9000. PAYMENTS AND ACCOUNTS
Revisions to the sections regarding foster care payments are currently under
revision to reflect the new Foster Care Rate Structure, which was effective
January 1, 2001.
- Additional funding beyond basic rates may be necessary to maintain a child in foster family care or a relative placement.
- Funding is intended to enable care in the most family-like, least restrictive setting. However, it is also appropriately used to enable care pending placement into a specialized, more restrictive, appropriate care setting when such resources are not immediately available.
- Additional funding beyond basic rates is an exception and not an entitlement to all children in care who have extraordinary needs.
- The Division of Children and Family Services (DCFS) social worker, the supervisor, and/or the Area Administrator must determine that the need is critical and that funding is available within regional allotments.
- The DCFS Regional Administrator is responsible for all allotted service delivery funds and determines the level of additional funding available to meet special needs. All expenditures must be within regional allotments.
See the interim Foster Care Redesign Handbook for requirements, instructions, and tasks for implementation of Foster Care rate restructuring. Restructuring of foster care rates will be phased in through June 2001.
- The private agency or DCFS social worker may authorize a special rate, up to state authorized maximum amounts, in addition to the basic rate for board and room, for a child in need of special and specific care. The private agency or DCFS social worker must write a justification for approval by the DCFS supervisor.
- The supervisor must approve the special rate before payment is made. If the special rate is approved, the supervisor must review the need for continued payment every six months. The supervisor must document approval of the special rate in the child's case file at initiation and renewal.
- Documentation contained in the child's Health & Education database of the child's behavior, emotional, intellectual, and/or physical problems is sufficient justification for a special rate.
To be eligible to receive the special rate on behalf of a child in their care, the foster parent(s) are not required to complete Foster Parent Scope training provided by the Division of Licensed Resources (DLR).
- To be eligible for special rate foster care, children with behavioral/ emotional problems need to exhibit at least three of the following behaviors, which are documented in the Behavior Issues section of the child's FamLink Health & Education database:
- Recurring use of illicit drugs;
- Regular overuse of alcohol;
- Poor school adjustment and/or truancy;
- Sexual acting out;
- Frequent shoplifting and/or other theft;
- Chronic running away;
- Demonstrated property destruction in own home and/or foster home
- Regular, frequent peer conflict which may require action by foster parent;
- Significant sleep problems which may cause disruption in the normal sleep patterns of the foster parent(s);
- Destructive attention-seeking behavior which may demand extra attention by foster parent(s);
- Frequent noncompliance with requests of parent(s), foster parent(s), teacher, or other authority figures;
- Failure to use normal cautions in using potentially flammable substances;
- Soiling and enuresis over age six; and
- Extremely bizarre behavior, reflecting psychosis or other severe mental disorder.
- To be eligible for special rate foster care, intellectually and/or physically challenged children need to exhibit at least two of the criteria listed below, which are documented in the child's record. If Foster Care Passport Program (FCPP) staff has constructed a Passport for the child, the child's social worker must have documented any of the following dysfunctions, except "awaiting institutional placement," in the child's Health & Education database:
- Requires physical assistance, inappropriate to the child's age, of foster parent in feeding, dressing, bathing, or toileting;
- Needs the physical help of foster parent in order to be mobile;
- Needs regular and organized physical therapy by foster parent under the orders/direction of a professional;
- Needs medication administered by foster parent on a regular basis per physician's orders;
- Needs physical assistance by foster parent for drainage of ileum conduit, colostomy;
- Requires suctioning, mist tent, etc., care which is provided by a foster parent;
- Epileptic child who has uncontrollable seizures;
- Awaiting institutionalization placement;
- Habitually wanders unless closely supervised;
- Failure to thrive below third percentile; and
- Born addicted to drugs requiring additional care and support during the withdrawal period.
- The Regional Administrator and the Regional Manager provide for all of their respective employees to have access to terminal alerts broadcast through FamLink.
- To prevent overpayments when children leave one residential placement to go to another or to return home, the CA social worker shall make payment only through the day before the date of discharge. No double payments are to occur by paying for the same date of care in two different facilities.
- CA shall pay for temporary absences of children from foster family and group care only in compliance with WAC 388-25-0180. In addition, the following conditions shall apply:
- CA shall not pay for absences of a child from foster family care, unless there is an agreement with the foster family for the child to return to their home within 15 days.
- When a child leaves a foster care placement, unless there is agreement by DCFS and the foster parent to place the child back into the foster home, the social worker shall prorate the foster care payment, including special rate and exceptional cost, for the month, paying only for the actual days of care provided, not including the last day of placement. Acceptable absences, where the plan is to return the child to the foster home within 15 days, include:
- Planned visitation;
- Attendance at summer camps and similar activities;
- Respite placements;
- Temporary placement while foster parent(s) is vacationing or receiving medical treatment;
- Juvenile detention placement of youth; or
- Runaways when the bed is being held for the return of the child.
- An exception to policy (ETP) may be submitted to the Regional Administrator to continue payment beyond 15 days of absence or when a planned absence is for a reason other than listed above, if continued payment is necessary to continue a plan of care which is in the child's best interests.
- In the event of an unplanned absence from the foster family home, if the created vacancy remains unfilled, the social worker may authorize up to three days of payment to determine if the child will be returned to the foster home.
- Overpayments also occur in foster family or group care when the authorized goods or services are not provided but payments are made. Examples include payments for Exceptional Cost or Medicaid Personal Care Services that are paid but not delivered.
- The social worker or other staff designated by the Regional Administrator will need to calculate an overpayment when payments are made for services not delivered and for those days paid if the child is absent from the foster family home for reasons other than those listed in paragraph A, above.
- The designated staff completes a Social Service Overpayment Notice, DSHS 18-398.
- The designated staff sends a copy of the form to the foster parent with instructions to forward repayment directly to the Office of Financial Recovery (OFR).
- The designated staff also sends copies of the forms to OFR, along with documentation supporting the finding of an overpayment and the calculations and retains a copy of the overpayment notice in the client and/or vendor file.
- Each Regional Administrator will put into place regional controls that identify placements that have ended and which require overpayments to be collected in accordance with this standard.
- Each Regional Administrator will put into place regional controls that identify how foster care payments above base rates are monitored to achieve improved outcomes.
Foster parents, as non-contracted care providers, do not have a right to a fair hearing.
- When a foster parent believes no overpayment has occurred, the overpayment has been computed in error, or the overpayment should not have to be repaid, the foster parent requests review by the department.
- The Foster Care Program Manager, in the CA Division of Program and Policy Development, reviews the overpayment dispute and determines the amount of overpayment to repaid or forgiven. The Program Manager uses as the basis of the decision information provided by the social worker, OFR, and the care provider.
- DCFS regional staff shall respond promptly and completely to all requests for additional information from the Foster Care Program Manager.
- Payment of foster care is for 24-hour care. Payment of both foster care and child day care for the same child to a dually licensed home is a double payment. Trading children between dually licensed homes would similarly result in double payments.
- Before authorizing child care payments for a child in foster care, the child's social worker will verify the employment of the foster parent(s) outside the home or in the home in an occupation that would normally be performed outside the home. The social worker will document in the child's record through wage stubs or other appropriate means verification of the employment. The social worker will include the name of the employer, the hours worked, and the telephone number at the work site where the foster parent can be contacted. The social worker will verify the foster parent(s) employment status every six months while payments continue.
- For foster parents whose work site is their home, the social worker will verify the actual hours of employment and limit child day care payments to those hours only.
- Any Foster Parent Employment Child Care payments to be continued to dually licensed homes must be reviewed and approved by the Area Manager, with justification and documentation of the approval included in the child's record.
Payment must be made through SSPS when service authorization codes are available. Social workers, program managers, and Regional Business Managers shall not use Invoice Voucher A-19s to make payment in such cases as federal revenue will be lost and/or fiscal expenditure information will be inaccurate.
When a vendor makes a request for a replacement warrant, the responsible staff:
- Sends/gives the vendor a copy of Vendor Affidavit of Lost, Stolen, or Destroyed Warrant, DSHS 9-013(X), with instructions to complete the top half of the form, sign, notarize, and return the original affidavit and one copy to the local CA office.
- Mails the original affidavit to DSHS, Disbursements Section, MS 45843, Olympia, WA 98504.
- Attaches a copy of the affidavit to a copy of the original payment authorization document (DSHS 14-154A/159) and places it in the social service record or payment batch file.
- Under no circumstances initiates another voucher. CA workers are to ensure only the proper affidavit is completed and submitted to Disbursements.
DSHS Disbursements staff checks with the State Treasurer's Office to determine if the warrant is outstanding. If staff finds that the warrant has been cashed, an investigation is undertaken before reissuing a warrant.
- The DCFS Regional Administrator and the Division of Licensed Resources (DLR) Regional Manager establish controls to ensure that only properly designated personnel input to the Social Service Payment System (SSPS) via the Case and Management Information System (CAMIS).
- The Regional Administrator and Regional Manager, through written procedures, designate staff to maintain security for CAMIS and for SSPS in their respective areas of responsibility.
- The Regional Administrator and the Regional Manager see that the following are done:
- Current written SSPS procedures are available to staff, and staff are aware of their location.
- Appropriate staff have a copy at their desk.
- Each office has at least one current copy of the SSPS Manual.
- Staff are appropriately trained in using SSPS.
- SSPS payments are adequately monitored.
- The Regional Administrator and Area Manager are responsible to see that no SSPS payments are made to vendors without a valid contract in place, unless otherwise allowed by the specific SSPS service and payment code.
- The Regional Administrator and the Regional Managers establish procedures to retain the following reports in the regional and local offices:
|Purged But Not Paid Report
|Client Payment Detail
|Provider Services Summary
|All Services Summary
|Client Payment Detail Listing
||1 year or 5 years*
|Client Payment by Service
|Service Code by Reporting
|Adoption Family Services
|Payee by Reporting Unit
*This report must be retained for five years if the office does not have a
- The Regional Administrator and the Regional Manager provide for all of their respective employees to have access to terminal alerts broadcast through CAMIS.
The Regional Administrator designates a regional SSPS Coordinator whose responsibilities include:
- Monitor a sample of SSPS output reports on a quarterly basis.
- Act as the primary contact person with SSPS Control in the Management Services Administration.
- Clarify SSPS information coming into CA from Management Services Administration.
- Act as a resource to local SSPS coordinators and supervisors for training and/or payment problems.
- Assist in developing SSPS procedures, providing SSPS training, and completing corrective action in response to paragraph A, above.
- The Area Manager is responsible to assign a staff person n each office to maintain the following lists:
|Duplicate Invoice List
|Paper Batch Transmittal List
|SSPS Transaction Input List
- The use of each form is described in SSPS Manual, Section 99.
- Area Manager Reports
- The Area Manager uses the following reports to monitor local office and unit activity on a monthly basis:
|Worker/Supervisor Activity Reports
|Authorization in Error Weeks Elapsed without Correction
- Area Managers assign a gatekeeper in each office to control the creation of provider numbers and to see that the following steps are taken:
- The assigned staff always conducts a provider file clearance before creating a new provider number, using the first three letters of the provider's name. This will pick up alternate spellings and minimize the creation of duplicate provider files.
- To change information on an existing provider file, the appropriate individual (i.e., Local SSPS Coordinator, Regional SSPS Coordinator, Regional Contracts Coordinator, or assigned licenser) must give authorization.
- Operator Numbers
- Operator numbers allow administrative support and social work staff to complete SSPS authorization and provider file input through FamLink. Each employee with an operator number is required to keep his/her password secret. Only selected terminals have entry to these transactions by use of operator numbers and passwords. Area Managers determine which employees are to be assigned operator numbers and access to selected terminals. The unit supervisor sees that SSPS Control, MS 45812, is notified within five working days after an employee leaves or changes job functions.
- The Area Manager designates security staff to document changes, additions, or deletions to operator numbers and terminal access, with documentation available for review by federal, state, and internal auditors. Designated security staff retain this documentation for at least two years.
- Local offices (reporting units) will establish and maintain auditable controls of SSPS and have written procedures for staff functions relating to SSPS. Local office procedures are to contain all information required herein. Local offices will add to these requirements the specific information that pertains to their office procedures.
- Local offices are to have procedures for approval by management of exception payments prior to authorization, including signatures as required.
- For contracted services, the supervisor shall be responsible to see that the social worker or other designated staff verifies, through the FamLink contracts module, that the proposed vendor is a contractor in good standing with the department before processing SSPS payment or service authorizations.
- Designated staff perform the following in authorization preparation:
- Authorize payment of appropriate services for clients to whom they are assigned.
- When asked to authorize emergency services for a social worker who is unavailable, the designated staff uses that other worker's SSPS worker identification (ID). The authorizing worker must sign the authorizations prior to data input. The designated staff give copies of all authorizations to the clerical staff responsible for reconciling the transactions.
- Correct errors on authorizations.
- For one-time service authorizations, verify that goods or services were delivered prior to authorizing payment. Appropriate receipts must be present before payment and closure of the DSHS 14-159.
- For those services requiring supervisory approval, as identified in the SSPS Manual, Appendix C, obtain such approval prior to input. Appropriate authorizing documents may be attached to the Social Service Authorization (SSA), DSHS 14-154(X), or the FamLink "Print Screen."
- Should complete authorizations for input on a daily basis but shall complete them for input no less often than every fifth work day.
- Social Worker Reports-Social workers or other designated staff shall use the following reports to monitor services and to track status:
|Worker Service Report
|Expired & Expiring Service Tickler
- Social workers initiate and maintain FamLink placement information.
- Each social worker or other designated staff reviews the Worker Service Report (SSPS032) and:
- Identifies any services, providers, or clients they did not authorize.
- Identifies any unusual authorizations, unusual payments, or authorizations in the wrong amount.
- Resolves discrepancies or reports discrepancies to the immediate supervisor when resolution is not possible.
- Each social worker or other designated staff reviews the Expired and Expiring Service Report (SSPS013) and the Birthday Tickler (SSPS039) to identify services which need to be terminated, extended, or changed.
- Social workers and other designated staff participate in offered training.
- Input should be done on a daily basis but shall be done no less than every fifth work day.
- The input clerk or other authorized personnel initials, dates, and records the authorization number on the DSHS 14-154A or prints the FamLink screen and initials and dates it. Assigned staff distribute copies as required. Assigned staff prioritize input with attention to the following deadlines: ACES, monthly invoice, expired services, and supplemental invoice.
- Social workers doing their own input print the FamLink screen and sign and date the printed copy. The workers file one copy in the case file and give one copy to clerical support to use in checking the Transaction Listing. The social workers distribute other copies as required by regional or local procedures.
- Staff doing input must verify current enrollment for medical coverage before inputting medical authorizations.
- When staff doing input are entering a paid service via FamLink for which a license is required and the license expiration date is prior to the service end date, the input staff may change the service end date to reflect the license expiration date without sending the authorization back to the social worker for correction.
- When input staff is entering a placement-related service via FamLink for which the placement module has not been updated to reflect current status, the input staff returns the authorization to the authorizing worker. It is the social worker's responsibility to ensure that placement information is entered.
- Assigned staff other than the one doing input checks input documents against the Transaction Listing (SSPS 017) and signs and dates the document upon completion of the review. Assigned staff bring discrepancies to the attention of the appropriate supervisor. Offices are to retain the Transaction Listing for 24 months after the daily work has been checked off by clerical and appropriate supervisor. Assigned staff destroy all clerical copies of authorizations not needing further review.
- Support staff, within one work day of receipt, forward SSPS output reports to unit supervisors. If two sets of reports are received, support staff will distribute one set to the supervisor for review and forward the other set to the social worker.
- A designated staff is responsible for distribution of SSPS reports and for storing reports and microfiches in accordance with established retention requirements. The assigned staff maintains billing reports, including microfiche, in a location accessible to staff.
- A designated staff is responsible for ordering and distributing all SSPS manuals and policies required to support program operations.
- Staff are to be aware of procedures for batching SSPS authorizations which are outlined in the SSPS Basics Manual, Section 10.10.
- SPSS Worker ID
- The six (6) digit SSPS Worker Identification allows social work staff to authorize services for eligible clients in designated reporting units. Supervisors are to notify designated security staff within five working days of the need for any additions, deletions, or changes to the SSPS Worker ID in their unit. The required data includes:
- Employee's name;
- SSPS Worker ID (old and new if being changed);
- Position number;
- Worker telephone number; and
- Reporting unit number.
- The supervisor oversees security staff input of changes, additions, and deletions via FamLink. Retention of all changes, additions, and deletions are maintained in the FamLink data base.
- The unit supervisor or other employee designated by the Area Manager and knowledgeable of documentation requirements and payment policies randomly checks, co-signs, and dates at least 25 percent of the services that meet the following criteria:
- Services opened and closed at the time of initial input.
- One time payments that are terminated with a termination code that will cause a payment to be made (1A, 1B, 2A, 3B).
- Service which is authorized as an exception to the normal payment amount, including any service code beginning with a "9."
- The staff reviewing the sample of services retains all DSHS 14-154A/159s randomly checked and attaches them to the signed and dated Transaction Listing. The office retains these DSHS 14-154A/159s with the Transaction Listing for two years.
- The supervisor of each unit reviews monthly each social worker's Worker Service Report (SSPS032) and Expired Services Report (SSPS013) to monitor authorizations and expenditures.
- The supervisor reviews SSPS reports received from support staff within five working days, then immediately distributes to social workers.
- Reports for Supervisory Use in Monitoring-Supervisors use the following reports as part of their monitoring of social workers' activities:
|Expired & Expiring Service Tickler
|Local Office Client listing by Service
|Provider Listing by Paid Service
|Worker Service Report
- Each supervisor:
- Has transactions checked promptly and discrepancies resolved.
- Discerns and resolves discrepancies reported by social workers or clerical staff.
- Reviews the Worker Service Report (SSPS032) monthly for accuracy and appropriateness of services.
- Discusses with each social worker on a monthly basis the expectation to review the following SSPS reports for accuracy and to take appropriate action as needed to prevent late payments and other errors:
- Expired and Expiring Service Report (SSPS013);
- Worker Service Report (SSPS032);
- Birthday Tickler Report (SSPS039); and
- Arranges for staff participation in training.
The local SSPS coordinator, designated by the Area Manager:
- Provides technical assistance to social services and support staff in their local office.
- Acts as back-up support for the regional SSPS coordinator.
- Assists in developing and coordinating SSPS policies and procedures.
- Assigned staff review the Morning Report and resolve any errors using Correction procedures in the SSPS Manual, Appendix T. Medical Assistance Administration (MAA) staff review the Morning Report and will correct any errors regarding eligibility or information for medical assistance.
- Social workers and clerical staff have the capability to verify payments made, invoices sent, and check for possible errors on returned invoices. Designated staff request duplicate invoices from SSPS Data Control, MS 45812, Olympia. Only local and regional SSPS coordinators may request expedited payments.
- Payment problems that cannot be resolved at the local level must be referred to the regional SSPS coordinator.
Basic instructions/information for provider file numbers are found in SSPS Basics Manual. All provider numbers are created and updated through FamLink.
"Overpayment" means any money paid by the department for services or goods not rendered, delivered, or authorized or where the department paid too much for services or goods or services rendered, delivered, or authorized.
- Purpose and Scope
- These procedures establish guidelines for CA staff in the resolution of vendor or foster parent disputes regarding payments through an administrative hearing and pre-hearing process. It provides direction when staff determines that an overpayment to a vendor or foster parent exists, for staff participation in steps to recover the overpayment, and for staff participation in the settlement of any overpayment disputes. The procedures also provide direction for pre-hearing efforts to mediate and resolve payment disputes prior to proceeding to hearing.
- Contracted and non-contracted service providers, including foster parents, may seek dispute resolution through these procedures, under the Administrative Procedure Act and RCW 43.20B.675, with respect to overpayments. However, the following limitations apply:
- The right of vendors or foster parents to seek an administrative hearing to contest alleged overpayments applies only to overpayments for goods or services provided on or after July 1, 1998.
- These procedures do not create a right to a hearing where no dispute right previously existed except as provided in RCW 43.20B.675. These procedures and department policy limit disputes for foster family and child day care providers to:
- Alleged overpayments;
- Perceived failure of the department to pay for services actually provided under an agency service authorization; and
- Licensing actions taken under WAC 388-73-036 or WAC 388-155-090, as applicable.
- Adoptive parents who receive assistance through the Adoption Support Program are not vendors within the meaning of the law. They have hearing rights under other provisions of law and WAC. Accordingly, payment disputes involving the Adoption Support Program do not fall within the scope of these procedures.
- Discovery or recovery of overpayments has no time limit. The department may identify and initiate recovery of overpayments without regard to the length of time that may have elapsed since the overpayment actually occurred or was discovered.
- CA employees do not have authority to forgive or waive overpayments, nor to offset overpayments from future payments. All such authority rests with the Office of Financial Recovery (OFR). Designated CA staff may mediate a disputed payment with the vendor, but final approval for any negotiated proposed settlement rests with OFR.
- Governmental entities, including Indian Tribes, with an Inter-local Agreement with the department do not have the right to an adjudicative hearing through the Office of Administrative Hearings (OAH). The dispute process described in the agreement between the entity and the department governs the resolution process.
- RCW 43.20B.675 and DSHS Administrative Policy 10.02 provide that all vendors have the right to request an adjudicative proceeding if they have a bona fide dispute. Disputes involving rates set in rule or Washington Administrative Code (WAC) are not subject to resolution through an adjudicative hearing held by OAH. The responsible CA organizational unit must routinely offer a pre-hearing conference to all clients and vendors that request an administrative hearing.
- The department and CA must, when undertaking activities relating to overpayment identification and recovery as well as adjudicative proceedings, comply with:
- DSHS Administrative Policy 7.02, Equal Access to Services for Individuals with Disabilities;
- DSHS Administrative Policy 7.20, Communication Access for Persons Who Are Deaf, Deaf/Blind, and Hard of Hearing; and
- DSHS Administrative Policy 7.21, Provision of Services to Limited English Proficient (LEP) Clients
- Regional and Headquarters Procedures:
- Each DCFS Regional Administrator, DLR Regional Manager, or division Director, as applicable, must establish procedures to provide for consistency in the handling of vendor/contractor disputes in accordance with the Children's Administration Pre-hearing Procedures. Procedures must include:
- Methods to informally notify vendors of their right to request a formal adjudicative proceeding if they have a bona fide contract dispute and to provide all appellants with a copy of the CA written pre-hearing process. (OFR provides formal notification of overpayments.) The department limits adjudicative disputes for foster parents to those issues identified in paragraph A.2., above;
- Pre-hearing/alternative dispute resolution that incorporates routine offers of a pre-hearing conference to all clients or vendors who have requested an administrative hearing;
- Identification of overpayments and steps to initiate recovery of amounts due to the department as a result of overpayments;
- Designation of staff to represent CA in behalf of the department in pre-hearing/alternative dispute resolution and administrative hearings for disputes resulting from activities or actions of the applicable organizational unit;
- Identification of staff to mediate overpayment and other disputes prior to a formal administrative hearing;
- A system to identify overpayments in a timely manner;
- A method to document that an overpayment has occurred;
- A method to notify the vendor/provider that an overpayment has occurred and to determine the vendor's agreement or disagreement with that determination; and
- Identification of staff assigned to review overpayments and to refer them to OFR for collection.
- CA expects disputes to be resolved at the lowest possible level in the organization. Therefore, CA staff will handle disputes at the following organizational levels:
- The DCFS Regional Administrator is responsible for the dispute resolution process for all payments authorized by local office social workers and all payments authorized under regionally managed contracts and service agreements. Regional DCFS staff will coordinate pre-hearing conferences, mediation activities, and administrative hearings for regionally-managed contracts.
- Assigned CA Division of Program and Policy Development or Office of Foster Care Licensing (OFCL) headquarters staff, as applicable, will handle pre-hearing conferences, mediation activities, and administrative hearings arising from headquarters-managed contracts and service agreements.
- Determination of Existence of an Overpayment and Documentation of Referral
- If any CA employee has reason to believe that the department has overpaid a contractor or vendor, that employee must contact the employee who authorized the payment and the authorizing employee's supervisor by written memo or e-mail.
- The CA employee identifying the overpayment must inform the authorizing employee and that employee's supervisor that the employee has reason to believe an overpayment has occurred and must provide the information that led the employee to that conclusion.
- If the authorizing employee identifies an overpayment, that employee must inform and provide supporting information to the supervisor.
- The authorizing employee, or other employee designated in DCFS or DLR regional procedures or CA headquarters procedures must contact the vendor/provider directly to inform the vendor/provider of the identified overpayment and the reason the payment constitutes an overpayment.
- This contact provides the CA employee and the vendor/provider an opportunity to identify any errors in the conclusion that an overpayment occurred and to enable the CA employee to discontinue overpayment procedures if CA incorrectly identified an overpayment.
- This contact serves as an opportunity for CA to educate the vendor/provider in correct methods to complete invoices in order to prevent overpayments from recurring.
- In addition, the CA employee can support the vendor/provider in continuing to offer services to CA and its clients.
- If the vendor/provider is a foster parent who disagrees with CA determination of an overpayment, the CA employee informs the foster parent of the foster parent liaison program and provides the contact telephone number for the CA office's liaison.
- If the CA employee, after contact with the vendor/ provider, continues to believe that an overpayment occurred, the authorizing worker or other employee designated by regional procedures informs the vendor/ provider that the employee will notify OFR of the overpayment. OFR will send an official notice of overpayment to the provider/vendor. This notice will include instructions for the vendor/provider to return the overpaid funds to the department and information on steps to dispute the overpayment.
- The employee who originally authorized the payment gathers written documentation of the overpayment. This may include gathering payment records through the SPAYMENT procedure in FamLink.
- The authorizing employee refers to the regional designee any overpayments, with supporting documentation. This information will include documentation of the vendor/ provider's agreement or disagreement with the determination of overpayment. The regional designee reviews the referral information to ensure that supporting documentation adequately supports the conclusion that an overpayment in the amount stated did occur.
- Referral to the Office of Financial Recovery
- The applicable CA designee sends the completed SSPS Overpayment Notice, DSHS 18-398A, (dated 7/1998) along with the documentation of the overpayment, to OFR.
- OFR then issues formal notice of the overpayment by certified mail to, and tracks responses from, the vendor/provider. If the vendor/provider wants to formally dispute the overpayment, the vendor/provider must respond to OFR within 28 days of the notice of overpayment.
- If the vendor/provider does not dispute the overpayment, OFR establishes a schedule for repayment with the vendor/provider. In accordance with RCW 43.20B.695, interest will not accrue when the overpayment results from department error.
- Disputed Department Actions
- OAH schedules a hearing when a vendor/provider requests a hearing. After a vendor/provider requests a hearing, the CA authorized staff person offers a pre-hearing conference. The pre-hearing conference may be a telephone call, a meeting, or a mediation session with a third party mediator.
- The responsible CA organizational unit must identify individuals authorized to mediate a disagreement between the department and the vendor/provider. Those persons designated to refer overpayments to OFR for collection may not serve in the role of mediator for overpayment disputes.
- If the CA authorized staff and the vendor/provider reach a settlement, the CA representative and the vendor/provider may execute a stipulated agreement in writing, signed by the parties. If the parties do not resolve the dispute, the formal hearing with OAH takes place as scheduled.
- For overpayments:
- If the vendor/contractor and the CA representative reach an agreement, before signing the agreement, the CA representative must contact OFR at (360) 664-5557 to obtain verbal approval for the stipulated agreement if it forgives an identified overpayment.
- If the OFR representative approves the agreement, the CA representative and the vendor/contractor representative sign the agreement, and the CA representative mails it to the OFR representative for signature. Once the OFR representative signs the agreement, it takes effect.
- If the administrative hearing occurs, the CA employee who authorized the payment must participate in the administrative hearing. Regional or headquarters procedures, as applicable, determine if additional individuals will participate in the administrative hearing to represent the department.
- The vendor or client must send the repayment directly to OFR. If a CA office receives money that is to be applied to a vendor overpayment, assigned accounting staff in the office transmits the money to OFR on a Daily Funds Transmittal, DSHS 18-320(X).
- Accounting staff indicates the nature of the overpayment in the comment section of the Daily Funds Transmittal.
- When OFR receives payments from vendors for whom it has not received an overpayment packet, OFR staff will send notification to the appropriate CA office.
- If CA determines that the payment or any portion was submitted in error or that OFR applied funds incorrectly, responsible staff transmits this information to OFR in writing within 30 days. OFR will then initiate appropriate action.
- If CA staff determines that the payment or any portion was a program donation, designated staff transmits this information to OFR, including the identity of the program to which the donation was made to enable OFR to credit the proper account.
Interest on vendor debt is administered in accordance with DSHS Administrative Policy 10.02, Vendor or Provider Overpayment and Debt Policy.
- Under DSHS Administrative Policy 4.02, OFR is delegated responsibility and authority for managing the department's Accounts Receivable in a manner outlined in Administrative Policy 12.04.
- Each Regional Administrator/designee will determine the region's own policy on receipt of cash.
See chapter 11000, section 11800, Trust Funds Accounting, for requirements relating to client trust accounts.
- RCW 43.88.195 allows agencies to establish new accounts with the permission of the Office of Financial Management (OFM). Administrator's Accounts are expendable trusts that are local fund accounts available to provide instant assistance to eligible clients. Their sources of funds are usually donations and fund raisers.
- Please Note: If funds are given for a specific purpose, moneys can only be dispensed for that specific purpose. Accounting records must be maintained so that moneys donated and spent for a specific purpose may be audited.
- CA local offices are to:
- Develop a statement of purpose for the account; for example, "The sole purpose of this account is to provide direct needs and opportunities for children and their families when no other resource is available."
- Stipulate the criteria for use, the amount available per request, and the process that will be developed to allow access to Administrator Account funds.
- Write a memo to the Regional Administrator requesting the establishment of an Administrator's Account. In the request, include the fund's purpose, criteria for use, and process for accessing funds. The Regional Administrator or designee will send a written request to the Chief, DSHS Office of Accounting Services, with a copy to the CA Director of Management Services. The written request must include the name of the bank, name and classification of individuals authorized to sign account checks, and the name and classification of the individual responsible for reconciling monthly bank statements with the office records.
- Once the DSHS Office of Accounting Services has granted authority to establish the account, the local office identifies staff to be the:
- Accounts Receivable Coordinator;
- Committee or Person(s) to review/approve requests for funds;
- Disposition Person;
- Fund Trustee;
- Mail Person;
- Recording Person, and
- Reconciliation Person.
- To the extent possible, the duties listed in section 9920(B) are to be separated.
- If the duties cannot be separated due to a lack of staffing, a "Separation of Duties" waiver which includes compensating controls to show safeguard of the account must be on file in the regional office.
- The waiver must be signed by the Fund Trustee, the trustee's supervisor, the second line supervisor, and the Regional Administrator.
- Please note: Any cash or negotiable items received are to be deposited within 24 hours.
The Regional Administrator, usually through the Regional Business Manager and/or the Clerical Supervisor, designates staff to carry out the duties outlined below.
The Mail Person logs any cash or negotiable items in the Cash Items Mail Log, DSHS 19-48, and gives it to the Accounts Receivable Coordinator.
The Accounts Receivable Coordinator:
- Receives the Cash Items Mail Log and the cash/negotiable items from the mail person.
- Verifies that the cash/negotiable items are shown on the Cash Items Mail Log and, after verification, dates and signs the mail log, retaining the pink copy.
- Issues a pre-numbered and sequential receipt for all cash/negotiable items requiring a receipt. If the cash/negotiable items received are for a specific purpose, they are to be referred to as a restricted donation, with a note of the restriction on the receipt issued to the donor.
- Prepares the disposition documents required for the disposal of cash and negotiable items. The disposition documents will include the bank deposit slip, the Cash Items Mail Log, and a copy of the receipt issued to the donor.
- Secures all cash and negotiable items until transferred to the Disposition Clerk along with the disposition documents.
The Disposition Person:
- Verifies that the cash and/or negotiable received from the Accounts Receivable Coordinator equals the amount shown on the disposition documents. Completes the disposition entries on the various receipt and disposition documents. Signs and dates the disposition documents.
- Secures the deposit until it can be taken to the bank. Gives bank- validated deposit slips along with the copies of the receipt and disposition documents to the recording person on the same day the deposit is made.
- Receives approved disbursement authorizations from committee or person(s) responsible for reviewing and approving requests for funds.
- Prepares check (in ink) and writes the check number on the Disbursement Authorization. Has the check signed by at least two people who are authorized on the bank account signature card.
- Gives the completed Disbursement Authorizations to the Recording Person.
The Recording Person:
- Reconciles the daily cash receipts and bank validated deposit slips.
- Records all deposits in the Cash Receipts Journal and Ledger Sheet.
- Verifies the amounts of checks to disbursement authorizations and completes entries to the check register, Cash Disbursements Journal, and the Ledger Sheet. Secures signed checks until they are mailed or given to the appropriate person.
The Reconciliation Person:
- Upon receiving the Administrator's Account monthly bank statement, reconciles the statement to the Ledger Sheet and other journals. Completes the reconciliation on the back of the bank statement.
- Prepares the Administrator's Account Monthly Activity Report and the Bank/Reconciliation Report. Gives them and the appropriate ledgers and journals, along with the bank statement, to the Fund Trustee for review.
The committee or person(s) responsible for review and approval of Disbursement Authorizations approves, modifies, or denies the completed Disbursement Authorization based on the local office use-of-funds criteria and any restrictions that may have been placed on the funds by the donor.
The Fund Trustee:
- Oversees the management and accountability of the Administrator's Account.
- Reconciles the accounting records to the trustee's records on a quarterly basis. If there are variances, the trustee researches and documents, corrects, or takes appropriate action. He/she prepares the Trustee's Reconciliation Report, DSHS 19-207, and signs and dates it.
- A CA staff person submits a completed Request for Disbursement Authorization form to the committee or person(s) assigned by the Regional Administrator the duties of approving these requests.
- The completed form includes the amount, case name, case number, and purpose of the requested funds. The form is signed and dated by the worker.
When it is necessary to pay advance fees to vital statistics agencies in other states for records of birth, death, marriage, or other events, the social worker:
- Verifies the amount of fee required for the information needed and obtains the address of the state vital statistics agency.
- Prepares a letter in duplicate to the agency for the supervisor's signature indicating:
- The type of record/information requested.
- The name and case number (if applicable) of the party for whom the record is requested.
- The CA address to which the vital statistics agency shall mail the record.
The supervisor signs and forwards both copies of the letter, along with a memorandum requesting that a check be issued for the appropriate fee, to:
Department of Social and Health Services
Supervisor, Disbursements Section
Attn.: Administrative Revolving Fund
Mail Stop 45843
Olympia, Washington 98504
- Issues a check on the DSHS Administrative Revolving Fund and mails it with the requesting letter to the vital statistics agency indicated.
- Returns the copy of letter to the originator notifying them that the request has been forwarded to the vital statistics agency.