Department of Health and Human Services
Departmental Appeals Board
AFDC QUALITY CONTROL REVIEW PANEL
SUBJECT: Illinois Department of Public Aid
Docket Nos. A-94-046, A-94-047
Decision No. QC 63
DATE: March 23 1994
DECISION
The Illinois Department of Public Aid (Illinois) appealed
two quality
control (QC) review determinations of the
Regional Administrator of the
Administration for Children
and Families (ACF). The Quality Control
Review Panel
(Panel) consolidated these two cases, as the appeal in
Docket No. A-94-047 concerned the same legal and factual
issues as in
Docket No. A-94-046. 1/ In its appeal
requests, Illinois
acknowledged that the issues in these
two appeals were the same ones decided
by the Panel in
Illinois Dept. of Public Aid, DAB QC48 (1993), which
resolved three earlier Illinois appeals in Docket Nos.
A-92-202,
A-93-019, and A-93-101.
The central issue in all five of these Illinois appeals
is whether
Illinois improperly calculated the initial
payment amount of Aid to Families
with Dependent Children
(AFDC). Illinois contended that it was proper
to prorate
the recipients' initial AFDC payment from the date of the
recipients' approval for AFDC until the day before their
cases were
placed on Illinois' regular automated payment
roll (the initial prorated
entitlement or IPE period)
where the IPE period was longer than one fiscal
month.
Illinois contended further that its IPE methodology was
consistent with the Social Security Act (Act), federal
regulations, the
AFDC Quality Control Manual (QCM), and
its own State plan. In all five
appeals, ACF contended
that instead of paying for the month of application
and
the next fiscal month (which made up the IPE period) on a
prorated
basis, Illinois should have prorated that part
of the payment which
consisted of the days remaining in
the application month and then paid a
flat grant for the
part of the payment which represented the next fiscal
month. In Decision No. QC48, the Panel sustained ACF's
determination regarding the calculation of the IPE
payment.
2/
Regarding the appeals in question here, in Docket No.
A-94-046, State QC
reviewed a $357.00 payment made during
the April 1992 review month.
State QC found that the
recipient was underpaid $9.00, stating that the
recipient
should have been paid $366.00, covering 41 days (the
entire
IPE period). Federal QC review found the April
1992 review month
payment of $89.00 to be correct.
Federal QC determined that the April
review month
consisted of ten days only (the number of days remaining
in
the application month following the recipient's
approval for AFDC payment),
not the 41 days alleged by
State QC review. In Docket No. A-94-047,
State QC
reviewed a $366.00 payment made during the July 1992
review
month. State QC review found that the recipient
was overpaid $310.00
due to unreported child support
income. Federal QC review found that
the recipient was
overpaid $70.00, having determined that the July review
month consisted of ten days only (the number of days
remaining in the
application month following the
recipient's approval for AFDC payment), not
the 41 days
(the entire IPE period) alleged by State QC review.
In its March 18, 1994 reply, Illinois acknowledged again
that the issues
in Docket Nos. A-94-046 and A-94-047 are
the same issues the Panel decided
in Decision No. QC48.
Illinois acknowledged further that its appeals
in Docket
Nos. A-94-046 and A-94-047 were submitted only to
preserve
Illinois' appeal rights. We conclude, in the
absence of any new
argument or evidence in support of
Illinois' position regarding the
calculation of the IPE
payments in these appeals, and for the reasons
discussed
in Decision No. QC48 (which we incorporate herein by
reference), that Illinois incorrectly calculated the
payment for the IPE
period in Docket Nos. A-94-046 and A-
94-047. Illinois should have
prorated that part of the
IPE payment which consisted of the days remaining
in the
application month and then paid a flat grant for that
part of the
payment which represented the next fiscal
month.
Accordingly, we uphold the ACF Regional Administrator's
determination in
both appeals.
Peggy McFadden-Elmore
Carolyn Reines-Graubard
Maxine Winerman
* * * Footnotes * * *
1. Initially,
Illinois' appeal of ACF's
determination in Docket No. A-94-046 contained an
issue
concerning timeliness. However, in Illinois' March 18,
1994
reply, Illinois withdrew its appeal of the
timeliness issue, stating that
the issue was not properly
before the Panel.
2. The Panel remanded
Docket No. A-93-101 to
ACF to determine whether income received by the
recipient
during the review month should be applied in full or in
prorated part only against the AFDC payment for which the
recipient was
eligible. This question was not raised by
the parties in Docket Nos.
A-94-046 and A-94-047.
(..continued)