10.2 Fraud Investigation, Payment Recovery, and Sanctions

Lead Agencies must have the necessary controls to identify fraud and other program violations to ensure program integrity. Program violations can include both intentional and unintentional client and/or provider violations, as defined by the Lead Agency. These violations and errors, identified through the error-rate review process and other review processes, may result in payment or nonpayment (administrative) errors and may or may not be the result of fraud, based on the Lead Agency definition. 10.2.1 Strategies used to identify and prevent program violations Check the activities the Lead Agency employs to ensure program integrity, and for each checked activity, identify what type of program violations the activity addresses, describe the activity and the results of these activities based on the most recent analysis. a. [x] Share/match data from other programs (e.g., TANF program, Child and Adult Care Food Program, Food and Nutrition Service (FNS), Medicaid) or other databases (e.g., State Directory of New Hires, Social Security Administration, Public Assistance Reporting Information System (PARIS)). i. [x] Intentional program violations. Describe the activities, the results of these activities, and how they inform better practice: In order to confirm eligibility criteria, Colorado Child Care Assistance Program staff use interfaces with other programs, including Department of Labor, TANF and Child Support Services (ACSES), as needed. The information obtained from these systems provides verification of information used to confirm eligibility criteria and verify client information to include employment and wages, demographic information, information regarding the eligibility for and receipt of public assistance benefits, and child support expense and income details. The results of this activity mitigate the potential for fraud in the program by utilizing the information obtained from these sources to research potential allegations of fraud and to confirm or refute information gathered when determining eligibility and/or conducting investigations. ii. [x] Unintentional program violations. Describe the activities, the results of these activities, and how they inform better practice: In order to confirm eligibility criteria, CCCAP staff use interfaces with other programs, including Department of Labor, TANF and Child Support Services (ACSES), as needed. The information obtained from these systems provides verification of information used to confirm eligibility criteria and verify client information to include employment and wages, demographic information, information regarding the eligibility for and receipt of public assistance benefits, and child support expense and income details. This practice mitigates the need for an additional inquiry and provides the CCCAP worker with reliable information to use in the determination of eligibility and payment calculation, reducing the likelihood of errors and/or unintentional program violations. iii. [x] Agency errors. Describe the activities, the results of these activities, and how they inform better practice:: In order to confirm eligibility criteria, CCCAP staff use interfaces with other programs, including Department of Labor, TANF and Child Support Services (ACSES), as needed. The information obtained from these systems provides verification of information used to confirm eligibility criteria and verify client information to include employment and wages, demographic information, information regarding the eligibility for and receipt of public assistance benefits, and child support expense and income details. This practice mitigates the need for an additional inquiry and provides the CCCAP worker with reliable information to use in the determination of eligibility and payment calculation, reducing the likelihood of errors and/or agency errors. b. [x] Run system reports that flag errors (include types). i. [x] Intentional program violations. Describe the activities, the results of these activities, and how they inform better practice: CDEC regularly reviews reports from the Colorado Financial Management System (CFMS) and CHATS to monitor conflicts in attendance records. CDEC staff also review CHATS and ATS to monitor payments and additional care needs to the appropriate rates, and other potential high-risk areas. Counties are also expected to review risk-based reports and errors that impact eligibility and payment accuracy. Risk-based reports include but are not limited to timely processing, absence payments, provider rates, and case management activities. The review of these reports will result in correct provider payments and will reduce the exceptions identified on the risk-based reports, reduce and/or prevent duplicate payments, and ensure providers are paid in the right amount at the right time for the right child. Reviews of these reports also help counties to identify anomalies and target specific cases and provider files for further research. ii. [x] Unintentional program violations. Describe the activities, the results of these activities, and how they inform better practice: CDEC regularly reviews reports from the Colorado Financial Management System (CFMS) and CHATS to monitor conflicts in attendance records. CDEC staff also review CHATS and ATS to monitor payments and additional care needs to the appropriate rates, and other potential high-risk areas. Counties are also expected to review risk-based reports and errors that impact eligibility and payment accuracy. Risk-based reports include but are not limited to timely processing, absence payments, provider rates, and case management activities. The review of these reports will result in correct provider payments and will reduce the exceptions identified on the risk-based reports, reduce and/or prevent duplicate payments, and ensure providers are paid in the right amount at the right time for the right child. Reviews of these reports also help counties to identify anomalies and target specific cases and provider files for further research. iii. [x] Agency errors. Describe the activities, the results of these activities, and how they inform better practice: CDEC regularly reviews reports from the Colorado Financial Management System (CFMS) and CHATS to monitor conflicts in attendance records. CDEC staff also review CHATS and ATS to monitor payments and additional care needs to the appropriate rates, and other potential high-risk areas. Counties are also expected to review risk-based reports and errors that impact eligibility and payment accuracy. Risk-based reports include but are not limited to timely processing, absence payments, provider rates, and case management activities. The review of these reports will result in correct provider payments and will reduce the exceptions identified on the risk-based reports, reduce and/or prevent duplicate payments, and ensure providers are paid in the right amount at the right time for the right child. Reviews of these reports also help counties to identify anomalies and target specific clients and providers for further research, resulting in fewer agency errors. c. [x] Review enrollment documents and attendance or billing records. i. [x] Intentional program violations. Describe the activities, the results of these activities, and how they inform better practice: Counties are required by rule to audit provider records monthly. These reviews are conducted using the statewide standardized review elements and review tools to ensure consistency and accuracy. Counties share the results of the provider reviews and applicable findings, identify the actions they take to resolve the errors, and processes they put in place to prevent the errors from recurring. The reviews are also used to identify instances of potential fraud based on attendance or billing records for further research and follow-up by counties to ensure provider information and payments are accurate. The results of this activity mitigate the potential for fraud in the program by ensuring the provider information and payments are accurate. ii. [x] Unintentional program violations. Describe the activities, the results of these activities, and how they inform better practice: Counties are required by rule to audit provider records monthly. These reviews are conducted using the statewide standardized review elements and review tools to ensure consistency and accuracy. Counties share the results of the provider reviews and applicable findings, identify the actions they take to resolve the errors, and processes they put in place to prevent the errors from recurring. The results of this activity mitigate the potential for unintentional program violations and ensure the provider information and payments are accurate, resulting in fewer unintentional program violations. iii. [x] Agency errors. Describe the activities, the results of these activities, and how they inform better practice: Counties are required by rule to audit provider records monthly. These reviews are conducted using the statewide standardized review elements and review tools to ensure consistency and accuracy. Counties share the results of the provider reviews and applicable findings, identify the actions they take to resolve the errors, and processes they put in place to prevent the errors from recurring. The reviews are also used to identify instances of improper payments based on attendance or billing records for further research and follow-up by counties to ensure provider information and payments are accurate. d. [x] Conduct supervisory staff reviews or quality assurance reviews. i. [x] Intentional program violations. Describe the activities, the results of these activities, and how they inform better practice: CDEC CCCAP team utilizes three different levels of reviews to support this activity: Monthly, random case file reviews are conducted at the county-level to ensure eligibility determinations and subsidy payments are accurate based on CCCAP regulations and policies. Counties share the results of the findings, identify the actions they take to resolve the errors, and processes they put in place to prevent the errors from recurring. CCCAP staff also conduct monthly reviews of client case files to ensure accuracy and alignment with CCCAP regulations. The findings of each review are summarized for the county and areas of concern identified by CCCAP staff are clearly documented and followed up on by CCCAP staff to ensure the case under review is corrected and to prevent future errors. Finally, as part of county monitoring reviews the CCCAP conducts supervisory reviews of eligibility determinations and compliance with CCCAP regulations, child care authorizations, provider payments, and parent fees. All of the reviews are conducted utilizing standardized definitions, review elements, review processes, and review tools to ensure consistency in reviews and accurately reflect errors and trends. The results from these reviews are compiled by the CCCAP and are used to monitor county performance, identify error trends and opportunities for improvement, and develop strategies to rectify or prevent ongoing violations. The results from the reviews will allow CCCAP to utilize the information obtained from the reviews to identify areas of concern (such as insufficient verification and case documentation) or incorrect payments to be researched by counties for potential fraud or program violations. ii. [x] Unintentional program violations. Describe the activities, the results of these activities, and how they inform better practice: CDEC CCCAP team utilizes three different levels of reviews to support this activity: Monthly, random case file reviews are conducted at the county-level to ensure eligibility determinations and subsidy payments are accurate based on CCCAP regulations and policies. Counties share the results of the findings, identify the actions they take to resolve the errors, and processes they put in place to prevent the errors from recurring. CCCAP staff also conducts monthly reviews of client case files to ensure accuracy and alignment with CCCAP regulations. The findings of each review are summarized for the county and areas of concern identified by CCCAP staff are clearly documented and followed up on by CCCAP staff to ensure the case under review is corrected and to prevent future errors. Finally, as part of county monitoring reviews the CCCAP conducts supervisory reviews of eligibility determinations and compliance with CCCAP regulations, child care authorizations, provider payments, and parent fees. All of the reviews are conducted utilizing standardized definitions, review elements, review processes, and review tools to ensure consistency in reviews and accurately reflect errors and trends. The results from these reviews are compiled by the CCCAP staff and are used to monitor county performance, identify error trends and opportunities for improvement, and develop strategies to rectify or prevent ongoing violations. The results from the reviews will allow the CCCAP team to utilize the information obtained from the reviews to identify areas of concern (such as insufficient verification and case documentation) or incorrect payments to be researched by counties for potential unintentional program violations. iii. [x] Agency errors. Describe the activities, the results of these activities, and how they inform better practice: CDEC CCCAP team utilizes three different levels of reviews to support this activity: Monthly, random case file reviews are conducted at the county-level to ensure eligibility determinations and subsidy payments are accurate based on CCCAP regulations and policies. Counties share the results of the findings, identify the actions they take to resolve the errors, and processes they put in place to prevent the errors from recurring. CCCAP staff also conducts monthly reviews of client case files to ensure accuracy and alignment with CCCAP regulations. The findings of each review are summarized for the county and areas of concern identified by CCCAP staff are clearly documented and followed up on by CCCAP staff to ensure the case under review is corrected and to prevent future errors. Finally, as part of county monitoring reviews the CCCAP conducts supervisory reviews of eligibility determinations and compliance with CCCAP regulations, child care authorizations, provider payments, and parent fees. All of the reviews are conducted utilizing standardized definitions, review elements, review processes, and review tools to ensure consistency in reviews and accurately reflect errors and trends. The results from these reviews are compiled by the CCCAP staff and are used to monitor county performance, identify error trends and opportunities for improvement, and develop strategies to rectify or prevent ongoing violations. The results from the reviews will allow the CCCAP team to utilize the information obtained from the reviews to identify areas of concern (such as insufficient verification and case documentation) or incorrect payments to be researched by counties to reduce agency errors. e. [x] Audit provider records. i. [x] Intentional program violations. Describe the activities, the results of these activities, and how they inform better practice: The CCCAP and counties conduct reviews of provider records through risk-based reports to evaluate attendance records and provider payments for accuracy. The CCCAP also conducts reviews of provider files as part of the county monitoring process to inform county performance monitoring and identify opportunities for improvement and technical assistance. In addition, Counties are required by rule to conduct reviews of provider records monthly as part of their required monitoring. The results of these reviews are shared with CDEC and utilized to monitor county performance, identify statewide error trends and opportunities for improvement, and develop strategies to rectify or prevent ongoing violations. In addition, the information obtained from these reviews may be used in researching the provider file to determine if further research is necessary and/or by the county office to determine if potential fraud and/or program violations occurred, reducing the likelihood of fraud and/or decreasing improper payments. ii. [x] Unintentional program violations. Describe the activities, the results of these activities, and how they inform better practice: The CCCAP and counties conduct reviews of provider records through risk-based reports to evaluate attendance records and provider payments for accuracy. CDEC also conducts reviews of provider files as part of the county monitoring process to inform county performance monitoring and identify opportunities for improvement and technical assistance. In addition, Counties are required by rule to conduct reviews of provider records monthly as part of their required monitoring. The results of these reviews are shared with CDEC and utilized to monitor county performance, identify statewide error trends and opportunities for improvement, and develop strategies to rectify or prevent ongoing violations. In addition, the information obtained from these reviews may be used in researching the provider file to determine if further research is necessary by the county office to determine if unintentional program violations occurred, resulting in fewer unintentional program violations. iii. [x] Agency errors. Describe the activities, the results of these activities, and how they inform better practice: The CCCAP and counties conduct reviews of provider records through risk-based reports to evaluate attendance records and provider payments for accuracy. CDEC also conducts reviews of provider files as part of the county monitoring process to inform county performance monitoring and identify opportunities for improvement and technical assistance. In addition, Counties are required by rule to conduct reviews of provider records monthly as part of their required monitoring. The results of these reviews are shared with CDEC and utilized to monitor county performance, identify statewide error trends and opportunities for improvement, develop strategies to rectify or prevent ongoing violations, and reduce agency errors. f. [x] Train staff on policy and/or audits. i. [x] Intentional program violations. Describe the activities, the results of these activities, and how they inform better practice: CDEC holds regular meetings with county staff to train on changes and updates to rules and policies regarding intentional and unintentional program violations. Training identified as mandatory to complete required tasks is identified for county users based on their role and responsibility. As a result, all users are expected to complete training prior to gaining access in CHATS, resulting in assurances that all users only have access to the system to complete their tasks. In addition, CDEC provides training and user guides for counties to conduct county reviews. This requirement enforces separation of duties and prevents internal and/or user fraud by limiting system access to functions the user is trained in and ensures staff are aware of expectations. ii. [x] Unintentional program violations. Describe the activities, the results of these activities, and how they inform better practice: CDEC holds regular meetings with county staff to train on changes and updates to rules and policies regarding intentional and unintentional program violations. Training identified as mandatory to complete required tasks is identified for county users based on their role and responsibility. As a result, all users are expected to complete training prior to gaining access in CHATS, resulting in assurances that all users only have access to the system to complete their tasks. In addition, CDEC provides training and user guides for counties to conduct county reviews. This requirement enforces separation of duties and prevents internal and/or user fraud by limiting system access to functions the user is trained in and ensures staff are aware of expectations, ultimately reducing the number of unintentional program violations. iii. [x] Agency errors. Describe the activities, the results of these activities, and how they inform better practice: CDEC holds regular meetings with county staff to train on changes and updates to rules and policies regarding intentional and unintentional program violations. Training identified as mandatory to complete required tasks is identified for county users based on their role and responsibility. As a result, all users are expected to complete training prior to gaining access in CHATS, resulting in assurances that all users only have access to the system to complete their tasks. In addition, CDEC provides training and user guides for counties to conduct county reviews resulting in better quality reviews and better data to inform future actions, ultimately reducing the number of agency errors. g. [ ] Other. Describe the activity(ies): i. [ ] Intentional program violations. Describe the activities, the results of these activities, and how they inform better practice: ii. [ ] Unintentional program violations. Describe the activities, the results of these activities, and how they inform better practice: iii. [ ] Agency errors. Describe the activities, the results of these activities, and how they inform better practice: 10.2.2 Identification and recovery of misspent funds Lead Agencies must identify and recover misspent funds that are a result of fraud, and they have the option to recover any misspent funds that are a result of unintentional program violations or agency errors. a. Identify which agency is responsible for pursuing fraud and overpayments (e.g., State Office of the Inspector General, State Attorney): CCCAP is county administered and state supervised so it is up to each county department of human/social services that administers CCCAP to pursue fraud and overpayments. CDEC CCCAP team is responsible for monitoring county fraud detection and prevention efforts, and ensuring action is taken by counties to appropriately identify, address and resolve fraud and overpayments. CDEC is responsible for pursuing fraud and overpayments related to non-subsidy activities. b. Check and describe all activities, including the results of such activity, that the Lead Agency uses to investigate and recover improper payments due to fraud. Consider in your response potential fraud committed by providers, clients, staff, vendors, and contractors. Include in the description how each activity assists in the investigation and recovery of improper payment due to fraud or intentional program violations. Activities can include, but are not limited to, the following: i. [x] Require recovery after a minimum dollar amount of an improper payment and identify the minimum dollar amount. Describe the activities and the results of these activities based on the most recent analysis: The threshold for recovery is $50.00. ii. [x] Coordinate with and refer to the other State/Territory agencies (e.g., State/Territory collection agency, law enforcement agency). Describe the activities and the results of these activities based on the most recent analysis: When the counties or their designee(s) determine that they have paid or are about to pay for child care as a result of a suspected criminal act, the facts used in the determination shall be reviewed with the counties' legal advisor, investigatory unit and/or a representative from the District Attorney's office. If the available evidence supports suspected criminal acts, the case shall be referred to the District Attorney. All Referrals to the District Attorney shall be made in writing and shall include the amount of assistance fraudulently received by the adult caretaker, teen parent, or child care provider. iii. [x] Recover through repayment plans. Describe the activities and the results of these activities based on the most recent analysis: When the counties or their designee have determined that an adult caretaker(s) or teen parent(s) has received public assistance for which he or she was not eligible due to an increase in household income, that causes the household's income exceeds eighty-five percent (85%) of the State median income, or a change in the qualifying eligible activity that was not reported within four weeks of its occurrence; or a childcare provider has received child care payments for which they were not eligible, the county, or its designee(s), determines if the overpayment is to be recovered. The county or its designee determines whether there was willful misrepresentation and/or withholding of information and considers or rules out possible fraud; the county or its designee determines the amount of overpayment; the county or its designee notifies the household or child care provider(s) of the amount due and the reason for the recovery using the prior notice rules; and the county or its designee enters the amount of the overpayment and other specific factors of the situation in the case record, including the calculation used to determine the recovery amount. For providers, the county departments of human services may recover through repayment plans. For adult caretakers or teen parents that commit fraud or an intentional program violation, the county sets up a recovery payment plan. Providers that owe recoveries for fraud or non-administrative errors may identify the amount to be recovered in monthly installments through a repayment plan until the amount is paid in full. iv. [x] Reduce payments in subsequent months. Describe the activities and the results of these activities based on the most recent analysis: For child care providers, the county departments of human services may recover funds by reducing payments in subsequent months. v. [x] Recover through State/Territory tax intercepts. Describe the activities and the results of these activities based on the most recent analysis: Counties may pursue tax intercepts on overpayments. The taxpayer is entitled to object to the offset intercept by filing a request for a county dispute resolution conference or state hearing within thirty calendar-days from the date that the pre-offset notice is mailed, faxed, emailed, sent via other electronic systems, or hand-delivered to the taxpayer. CDEC utilizes the state tax intercept process through the Colorado Department of Revenue (CDoR). The CDoR interface is run annually on 12/31 of each year, and subsequent daily files are run through CHATS to update information. vi. [x] Recover through other means. Describe the activities and the results of these activities based on the most recent analysis: Counties must pursue all legal remedies available to the county in order to recover the overpayment. Legal remedies include, but are not limited to: judgments; garnishments; claims on estates; and, the state income tax refund intercept process. vii. [x] Establish a unit to investigate and collect improper payments and describe the composition of the unit. Describe the activities and the results of these activities based on the most recent analysis: Counties are responsible for establishing their own structure to address the investigation and collection of improper payments. This varies from county to county. viii. [x] Other. Describe the activities and the results of these activities: CDEC addresses recovery of funds related to fraud and/or overpayment in non-subsidy activities in accordance with the respective provisions in the State’s standard contract and/or grant agreement. The means of recovery vary, but most frequently involve reducing payments in subsequent months or requiring repayment from the vendor in a lump-sum or through a repayment plan. c. Does the Lead Agency investigate and recover improper payments due to unintentional program violations? [ ] No. [x] Yes. If yes, check and describe below any activities that the Lead Agency will use to investigate and recover improper payments due to unintentional program violations. Include in the description how each activity assists in the investigation and recovery of improper payments due to unintentional program violations. Include a description of the results of such activity. i. [x] Require recovery after a minimum dollar amount of an improper payment and identify the minimum dollar amount. Describe the activities and the results of these activities based on the most recent analysis: The threshold for recovery is $50.00. ii. [ ] Coordinate with and refer to the other State/Territory agencies (e.g., State/Territory collection agency, law enforcement agency). Describe the activities and the results of these activities based on the most recent analysis: iii. [x] Recover through repayment plans. Describe the activities and the results of these activities based on the most recent analysis: Counties or their designee shall document the facts and situation that produced the overpayment and retain this documentation until the overpayment is paid in full or for three years plus the current year, whichever is longer; determine what benefits the household was eligible for and recover benefits for which the household was found to be ineligible, except in the case of willful misrepresentation or withholding of information; determine the payments for which the child care provider was not eligible and recover those payments, and initiate timely written notice allowing for the fifteen calendar day noticing period. Such notice shall include a complete explanation,including applicable rules, concerning the overpayment, recovery sought and appeal rights. Take action to recover following the right of appeal and fair hearing process. For providers, the county departments of human services may recover through repayment plans. For adult caretakers or teen parents that have an unintentional program violation, the county sets up a recovery payment plan that requires over-the-counter payments. Exception from recovery includes: 1.The household who is without fault in the creation of the overpayment; and, 2.The household who has reported any increase in income or change in resources or other circumstances affecting the household's eligibility within the timely reporting requirements for the program. iv. [x] Reduce payments in subsequent months. Describe the activities and the results of these activities based on the most recent analysis: For providers, the county departments of human services may recover funds by reducing payments in subsequent months. v. [x] Recover through State/Territory tax intercepts. Describe the activities and the results of these activities based on the most recent analysis: Counties may pursue tax intercepts on overpayments. The taxpayer is entitled to object to the offset intercept by filing a request for a county dispute resolution conference or state hearing within thirty calendar-days from the date that the pre-offset notice is mailed, faxed, emailed, sent via other electronic systems, or hand-delivered to the taxpayer. CDEC utilizes the state tax intercept process through the Colorado Department of Revenue (CDoR). The CDoR interface is run annually on 12/31 of each year, and subsequent daily files are run through CHATS to update information. vi. [x] Recover through other means. Describe the activities and the results of these activities based on the most recent analysis: Counties must pursue all legal remedies available to the county in order to recover the overpayment. Legal remedies include, but are not limited to: judgments; garnishments; claims on estates; and the state income tax refund intercept process. vii. [x] Establish a unit to investigate and collect improper payments and describe the composition of the unit. Describe the activities and the results of these activities based on the most recent analysis: Counties are responsible for establishing their own structure to address the investigation and collection of improper payments. This varies from county to county. viii. [ ] Other. Describe the activities and the results of these activities: d. Does the Lead Agency investigate and recover improper payments due to agency errors? [x] No. [ ] Yes. If yes, check and describe all activities that the Lead Agency will use to investigate and recover improper payments due to agency errors. Include in the description how each activity assists in the investigation and recovery of improper payments due to administrative errors. Include a description of the results of such activity. i. [ ] Require recovery after a minimum dollar amount of an improper payment and identify the minimum dollar amount. Describe the activities and the results of these activities based on the most recent analysis: ii. [ ] Coordinate with and refer to the other State/Territory agencies (e.g., State/Territory collection agency, law enforcement agency). Describe the activities and the results of these activities based on the most recent analysis: iii. [ ] Recover through repayment plans. Describe the activities and the results of these activities based on the most recent analysis: iv. [ ] Reduce payments in subsequent months. Describe the activities and the results of these activities based on the most recent analysis: v. [ ] Recover through State/Territory tax intercepts. Describe the activities and the results of these activities based on the most recent analysis: vi. [ ]Recover through other means. Describe the activities and the results of these activities based on the most recent analysis: vii. [ ] Establish a unit to investigate and collect improper payments and describe the composition of the unit. Describe the activities and the results of these activities based on the most recent analysis: viii. [ ] Other. Describe the activities and the results of these activities: e. What type of sanction will the Lead Agency place on clients and providers to help reduce improper payments due to intentional program violations or fraud? Check and describe all that apply: i. [x] Disqualify the client. Describe this process, including a description of the appeal process for clients who are disqualified. Describe the activities and the results of these activities based on the most recent analysis: All adult caretakers or teen parents that apply for CCCAP are provided with a written notice of the penalties for an Intentional Program Violation (IPV) on the child care application and statement of responsibility. An IPV is an intentional act committed by an adult caretaker(s) or teen parent(s), for the purpose of establishing or maintaining the CCCAP household's eligibility to receive benefits for which they were not eligible. An adult caretaker or teen parent commits an IPV when he or she makes a false or misleading statement or omission in any application or communication, with knowledge of its false or misleading nature, for the purpose of establishing or maintaining the household's eligibility to receive benefits. Counties are required to conduct an investigation of any adult caretaker(s) or teenparent(s) who has applied for or received CCCAP whenever there is an allegation or reason to believe that an individual has committed an IPV as described below. 1. Following investigation, action shall be taken on cases where documented evidence exists to show an individual has committed one or more acts of IPV. Action shall be taken through: a. Obtaining a "Waiver of Intentional Program Violation Hearing"; or, b. Conducting an administrative disqualification hearing; or, c. Referring case for civil or criminal action in an appropriate court of jurisdiction. Overpayment collection activities shall be initiated immediately in all cases even if administrative disqualification procedures or referral for prosecution is not initiated. Adult caretakers and teen parents have the right to a county dispute resolution conference or a state level Administrative Disqualification Hearing with the Administrative Law Court as long as it is not being referred for prosecution on a civil or criminal action in the appropriate state or federal court. If an individual is found to have committed an IPV, the disqualification penalty shall be in effect for: 1. Twelve months upon the first occasion of any such offense; 2. Twenty-four months upon the second occasion of any such offense; and, 3. Permanently upon the third such offense. ii. [x]Disqualify the provider. Describe this process, including a description of the appeal process for providers who are disqualified. Describe the activities and the results of these activities based on the most recent analysis: Counties may terminate a fiscal agreement with a child care provider for suspected or verified program violations. Child care providers shall be informed in writing in advance of the termination and of their right to an informal county dispute resolution conference if a fiscal agreement is terminated. iii. [x] Prosecute criminally. Describe the activities and the results of these activities based on the most recent analysis: When the counties or their designee(s) determine that they have paid or are about to pay for child care as a result of a suspected criminal act, the facts used in the determination shall be reviewed with the counties' legal advisor, investigatory unit and/or representative from the District Attorney's office. If the available evidence supports suspected criminal acts, the case shall be referred to the District Attorney. All referrals to the District Attorney shall be made in writing and shall include the amount of assistance fraudulently received by the adult caretaker, teen parent, or child care provider. iv. [ ] Other. Describe the activities and the results of these activities based on the most recent analysis: Appendix 1: Lead Agency Implementation Plan The Appendix will be available for Lead Agencies to use in CARS after the Plan approval letter is issued. For each non-compliance, Lead Agencies must describe the following: • Action Steps: List the action steps needed to correct the finding (e.g., update policy manual, legislative approval, IT system changes, etc.). For each action step list the: o Responsible Entity: Indicate the entity (e.g., agency, team, etc.) responsible for completing the action step. o Expected Completion Date: List the expected completion date for the action step. • Overall Target Date for Compliance: List date Lead Agency anticipates completing implementation, achieving full compliance with all aspects of the findings. (Note: Compliance will not be determined until the FFY 2025-2027 CCDF Plan is amended and approved). Appendix 1: Form [Plan question with non-compliance and associated provision will pre-populate based on preliminary notice of non-compliance] A. Action Steps for Implementation B. Responsible Entity(ies) C. Expected Completion Date Step 1: Step 2 (as necessary): [Additional steps added as necessary] Overall Target Date for Compliance: