider or an approved child day camp.

(H) The CDJFS shall report overpayments collected on the JFS 02827 "Monthly Financial Statement" (rev. 11/2000) and the "Child Care Information System" (CCIDS/3299) or other data system required by the ODJFS.

(I) 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 and providers. The CDJFS shall update these procedures as necessary.

(J) 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:

(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) Notify ODJFS child care licensing section or the Ohio department of education (ODE) licensing section in writing of any findings of fraud, determined by a court of law, involving a licensed child care facility.

(3) The ODJFS shall terminate the provider agreement when a provider has admitted to committing fraud or has been convicted of fraud, as determined by a court of law.

Effective: 08/28/2011
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, 7/1/08, 3/28/2010