DEPARTMENT OF PUBLIC WELFARE [ 55 PA. CODE CHS. 168 AND 3041 ] Subsidized Child Care Hearings, Overpayments and Absence Changes [42 Pa.B. 2000]
[Saturday, April 14, 2012]The Department of Public Welfare (Department) amends Chapters 168 and 3041 (relating to child care; and subsidized child care eligibility) to read set forth in Annex A under the authority in sections 201(2), 403(b) and 403.1 of the Public Welfare Code (code) (62 P. S. §§ 201(2), 403(b) and 403.1), as amended by the act of June 30, 2011 (P. L. 89, No. 22) (Act 22).
Omission of Proposed Rulemaking
Act 22 amended the code and added several new provisions. Specifically, Act 22 added section 403.1 of the code. Section 403.1(a)(1) of the code authorizes the Department to promulgate final-omitted regulations to establish standards for determining eligibility and the nature and extent of assistance. The basis for the final-omitted regulation is section 204(1)(iv) of the act of July 31, 1968 (P. L. 769, No. 240) (45 P. S. § 1204(1)(iv)), known as the Commonwealth Documents Law (CDL), which authorizes an agency to omit or modify notice of proposed rulemaking when the regulation relates to Commonwealth grants or benefits. See section 403.1(d) of the code. Child care subsidy is a Commonwealth benefit. In addition, until June 30, 2012, section 403.1 of the code expressly exempts certain regulations under the Regulatory Review Act (71 P. S. §§ 745.1—745.12), section 205 of the CDL (45 P. S. § 1205) and section 204(b) of the Commonwealth Attorneys Act (71 P. S. § 732-204(b)).
The Department is amending Chapters 168 and 3041 in accordance with section 403.1 of the code because this final-omitted rulemaking pertains to establishing standards for determining eligibility and the nature and extent of assistance. In addition, this final-omitted rulemaking implements section 403.1(c) of Act 22. As provided in section 403.1(c) of the code, the Department is permitted to exercise its rulemaking authority granted under section 403.1(a) of the code as may be necessary to ensure that expenditures for State Fiscal Year (FY) 2011-2012 for assistance programs administered by the Department do not exceed the aggregate amount appropriated for the program by the General Appropriations Act of 2011. Specifically, this final-omitted rulemaking will save $463,000 in State FY 2011-2012.
Purpose
The purpose of this final-omitted rulemaking is to amend the number of days of consecutive absences of a child allowed before the eligibility agency shall send an adverse action notice to a parent or caretaker. Reducing the allowable number of consecutive days of absence from 10 days to 5 days will result in cost-savings. For example, if a child cannot return to care because of a lengthy illness, the child care subsidy can be suspended during this time and eligibility can continue for up to 90 days.
In addition, the number of days of child care that will be paid if a parent or caretaker involuntarily loses work, begins a strike or graduates from or completes education or training will be reduced to 30 days. The parent will continue to have 30 additional days of eligibility, however subsidy will be suspended and payment will not be made to the provider. The additional 30 days of eligibility, for which child care subsidy is not paid, allows the parent or caretaker an additional 30 days to begin another work or training activity and not have to be placed at the bottom of the waiting list.
This final-omitted rulemaking will also deem the parent or caretaker responsible to pay the child care provider for any absences beyond the total number of absences allowed. Section 3041.18(b) (relating to attendance) specifies that a child is expected to attend child care on all days for which the parent or caretaker has established a need. Setting a standard for a total number of allowable absences and imposing consequences for exceeding the standard encourages the parent or caretaker to use the days of child care requested or report a change in the number of days needed. If a child has more than one enrollment in a day, a child is considered absent only once if the child is absent from more than one provider on the same day. The requirement to pay for absences does not apply to a parent or caretaker who is receiving subsidized child care under the Supplemental Nutrition Assistance Program (SNAP) employment and training program. In addition, suspended days will not count towards the total number of absent days.
Also, this final-omitted rulemaking amends the requirements for the Head Start expansion program to make certain that a child enrolled in the Head Start expansion program remains eligible as long as the parent or caretaker meets the criteria under § 3041.51 (relating to Head Start expansion program) and the child remains enrolled in Head Start. To be eligible for the Head Start expansion program, a family shall verify eligibility each time a child in the family applies for the Head Start expansion program. In addition, the amendment states that children in the Head Start expansion program remain eligible even if other family members become ineligible. Families with children not enrolled in the Head Start expansion program, but receiving subsidized child care, shall still meet the eligibility requirements.
Finally, this final-omitted rulemaking amends the regulations concerning the collection of overpayments. Specifically, the collection of overpayments in cases of suspected fraud will be delayed until the Office of Inspector General (OIG) completes its investigation. Overpayments involving fraud will be collected in conjunction with the OIG. This will allow the Department to determine whether the eligibility agency, OIG or the court is best suited to collect the overpayments.
Requirements
§ 168.72. Determining monthly child care costs
This section is amended to state that child care costs include a charge for up to 5 consecutive days on which the child was not in attendance, instead of 10 consecutive days.
This section is also amended by adding subsection (b). Subsection (b) states that if a child is absent more than 25 days during the State's fiscal year, the parent or caretaker will be responsible to pay the provider for each day a child is absent beginning with the 26th day of absence. The parent or caretaker will be required to pay the provider's verified published daily rate for each day of absence over the allowed number. A parent or caretaker who receives subsidized child care through the SNAP employment and training program, however, will not be required to pay for absent days that exceed the allowable number.
The Department posted a draft regulation on the Department's web site on February 24, 2012, with a 15-day comment period. The draft regulation included 20 allowable absences for the child if the parent or caretaker worked or trained less than 25 hours and 30 allowable absences if the parent or caretaker worked or trained 25 hours or more. As provided in more detail as follows, this subsection was revised to provide for 25 allowable absences based on the public comments received. The draft regulation was also revised to clarify that a child is considered absent only once during an enrollment day.
§ 3041.19. Absence
Subsection (a) is amended to decrease the number of consecutive days of absence allowed before the eligibility agency sends an adverse action notice. The amended regulation states that the adverse action notice shall be sent after 5 consecutive days of absence instead of 10 consecutive days of absence.
Subsection (c) has been added to this section. If a child is absent more than 25 days during the State's fiscal year, the parent or caretaker will be responsible to pay the provider for each day a child is absent beginning with the 26th day of absence. The parent or caretaker will be required to pay the provider's verified published daily rate for each day of absence over the allowed number. Suspended days of service as specified in § 3041.21 (relating to subsidy suspension) are not considered days of absence.
Subsection (c) was also revised after public comment. The draft regulation included 20 allowable absences for the child if the parent or caretaker worked or trained less than 25 hours and 30 allowable absences if the parent or caretaker worked or trained more than 25 hours. Based on the comments received, this subsection was revised to provide 25 allowable absences. The draft regulation was also revised to clarify that a child is considered absent only once during an enrollment day.
§ 3041.20. Subsidy continuation during breaks in work, education or training
This section has been amended to state that a family's eligibility and payment for subsidized child care continues for 30 calendar days from the date of an involuntary loss of work, the date a strike begins or the date the parent graduates from or completes education or training. On day 31, the child care subsidy will be suspended and the family's eligibility will continue for an additional 30 days. The additional 30 days of eligibility, for which child care subsidy is not paid, allows the parent or caretaker an additional 30 days to begin another work or training activity and not have to be placed at the bottom of the waiting list. The regulation previously allowed the family to be eligible and payment to be issued for 60 days.
§ 3041.21. Subsidy suspension
This section is amended to decrease the number of days of consecutive absences before subsidy can be suspended for up to 90 days for a child who meets specific criteria. The number of days of consecutive absence have decreased from 10 days to 5 days, which aligns with the change made to § 3041.19 (relating to absence). The criterion to qualify for subsidy suspension has not changed.
§ 3041.51. Head Start expansion program
Subsection (b) is amended to state that the parent or caretaker shall meet the eligibility requirements in subsection (f) each time a child in the family applies for the Head Start expansion program. An addition was also made to subsection (f) to include the need to verify income eligibility as specified in § 3041.41 (relating to financial eligibility) each time a child in the family applies for the Head Start expansion program.
Subsection (c) is amended to state that the eligibility agency will verify with the Head Start program that the child is enrolled in a Head Start program that meets Federal and State Head Start standards.
Under the amended regulation, the eligibility agency will not be permitted to complete a partial redetermination or redetermination on a child who is enrolled in the Head Start expansion program until a child is no longer enrolled in the Head Start program. The eligibility agency will conduct a partial redetermination or redetermination if the family has additional children who are not enrolled in Head Start, but receive subsidized child care.
A child enrolled in the Head Start expansion program is not subject to partial redetermination or redetermination regulation in subsection (i). Eligibility for a child enrolled in the Head Start expansion program is unrelated to the eligibility of other children in the family who are not enrolled in the Head Start expansion program and receive subsidized child care. Eligibility for a child enrolled in the Head Start expansion program shall continue as specified in subsections (a)—(k).
§ 3041.167. Notice of overpayment
Subsection (b)(5) is amended by adding the language ''except in cases of suspected fraud.'' The addition of this language rescinds the requirement to include the repayment methods in the notice of overpayment when the overpayment is due to suspected fraud.
§ 3041.182. Eligibility agency responsibilities regarding overpayment
This section specifies that cases of suspected provider fraud will be referred to the OIG.
§ 3041.183. Delaying recoupment
This section is amended to delay recoupment for cases referred to the OIG for suspected fraud until the investigation is complete. It also establishes that the method of recoupment in cases of suspected fraud will be determined in conjunction with the OIG.
§ 3041.186. Collection
This section is amended by adding the requirement that the collection of overpayments in cases of suspected fraud shall be done in conjunction with the OIG. When the OIG has determined fraud, in an active case, the eligibility agency shall determine the collection method in conjunction with the OIG.
§ 3041.188. Collection for a family whose child is no longer in care
This section is amended by adding the requirement that the collection of overpayments in cases of suspected fraud shall be done in conjunction with the OIG. When the OIG has determined fraud, in a case when the child is no longer in care, the eligibility agency shall determine the collection method in conjunction with the OIG.
§ 3041.189. Disqualification
This section is amended by adding an additional criteriawhen a parent or caretaker is disqualified from participating in the subsidized child care program. If the parent or caretaker agrees to be disqualified by signing an administrative disqualification hearing waiver, the parent or caretaker will be disqualified.
Affected Individuals and Organizations
Parents and caretakers who receive subsidized child care are affected by this final-omitted rulemaking. If a parent or caretaker's child has five consecutive absences, the child care subsidy will be suspended. In addition, parents and caretakers will be required to pay for absences over a specified amount in a fiscal year. Parents and caretakers are also required to meet eligibility requirements each time a child in the family applies for the Head Start expansion program.
In addition, providers and eligibility agencies are affected by this final-omitted rulemaking. Providers are required to notify the eligibility agency when a child is absent for 5 consecutive days. Eligibility agencies are required to verify enrollment directly with the Head Start expansion program. In addition, eligibility agencies are required to track the number of absences for each child receiving subsidized child care to determine if a child exceeds the allotted number of absences. Finally, eligibility agencies are required to refer all suspected cases of fraud to the OIG.
Accomplishments and Benefits
This final-omitted rulemaking implements section 403.1 of the code. As provided in Act 22, this final-omitted rulemaking will help the Department's efforts to conserve resources to ensure that the expenditures for State FY 2011-2012 for assistance programs administered by the Department do not exceed the aggregate amount appropriated for assistance programs by the General Appropriations Act of 2011.
Fiscal Impact
The Commonwealth will realize an estimated savings of $463,000 in State FY 2011-2012.
Paperwork Requirements
There are new paperwork requirements under the final-omitted rulemaking. Under the amended regulation, when applying for the Head Start expansion program, the parent or caretaker will be required to verify that the eligibility requirements are met for subsidized child care each time a child in the family applies for the Head Start expansion program. Verification will include income eligibility.
The eligibility agency is required to conduct partial redeterminations or redeterminations if the family has additional children who are not enrolled in Head Start, but receive subsidized child care. The number of redeterminations will increase under the amended regulation.
In addition, the eligibility agency will need to track the number of absences for each child receiving subsidized child care to determine if a child exceeds 25 absences.
Public Comment
Although this rulemaking is being adopted without publication as proposed rulemaking, the Department posted a draft regulation on the Department's web site on February 24, 2012, with a 15-day comment period. The Department invited interested persons to submit written comments regarding the draft regulation to the Department. The Department received 48 comments. The Department also discussed the Act 22 regulations and responded to questions at the House Health Committee hearing on March 8, 2012.
The Department considered the comments received in response to the draft regulation. For the following reasons, the Department has decided to revise the regulations concerning the number of absences allowed before a parent or caretaker is deemed responsible to pay the provider if additional absences occur. The regulations were also revised to clarify that a child is considered absent only once during an enrollment day.
Discussion of Comments
Following is a summary of the major comments received within the public comment period following publication of the draft regulation and the Department's response to the comments.
Comment
Several commentators stated that the Department did not allow sufficient time for review and comment of the regulations. In addition, commentators requested the public comment period be extended an additional 30 days due to the policy changes and the volume of regulations.
Response
The Department engaged in a transparent public process through which the Department solicited and received numerous comments and input from stakeholders and other interested parties. As previously mentioned, the Department posted the draft regulation on the Department's web site on February 24, 2012. The Department invited interested persons to submit written comments, on or before March 9, 2012, regarding the draft regulation to the Department. In addition, the Department's Regulatory Agenda announced the Act 22 regulations at 42 Pa.B. 879, 893 (February 11, 2012).
As a final-omitted regulation under Act 22, the Department was not required to have a public comment process. However, to encourage transparency and public input, the Department provided an opportunity for comment by posting the draft regulation on the Department's web site. This public comment process provided sufficient opportunity for interested parties to submit comments, as supported by the number of comments that were submitted. Therefore, the Department is not extending the public comment period.
Comment
Comments were received both in support and opposition of the regulation regarding consecutive days of absence changing from 10 days to 5 days. Comments varied from supporting the 5 days of absence to opposing the reduction because illness can last longer or the absences will be difficult to track.
Response
The Department is maintaining the policy to reduce the allowable number of consecutive days of absence from 10 days to 5 days as provided in the draft regulations. This amendment will ensure that a child care subsidy is only provided on a limited basis to children who are not in child care.
Comment
Comments were received both in support and opposition to capping the number of absences allowed before a parent or caretaker is responsible to pay the provider for additional absences. Recommendations included making the number of absences the same regardless of the number of hours a parent or caretaker works or trains and adding exceptions for illness or hospitalization.
Response
Based on the comments received, the Department revised the regulation to allow a child to be absent a total of 25 enrollment days in a fiscal year before the parent is responsible for paying the provider for additional absent days, regardless of how many hours the parent or caretaker is working or training. Originally, the regulation differentiated the number of absences allowed according to the number of hours the parent or caretaker worked or trained—20 enrollment days if the parent or caretaker worked or trained less than 25 hours and 30 enrollment days if the parent or caretaker worked or trained 25 hours or more.
Due to varying training and work schedules, the Department revised § 168.72 (relating to determining monthly child care costs) and § 3041.19 to align the number of paid absences in a year. If a child's absences exceed 25 total enrollment days in the State's fiscal year, the parent or caretaker is responsible to pay to the provider the provider's verified published daily rate for each day of absence starting with the 26th day of absence. In addition, the Department clarified that a child is considered absent only once during an enrollment day.
Comment
Comments were received both in support and opposition of the regulation involving the time frames for eligibility and suspension when there is an involuntary loss of work, strike completes education or training. Comments varied from supporting the payment of child care subsidy only up to 30 days to opposing the reduction from 60 days due to the current economic climate and the difficulties with finding a job.
Response
The Department is maintaining the policy that 30 days of child care subsidy will be paid after a parent or caretaker involuntarily loses work, begins a strike or graduates or completes education or training. After 30 days, the child care subsidy will end. The family's eligibility, however, will remain for an additional 30 days in the event another job is found during that time. This change ensures that child care subsidy is only provided for children who need child care, while still allowing a grace period for the parent or caretaker to find another job.
Comment
Comments were received both in support and opposition to the regulatory amendment concerning disqualification and overpayments. Commentators suggested the regulations be revised to contain protections against abuse of the hearing waiver process. In addition, commentators suggested the regulations be revised to specify the collection method in cases of suspected fraud.
Response
The Department is maintaining the policy concerning the disqualification hearing waiver and also the collection of overpayments in cases of suspected fraud. If a parent or caretaker agrees to be disqualified by signing an administrative waiver, the parent or caretaker will be disqualified. The collection of overpayments in cases of suspected fraud will be delayed until the OIG completes its investigation. Overpayments involving fraud will be collected in conjunction with the OIG. This change will allow the Department to determine whether the eligibility agency, OIG or the court is best suited to collect overpayments. Further, delaying recoupment in cases of suspected fraud will allow a thorough investigation to take place.
Comment
Commentators submitted recommendations concerning special eligibility for children enrolled in Head Start. These recommendations included requiring redeterminations for children enrolled in Head Start who receive subsidized child care, developing clear notification regarding sibling rules and providing sufficient time between notification and discontinuation of subsidy.
Response
The Department is maintaining the policy that to be eligible for the Head Start expansion program, a family shall verify eligibility each time a child in the family applies for the Head Start expansion program. Prior to amendment, the regulations only required parents and caretakers to report a job loss. Under the regulatory amendment, parents and caretakers will be required to continue to meet eligibility requirements.
Regulatory Review Act
Under section 403.1 of the code, this final-omitted rulemaking is not subject to the Regulatory Review Act.
Findings
The Department finds that:
(1) Notice of proposed rulemaking is omitted in accordance with section 204(1)(iv) of the CDL, 1 Pa. Code § 7.4(1)(iv) and section 403.1(d) of the code because the regulations relates to Commonwealth grants and benefits.
(2) Adoption of this final-omitted rulemaking in the manner provided by this order is necessary and appropriate for the administration and enforcement of the code.
Order
The Department, acting under the code, orders that:
(a) The regulations of the Department, 55 Pa. Code Chapters 168 and 3041, are amended by amending §§ 168.72, 3041.19—3041.21, 3041.51, 3041.167, 3041.182, 3041.183, 3041.186, 3041.188 and 3041.189 to read as set forth in Annex A.
(b) The Secretary of the Department shall submit this order and Annex A to the Offices of General Counsel for approval as to legality and form as required by law.
(c) The Secretary of the Department shall certify and deposit this order and Annex A with the Legislative Reference Bureau as required by law.
(d) This order shall take effect upon publication in the Pennsylvania Bulletin.
GARY D. ALEXANDER,
SecretaryFiscal Note: 14-532. No fiscal impact; (8) recommends adoption.
Annex A TITLE 55. PUBLIC WELFARE PART II. PUBLIC ASSISTANCE MANUAL Subpart C. ELIGIBILITY REQUIREMENTS CHAPTER 168. CHILD CARE PAYMENT DETERMINATION § 168.72. Determining monthly child care costs.
(a) Child care costs include the following:
(1) A charge for child care during the hours of the work-related activity, including travel time and sleep-time.
(2) A charge for up to 5 consecutive days on which the child was not in attendance.
(3) A charge for transporting the child to or from care if the charge is included as part of the normal child care charge and not levied as a separate charge.
(b) If a child's absences exceed 25 total enrollment days in the State's fiscal year, the parent or caretaker is responsible to pay to the provider the provider's verified published daily rate for each day of absence starting with the 26th day of absence. A child is considered absent only once during an enrollment day. A parent or caretaker who receives subsidized child care under the Supplemental Nutrition Assistance Program employment and training program is not be required to pay for absences under this subsection.
PART V. CHILDREN, YOUTH AND FAMILIES MANUAL Subpart B. ELIGIBILITY FOR SERVICES CHAPTER 3041. SUBSIDIZED CHILD CARE ELIGIBILITY GENERAL REQUIREMENTS AND BENEFITS § 3041.19. Absence.
(a) Upon notification from the provider that a child has been absent more than 5 consecutive days for which the child is scheduled to attend child care, not including days of a child's illness, injury or impairment that precludes a child from attending child care, or other reason as specified in § 3041.21 (relating to subsidy suspension), the eligibility agency shall send the parent or caretaker an adverse action notice terminating the child's eligibility and payment to the provider.
(b) The notice shall inform the parent or caretaker of the following:
(1) The parent or caretaker shall report to the eligibility agency the date of the child's return to care.
(2) Payment will not be terminated if the child returns to care by the date set forth on the notice.
(3) If the child does not return to care by the date set forth on the notice and there are no grounds for subsidy suspension, the child's subsidy will be terminated effective the date set forth on the notice.
(c) If a child's absences exceed 25 total enrollment days in the State's fiscal year, the parent or caretaker is responsible to pay to the provider the provider's verified published daily rate for each day of absence starting with the 26th day of absence. A child is considered absent only once during an enrollment day. Suspended days of service as specified in § 3041.21 are not considered days of absence.
§ 3041.20. Subsidy continuation during breaks in work, education or training.
A family's eligibility and payment for subsidized child care continues for and during the following:
(1) Thirty calendar days from the date of an involuntary loss of work, the date a strike begins or the date the parent graduates from or completes education or training. On day 31, the child care subsidy will be suspended and the family's eligibility will continue for an additional 30 days.
(2) A total of 84 calendar days from the first day of family leave, including maternity leave, as defined under the Family and Medical Leave Act of 1993 (29 U.S.C.A. §§ 2601—2654), provided there is a need for child care.
(3) Regularly scheduled breaks in work or breaks in education or training, if the regularly scheduled break is less than 31 calendar days.
§ 3041.21. Subsidy suspension.
(a) If a child is unable to attend child care for more than 5 consecutive days for which the child is scheduled to attend care, subsidy shall be suspended for up to 90 calendar days in the following circumstances:
(1) The child is visiting the noncustodial parent or caretaker.
(2) The child is ill or hospitalized, preventing the child from participating in child care.
(3) The child is absent because of family illness or emergency.
(4) The child remains at home with his parent or caretaker during family leave.
(5) The provider is closed because of failure to meet certification or registration requirements.
(6) The parent or caretaker needs to locate another provider because the current provider cannot meet the parent's or caretaker's child care needs.
(7) The parent or caretaker is on maternity or family leave, as defined under the Family and Medical Leave Act of 1993 (29 U.S.C.A. §§ 2601—2654).
(8) A parent or caretaker has a break in work, education or training that exceeds 30 calendar days but does not continue beyond 90 calendar days.
(b) The child is no longer eligible for subsidy payment or service if the child continues to be absent following 90 calendar days of suspension.
SPECIAL ELIGIBILITY PROGRAMS § 3041.51. Head Start expansion program.
(a) Head Start is a Federally-funded program designed to prepare at-risk children, 3 years of age or older but under 5 years of age, for school success. A Head Start expansion program is a program that combines the Head Start program with the subsidized child care program.
(b) A child who is enrolled in a Head Start program, whose parent or caretaker needs extended hours or days of child care beyond the hours or days provided by the Head Start program to work, is eligible for subsidized child care under this section, if the parent or caretaker meets the eligibility requirements for subsidized child care as specified in subsection (f), each time a child in the family applies for the Head Start expansion program.
(c) The eligibility agency shall verify with the Head Start program that the child is enrolled in a Head Start program that meets Federal and State Head Start standards.
(d) If a child in the family as specified in § 3041.31 (relating to family size) is enrolled in the Head Start expansion program, the family co-payment is based on family size and income. If additional children in the family are enrolled in subsidized child care, the family co-payment is based on family size and income.
(e) If extended hours or days of care are provided beyond the Head Start program hours or days, the extended hours and days of care shall be provided by a facility that has a certificate of compliance or registration by the Department as a child day care facility.
(f) Upon program entry and continuation in the Head Start expansion program, a parent or caretaker shall meet the following conditions:
(1) Verification of a minimum of 20 hours of work per week as specified in § 3041.43 (relating to work, education and training) each time a child in the family applies for the Head Start expansion program.
(2) Verification that extended hours and days of child care are needed to work as specified in subsection (b).
(3) Verification of income eligibility for subsidized child care as specified in § 3041.41 (relating to financial eligibility) each time a child in the family applies for the Head Start expansion program.
(4) Compliance with the waiting list conditions specified in § 3041.133 (relating to waiting list).
(5) Payment of the co-payment as specified in § 3041.101 (relating to general co-payment requirements).
(6) Report loss of work within 10 calendar days following the date work ended as specified in § 3041.127(b) (relating to parent and caretaker report of change).
(7) Report when a child is no longer enrolled in Head Start within 10 calendar days following the date the Head Start enrollment ended.
(g) Subsidy for a child receiving care under this section may be suspended during summer school breaks.
(h) A parent or caretaker whose child receives subsidized child care and is enrolled in a Head Start program is not required to report changes in circumstances during the period of the child's Head Start enrollment, unless the parent or caretaker loses work. If the parent or caretaker involuntarily loses work, the family remains eligible for the Head Start expansion program for up to 60 calendar days following the loss of work. If the parent or caretaker is unemployed for more than 60 calendar days, the family is ineligible for subsidized child care.
(i) The eligibility agency may not complete a partial redetermination or redetermination on a child enrolled in the Head Start expansion program until the Head Start program, the parent or caretaker or a reliable source confirmed by the eligibility agency reports to the eligibility agency that a child is no longer enrolled in the Head Start program.
(j) The eligibility agency shall conduct a partial redetermination or redetermination as specified in §§ 3041.129and 3041.130 (relating to partial determination based on reported changes; and redetermination of eligibility) if the family has additional children who are not enrolled in Head Start but receive subsidized child care.
(k) A child enrolled in the Head Start expansion program is not subject to partial redetermination or redetermination requirements as specified in subsection (i). Eligibility for a child enrolled in the Head Start expansion program is unrelated to the eligibility of other children in the family who are not enrolled in the Head Start expansion program and receive subsidized child care. Eligibility for a child enrolled in the Head Start expansion program shall continue as specified in this section.
NOTIFICATION AND RIGHT TO APPEAL § 3041.167. Notice of overpayment.
(a) The eligibility agency shall notify the parent or caretaker in writing of an overpayment.
(b) The notice of overpayment must include the following:
(1) The reason for the overpayment as specified in § 3041.181 (relating to overpayment).
(2) The period of the overpayment.
(3) The amount of the overpayment.
(4) An explanation of how the overpayment was calculated.
(5) The repayment methods as specified in § 3041.186 (relating to collection) except in cases of suspected fraud.
(6) The right of the parent or caretaker to appeal the decision on the overpayment and how to appeal as specified in §§ 3041.162 and 3041.171 (relating to notice of right to appeal; and appealable actions).
OVERPAYMENT AND DISQUALIFICATION § 3041.182. Eligibility agency responsibilities regarding overpayment.
(a) The eligibility agency shall inform a parent or caretaker who files an appeal and requests subsidy continuation pending appeal, that if the hearing decision is in favor of the eligibility agency or the Department, the parent or caretaker shall reimburse the amount of the overpayment unless the hearing officer determines a hardship.
(b) The eligibility agency shall pursue possible overpayments in active and closed cases, including those that were voluntarily closed.
(c) The following are the responsibilities of the eligibility agency when exploring possible overpayments:
(1) Determination of whether the overpayment is the result of one of the conditions specified in § 3041.181 (relating to overpayment).
(2) Written assurance that the methods of exploring overpayments are appropriate to the particular situation and to the different eligibility factors.
(3) Assurance that the methods of exploring overpayments do not infringe on the civil liberties of individuals or interfere with the due process of law.
(4) Investigation of a credible complaint that a parent or caretaker is erroneously receiving subsidized child care.
(5) Identification and documentation of the causes of the overpayment.
(6) Computation of the amount of the overpayment.
(7) Referral of suspected fraud cases to the Office of Inspector General.
(8) Submission of an overpayment notice to the parent or caretaker as specified in § 3041.167 (relating to notice of overpayment).
(d) The eligibility agency shall refer all cases of suspected provider fraud to the Office of Inspector General.
§ 3041.183. Delaying recoupment.
(a) Recoupment shall be delayed until after a hearing decision, if the family files an appeal of the overpayment decision no later than 10 calendar days after the date the written notice is postmarked or hand-delivered to the parent or caretaker by the eligibility agency.
(b) Recoupment shall be delayed for cases referred to the Office of Inspector General for suspected fraud until the investigation is complete.
(c) The method of recoupment in cases of suspected fraud will be determined in conjunction with the Office of Inspector General.
§ 3041.186. Collection.
(a) The eligibility agency shall collect the total amount of the overpayment from a family whose child continues to receive subsidized child care when the eligibility agency identifies an overpayment as specified in § 3041.182 (relating to eligibility agency responsibilities regarding overpayment).
(b) If the Department, eligibility agency or other entity identifies an overpayment unrelated to fraud, subject to repayment as specified in § 3041.181 (relating to overpayment), related to a family whose child continues to receive subsidized child care, the eligibility agency shall:
(1) Notify the parent or caretaker by a letter that a repayment is required, the amount of the repayment and the following repayment options:
(i) A one-time payment of the full amount owed.
(ii) A one-time partial payment and an increase in the co-payment to be paid until repayment is complete.
(iii) An increase in the co-payment until the repayment is complete.
(2) Automatically implement an increase to the co-payment until the repayment is complete when the parent or caretaker does not select an option as specified in paragraph (1) no later than 10 calendar days following the date of the letter.
(3) Notify the parent or caretaker by a second letter of failure to choose a repayment option as specified in paragraph (1), the amount of the increased co-payment and the number of weeks the increased co-payment will continue.
(c) When the Office of Inspector General has determined fraud in an active case, the eligibility agency shall determine collection methods in conjunction with the Office of Inspector General.
§ 3041.188. Collection for a family whose child is no longer in care.
(a) The eligibility agency shall collect the total amount of the overpayment as specified in § 3041.182 (relating to eligibility agency responsibilities regarding overpayment) from a family whose child is no longer receiving subsi-dized child care if the eligibility agency identifies an overpayment.
(b) If the Department, eligibility agency or other entity identifies an overpayment unrelated to fraud, for a family whose child is no longer receiving subsidized child care, the eligibility agency shall:
(1) Notify the Department of the subsidy termination date, the amount of the overpayment recouped and the amount outstanding. The Department will notify the parent or caretaker by letter of the overpayment, the amount of the outstanding overpayment and that repayment is required in either a single payment or under a payment plan agreeable to the parent or caretaker and the eligibility agency. The letter must state that the parent or caretaker has 10 calendar days to respond to the Department indicating agreement or disagreement and indicating the choice of a repayment method.
(2) Send a second letter that repeats the information contained in the letter specified in paragraph (1) when the Department notifies the eligibility agency that the parent or caretaker failed to respond. The second letter must also request a response from the parent or caretaker no later than 10 calendar days following the date of the letter.
(c) When the Office of Inspector General has determined fraud in a case when the child is no longer in care, the eligibility agency shall determine the collection methods in conjunction with the Office of Inspector General.
(d) The Department may institute civil legal proceedings when the parent or caretaker fails to respond to the second letter.
§ 3041.189. Disqualification.
(a) The parent or caretaker is disqualified from participating in the subsidized child care program if one of the following applies:
(1) A Federal or State court finds the parent or caretaker guilty of fraud in applying for or receiving subsidized child care.
(2) A hearing officer determines that the parent or caretaker committed fraud pursuant to the procedures and standards in Chapter 275 (relating to appeal and fair hearing and administrative disqualification hearings).
(3) The parent or caretaker signs a disqualification consent agreement as part of a court's deferred adjudication process.
(4) The parent or caretaker agrees to be disqualified by signing an administrative disqualification hearing waiver.
(b) Upon disqualification under subsection (a), a parent or caretaker and eligible children in the parent's or caretaker's family shall be prohibited from participation in the subsidized child care program:
(1) For 6 months from the date of the first conviction, hearing decision or determination.
(2) For 12 months from the second conviction, hearing decision or determination.
(3) Permanently from the date of the third conviction, hearing decision or determination.
(c) A parent or caretaker may not be granted a hearing on a court conviction or administrative disqualification hearing decision that led to the disqualification.
[Pa.B. Doc. No. 12-643. Filed for public inspection April 13, 2012, 9:00 a.m.]
