REVIEW REQUIREMENTS

Department of Health and Human Services
Administration for Children and Families


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EXHIBIT 1

GENERAL REVIEW STEPS

TESTING THE ACCEPTABILITY OF COMPUTERIZED DATA

The reviewers should conduct limited tests to determine if the data provided by computer-based systems is reliable and accurate.

GENERAL CASE EVALUATION RULES

A. Cases will be evaluated for the following State plan requirements (Category 1 Review Criteria) to determine compliance with the Federal requirements:

1. Case Closure;

2. Establishment of Paternity and Support Orders;

3. Expedited Processes;

4. Enforcement of Orders;

5. Disbursements of Collections;

6. Medical Support Enforcement;

7. Review and Adjustment; and

8. Interstate Services.

B. Initially, the reviewer will evaluate each case to determine whether it should be excluded from further analysis or whether some type of child support action (related to the provision of services) should be provided during the review period. If the State is using targeted or focused universes, then they will evaluate whether the case needed child support services related only to the specific function being evaluated.

C. A case may be excluded from further review because of the following reasons:

· No action was required during the review period;

· Insufficient time to take required case action;

· Case could have been closed in accordance with the Federal regulations §303.11;

· Case file or documentation on the State's automated system or the physical case file cannot be located or is inadequate for the reviewer to ascertain what actions were required and/or taken during the review period;

· Etc.

D. The reviewer will compute an "efficiency rate" for each Review Criterion to determine whether the State was in compliance with the Federal requirements. The "efficiency rate" should be calculated as follows:

Cases with Appropriate Action Taken = Efficiency Rate

Cases with Required Actions (percentage of cases for which required actions were taken)

The numerator, "Cases with appropriate actions(s) taken," represents the number of cases for a review criterion for which the last required action met Federal requirements or for which IV-D obtained a successful outcome (see K. below).

The denominator, "Cases with required actions" represents the universe of cases for a review criterion that needed child support services during the review period.

E. For each Review Criterion being evaluated, if a case required the service during the review period, it can only receive one "Action" or "Error."

F. If the State is utilizing a statewide statistical sample (rather than a focused sample), then a case should be evaluated for all the required Federal review criteria that needs to be provided during the review period. For example, a case could be evaluated for both Establishment of Orders and Enforcement of Orders.

G. Case activity will generally be reviewed for the 12-month review period only. Credit will not be given to child support activities provided prior to or after the 12-month review period. However, case activity that occurred prior to the review period may be used for the starting point for evaluating time frames that expired during the review period.

H. In keeping with the previous OCSE's definition of substantial compliance in 45 CFR 305.20, we have decided to evaluate cases using benchmarks of 90 percent to evaluate "Case Closure" and 75 percent for all other Review Criteria. We believe that these standards have been determined to be fair and equitable and have been evaluated through the regulatory process. We believe that the State should have benchmarks to evaluate cases to make a determination if they are meeting the Federal requirements and to determine when corrective actions are needed to improve their performance. The case reviews will not be used as a basis for determining substantial compliance or for determination of any child support penalties.

I. Time standards related to "Provision of Services in Interstate IV-D Cases" will be evaluated separately using the 75-percent benchmark; however, the extent to which child support services like establishing orders, enforcing orders, disbursing collections, medical support; etc. are provided or not provided should be evaluated under the appropriate Review Criteria. For interstate cases, the reviewer must ensure that initiating and responding (including Central registry) cases are evaluated.

J.Opening a case and locating non-custodial parents will be evaluated as part of "Establishment of Paternity and Support" and "Enforcement of Support Orders." These requirements are not an end in itself, but are, in fact, often the initial step in providing other major program services, including paternity and support establishment and enforcement.

K. In moving towards a more results-oriented review, if the State achieved a successful outcome (i.e., order established), the State will consider this case an Action case and the State will not evaluate any required time frames for the review period for that Review Criterion (i.e., Establishment of Paternity and Support). Successful outcomes will be considered for the following Review Criteria: "Establishing Paternity and Support;" "Enforcement of Support Obligations;" and "Review and Adjustment."

L. If the State did not successfully complete an outcome for a case for a Review Criteria and time standards must be evaluated, then the reviewer should evaluate the latest required action which occurred during the review period for which the time frame can be evaluated. This will also apply to the other review criteria for which time standards are being evaluated. Therefore, only one time standard will be evaluated for a case for a Review Criterion. (If the time standard would normally expire after the review period, but the action was completed/successful within the review period, then this action should be counted.) We believe that by concentrating on the latest require time standard, it will avoid creating a disincentive not to work a case because a time standard has been missed. Also, this approach focuses more on the results and measures than on how well a State is currently able to work the cases.

One State further commented that: "Evaluating the latest required action is key to self-assessment being meaningful. Self-assessment also leads to self-correction. Auditing a case which may have been out of compliance in the past does nothing to assess current operations which may have brought the case into compliance."

One State wanted us to clarify that for focused samples for a given criterion only one time standard would be evaluated for a case. However, if a State uses a statewide sampling approach or combines criteria for a targeted universe, then a case would only be evaluated for one time standard within a review criterion, but it could be evaluated for more than one review criterion.

M. If the State did not successfully complete an outcome for a case for a Review Criteria and time standards could not be evaluated because they expired prior to the review period, the reviewer should still determine whether any action could have been taken during the review period and whether the State provided the next required action. If the next required action was never taken during the review period, then the case would be classified as an Error case. For example, if a paternity and support order has never been established for a case and no action was ever taken to serve the alleged father after he was located, then the case should still be an Error case even if the 90-day time standard for service expired prior to the review period.

DETAILED REVIEW REQUIREMENTS

The following review requirements are the minimum requirements that the States must use in evaluating cases for its annual self-assessment review. The States may modify the review requirements by making them more restrictive or evaluating additional Federal or State requirements; however, they should document their review methodology in the annual report.

In addition, the State may evaluate the cases for the review criteria in any order. For example, a State may choose to evaluate Case Closure as the last step in reviewing cases. Also, some States may want to evaluate "Expedited Processes" immediately after evaluating "Establishment of Paternity and Support Order."

A. The State must have and use procedures required under the following criterion in at least 90 percent of the cases required for the following criterion.

1. CASE CLOSURE -- §303.11

If a IV-D case was closed during the review period, determine whether the following requirements were met:

· One or more Federal case closure criteria were applicable.

· 60-day notice sent, when appropriate

B. The State must have and use procedures required under the following Case Review criteria in at least 75 percent of the cases required for each criterion.

1. ESTABLISHMENT OF PATERNITY AND SUPPORT ORDER -- §§303.4 and 303.5:

a. If an order for support is required and established during the review period, the case meets the requirement (§305.20(a)(4)(i)).

b. If an order was required but not established during the review period, determine the last required action and review for the appropriate time frame from the following list.

· Open a case within 20 days (§303.2(b)).

· Whenever locate is necessary, access all appropriate location sources within 75 days (§303.3(b)(3)). This includes, at a minimum, all the following locate sources as appropriate: custodial parent; Federal Parent Locator Service (FPLS); US Postal Service; State employment security agency; unemployment data; Department of Motor Vehicles; and credit bureaus.

One State questioned if credit bureaus had to be accessed for locate purposes. These six appropriate locate sources were identified in the preamble in the Federal Register in OCSE AT-94-06, dated December 23, 1994, page 66244. These locate sources were selected because of their proven level of effectiveness in successfully identifying useful location information in most cases.

· Repeat location attempts quarterly and when new information is received in accordance with §303.3(b)(5).

· Establish an order or complete service of process necessary to commence proceedings to establish a support order, and, if necessary, paternity within 90 calendar days of locating the non-custodial parent, or document unsuccessful attempts to serve process in accordance with State's guidelines defining diligent efforts (§303.4(d) and §303.3(c)).

2. ENFORCEMENT OF ORDERS -- §303.6
(Enforcement cases include all cases in which both ongoing wage withholding is in place as well as those cases in which new or repeated enforcement actions were required during the review period.)

a. If a wage withholding collection was received during the last quarter of the review period and the case was submitted for Federal and State tax refund offset, if appropriate, then the case will be considered an Action case (§305.20(a)(4)(iii) and §303.6(c)(3)).

b. If wage withholding was not appropriate, and an enforcement collection was received during the review period, and the case was submitted for Federal and State tax refund offset, if appropriate, then the case will be considered an Action case (§305.20(a)(4)(iv) and §303.6(c)(3)).

c. If an order needed enforcement during the review period but wages were not withheld or other collections were not received (when wage withholding could not be implemented), determine the last required action, in addition to Federal and State tax refund offset, and review for the appropriate time frame from the following list.

· Repeat location attempts quarterly and when new information is received in accordance with §303.3(b)(5).

· If no immediate wage withholding order, begin initiated wage withholding within 15 calendar days of identifying delinquency equal to one month's arrears if non-custodial parent's address is known, or within 15 calendar days of locating non-custodial parent, whichever occurs later (§303.100(c)(2)).

· If immediate wage withholding ordered, send notice to employer within 15 calendar days of the date the support order was entered if employer was known, or within 2 business days after the date information regarding a newly hired employee is entered into the State Directory of New Hires of locating the employer's address, whichever occurs later (§303.100(f)(2) and §453A(g)(1)).

· If wage withholding is not appropriate or cannot be implemented, take an appropriate enforcement action (other than Federal and State tax refund offset), if service of process not needed, within no more than 30 days of identifying a delinquency or locating the non-custodial parent, whichever occurs later (§303.6(c)(2)).

· If wage withholding is not appropriate or cannot be implemented, if service of process is needed, take an appropriate enforcement action (other than Federal and State tax refund offset), within no more than 60 days of identifying a delinquency or locating the non-custodial parent, whichever occurs later, or document unsuccessful attempts to serve process in accordance with State's guidelines for defining diligent efforts (§303.6(c)(2)).

d. If case has arrearages, submit annually for Federal and State tax refund offset during the review period, if appropriate, in accordance with requirements of §303.72, §303.102 and §303.6(c)(3)).

3. DISBURSEMENT OF COLLECTIONS-- §454B of the Act

(This requirement is effective October 1, 1998; however, for those States that had local courts disbursing their collections prior to PRWORA, the requirement goes into effect October 1, 1999. This criteria does not have to be reviewed until it has gone into effect.)

Also, one State questioned if they needed to evaluate all collections received during the review period. We have clarified that this criterion only needs to be reviewed for the latest collection received for a case within the last quarter of the review period; however, this criterion lends itself to be reviewed through management reports of a State's automated system.

a. For cases with collections received in the last quarter of the review period, did the State distribute the latest collection received which was payable under §457(a) within the 2 business days after receipt from the employer or other source of periodic income, if sufficient information identifying the payee is provided (§454B(c) of the Act)? (Note: The State may delay distribution of collections to arrearages until the resolution of any timely appeal with respect to such arrearages.)

4. SECURING AND ENFORCING MEDICAL SUPPORT ORDERS -- §§303.30 and 303.31

a. For support orders being established during the review period, was medical support ordered? If not ordered, was medical support included in the petition for support to the court or administrative authority (§466(a)(19) of the Act and §303.31(b)(1))?

b. If health insurance ordered, were steps taken to determine if reasonable health insurance was available (§303.31(b)(7) and §303.30(a))?

c. If reasonable health insurance was available, but not obtained, were steps taken to enforce the order (§303.31(b)(7))?

d. If health insurance was obtained during the review period, was the Medicaid agency informed that coverage had been obtained (§303.31(b)(6))?

e. If health insurance obtained, was the custodial parent notified regarding the policy information (§303.31(b)(5))?

f. Were employers or others providing health insurance coverage requested to inform the State of lapses in coverage (§303.31(b)(9))?

g. If non-custodial parent was providing health insurance coverage and changes employment and the new employer provides health care coverage, did the State transfer notice of the health care provision to the new employer, which would enroll the child in the non-custodial parent's health plan, unless the non-custodial parent contested the notice(§466(a)(19) of the Act)?

5. REVIEW AND ADJUSTMENT OF ORDERS -- §303.8 and §466(a)(10) of the Act

Under PRWORA, States may elect one of the following review and adjustment methodologies: reviews and if appropriate, adjusts the support orders in accordance with State's guidelines; applies a cost-of living adjustment to orders; or uses automated methods (§466(a)(10) of the Act). Additionally, PRWORA changed the requirement from a mandatory review every 36 months for assistance cases to a review that only needs to be conducted every 36 months upon the request of either parent, or the request of the IV-D agency (for assistance cases).

a. If case was reviewed and adjusted, or a determination was made, as a result of a review, during the review period, that an adjustment was not needed, the State will be considered to have taken appropriate action (§305.20(a)(ii)).

b. If review was required but not completed during the review period, determine the last required action and review for the appropriate time frame from the following list.

· If locate is necessary to conduct a review, access all appropriate location sources within 75 days of opening case (§303.3(b)(3)). This includes, at a minimum, all the following locate sources as appropriate: Custodial parent; Federal Parent Locator Service (FPLS); US Postal Service; State employment security agency; unemployment data; Department of Motor Vehicles; credit bureaus; and quick locate in other States.

NOTE: One State questioned whether locate should be included under this criterion. We have included locate under this criterion since it had previously been included under this criterion in the audit regulations. We recognize that most of the time, if locate was an issue, it would probably be evaluated under Enforcement (if needed) rather than this criterion.

· Repeat location attempts quarterly and when new information is received in accordance with §303.3(b)(5).

· Provide the custodial and non-custodial parents notices, not less often then once every three years, informing them of their right to request the State to review and, if appropriate, adjust the order. The first notice may be included in the order. (Section 466(a)(10)(C) of the Act)? This first notice should be sent 3 years from the last time notification was provided to the parents or by December 31, 1996. After the initial notice, the State must periodically (at least once every 3 years) send notices to both parents.

· Within 180 calendar days of determining that a review should be conducted or locating the non-requesting parent, whichever occurs later, conduct a review of the order and adjust the order or determine that the order should not be adjusted (§303.8(f)(1)(ii))?

· If request received during the review period and a review is necessary, give both parties 30 days to contest any adjustment to that support order if the cost-of living or automated methods had been utilized (§466(a)(10)(A)(ii) of the Act)?

6. INTERSTATE SERVICES -- §§303.30 and 303.31

Interstate cases should be reviewed for the appropriate child support services needed during the review period for the above Compliance Review Criteria. However, in addition, the case should also be reviewed separately for any interstate time frames that applied during the review period.

a. For all interstate cases requiring services during the review period, determine the last required interstate action and review for the appropriate time frame from the following list.

INITIATING INTERSTATE CASES
· Except for using the State's long-arm statute for establishing paternity, within 20 calendar days of determining that the non-custodial parent is in another State and, if appropriate, receipt of any necessary information needed to process the case, refer that case to the responding State's interstate central registry for action (§303.7(b)(2)).

NOTE: One State asked us to clarify that the initiating State is not obligated to refer cases until appropriate documentation is available to process the case.

· If additional information requested, provide the responding State's central registry with requested additional information within 30 calendar days of the request (§303.7(b)(4)).

· Upon receipt of new information on a case, notify the responding State of that information within 10 working days (§303.7(b)(5)).

· Within 20 calendar days after receiving a request for review and adjustment take the appropriate action under the Uniform Interstate Family Support Act (UIFSA) (§303.7(b)(6)).

RESPONDING INTERSTATE CASES:

· Within 10 working days of receipt of an interstate IV-D case, the central registry must:

a) Review submitted documentation for completeness;

b) Forward the case to the State PLS for locate or to the appropriate agency for processing;

c) Acknowledge receipt of the case and request any missing documentation from the initiating State; and

d) Inform the IV-D agency in the initiating State where the case was sent for action (§303.7(a)(2)).

· Central registry must respond to inquiries from other States within 5 working days of receipt of request for a case status review (§303.7(a)(4)).

· Within 10 days of locating the non-custodial parent in a different jurisdiction or State, forward the case in accordance with Federal requirements (§§303.7(c)(5) and (6))

· Within 2 business days of receipt of collections, forward any support payments to the initiating State (§454B(c)(1) of the Act)).. If State has not implemented a State disbursement unit, use a 15-calendar day standard to measure timeliness through 9/30/99 (§303.7(c)(7)(iv)).

· Within 10 working days of receipt of new information, notify the initiating State of that new information (§303.7(c)(9)).

C. The State must have and use procedures required under the following Case Review criteria in at least 75 and 90 percent of the cases required for the following criterion.

1. EXPEDITED PROCESSES -- §303.101

a. For cases needing support obligations, regardless of whether paternity has been established, actions to establish support orders must be completed from the date of service of process or other successful notification to the time of disposition within the following time standards:

· 75 percent within 6 months (§303.101(b)(2)(i)) and ;

· 90 percent within 12 months (§303.101(b)(2)(i)).

b. In cases where the IV-D agency uses long-arm jurisdiction and disposition occurs within 12 months of service of process on the alleged father or non-custodial parent, the case may also be counted as a success for the 6-month standard (§303.101(b)(2)(iii)).