New Hampshire Title IV-E Foster Care Eligibility Review

New Hampshire Title IV-E
Foster Care Eligibility Review
September 25, 2000 to September 27, 2000

I. Introduction

During the week of September 25 to September 27, 2000, staff from the Regional and Central offices of the Administration for Children and Families' (ACF) and State of New Hampshire staff conducted an eligibility review of the State of New Hampshire's title IV-E foster care program.

The purpose of the title IV-E eligibility review was to validate the accuracy of New Hampshire's claims to assure that appropriate payments were made on behalf of eligible children, to eligible homes and institutions, and at allowable rates.

II. Scope of the Review

The New Hampshire title IV-E foster care review, which was conducted in Concord, encompassed a sample of all title IV-E foster care cases open during the period from October 1, 1999 to March 31, 2000. A computerized statistical sample of 88 cases was drawn from the Adoption and Foster Care Analysis and Reporting System (AFCARS) data, which was transmitted by the State Agency to ACF. The sampling frame consisted of cases of individual children who received at least one title IV-E foster care maintenance payment during the six-month period noted above. For each case, the child's case file was reviewed for the determination of title IV-E eligibility and to ensure that the foster home in which the child was placed was licensed for the period of the review.

In preparing for the review, it was discovered that a number of cases had not received a title IV-E payment during the period under review, therefore an additional 10 cases were drawn for a larger over sample pool.

During the initial primary review, 80 cases were reviewed. Seven (7) cases were determined ineligible for either part or all of the review period for reasons identified in the Case Record Summary of this report. Since the number of ineligible cases was less than nine, New Hampshire is considered to be in substantial compliance. Therefore, the state will not be required to participate in another primary review until FFY 2004.

III. Case Record Summary

The following details the ineligible cases, reasons for ineligibility and ineligible claims. The disallowance for ineligible cases is for the entire period of the ineligibility.

Sample No. 44
The child was removed from adoptive home and deprivation and financial need did not exist.
Total IV-E $54,276

Sample No. 103
The child was removed from home on 10/17/96 and court order was dated 10/17/96. The court order did not state contrary to the welfare and did not address reasonable effort to prevent removal or reasonable efforts to reunify child and family. State did not determine AFDC eligibility at the time of removal.
Total IV-E $36,495

Sample No. 346
The child's financial need did not exist throughout the entire review period; the child began receiving SSI payment on 12/11/98.
Total IV-E $23,608

Sample No. 385
The child was removed from adoptive home financial need and deprivation was not established. Reviewer could not locate court order with contrary to welfare of child and reasonable efforts to prevent removal and reasonable efforts to reunify child and family.
Total IV-E $83,362

Sample No. 613
Financial need and deprivation of parental support was not determined by case technician, approved for Medicaid only, however IV-E payments were generated.
Total IV-E $65,142

Sample No. 616
Deprivation did not exist throughout the entire period under review. Mother remarried on May 11, 1999 so child was ineligible after this period.
Total IV-E $15,841

Sample No. 921
Child was not removed from the home of a specified relative. Deprivation and financial need was not established.
Title IV-E $1,859
Grand Total IV-E $280,583

A review of the failed cases indicates that all seven cases had not met the requirement for AFDC eligibility. In a number of cases that failed, the cause of the overpayments was the result of system interface problems. The case technicians noted in the eligibility record the child was not IV-E eligible; however, when the child was put on Medicaid via the Bridges system, the system mistakenly claimed IV-E maintenance. We recommend that the agency review the causes of overpayments and take corrective action to implement system changes to Bridges. Finally a few cases failed because the Agency does not have a uniform procedure to ensure that the case technician staff was notified of changes in the status of the families which may affect AFDC and thus IV-E eligibility. For example one cased failed because the mother had remarried and the child could no longer be considered under AFDC criteria.

Two cases were eligible during the period under review, however during another period of time the children were not IV-E eligible but IV-E payment were made.

552	21636	$3,134
631	33397	3,363

Total		$6,497

Grand Total		$287,084
Federal Share		$143,542

IV. Strengths

Licenses were current for all foster homes and group homes for cases under review. Criminal records checks had been completed, not one case failed because of license ineligibility, it appears that the state's licensing system is functioning appropriately.

The review team stated that the records were well organized and were able to retrieve information easily.

Finally, it is clear that court documentation has vastly improved since the past Title IV-E review.

V. Areas in Need of Improvements

The state's automated system needs to be able to distinguish between cases that are eligible for Medicaid only, and cases which Title IV-E and Medicaid eligible to ensure payments under Title IV-E are made for only cases deemed IV-E eligible.

During the review, we identified 10 cases for which no foster care payment was made during the review period. In these ten cases, AFCARS data element #59 was coded "1" but should have been coded "0"(foster care maintenance payments were not being paid on behalf of the child.) The ten cases represent 10.2% of the total sample (10/98). The ten cases are sample: #277, #378, #482, #694, #785, #816, #881, oversamples #5, #16 and #18. We recommend that the agency review these cases to determine the cause of the miscoding, and take corrective action to remedy the discrepancy.

The agency needs to develop a uniform procedure to ensure changes in family status which may effect IV-E eligibility are communicated in a timely and consistent manner to the IV-E eligibility case technician staff.

The copies of the court records are on carbon paper and it was difficult to determine if the check marks were always in place. Secondly, when the carbon copies were duplicated, the copies were almost impossible to read.

VI. Disallowance

The initial primary review included a sample of 80 cases with a total Federal dollar value of $805,308. The sample was drawn from a universe of cases that received at least one Title IV-E maintenance payment during the six month AFCARS period of October 1, 1999 to March 31, 2000. Based upon the results of the review, 7 cases were not eligible for funding under the Title IV-E foster care and the dollar amount to be refunded to ACF is $143,540 which is 50% of the foster care payments for the ineligible case for the period of ineligibility.