Current through all regulations passed and filed through September 16, 2024
(A)
What is the
definition of "erroneous payment?"
Section
5107.02 of the Revised Code
defines Ohio works first (OWF) as the temporary assistance to needy families
(TANF) program established in Title IV-A of the Social Security Act, 49 Stat.
620 (1935),
42 U.S.C.
301 (8/1981). An "erroneous payment" is
defined in section 5107.76 of the Revised Code as a
payment of cash assistance under OWF to assistance groups not eligible to
receive the assistance. The provisions set forth in this rule apply to all
erroneous payments made on or after July 1, 1998, under OWF, including payments
of cash assistance for support services funded with TANF monies.
An erroneous payment may occur because of any
change in an assistance group's situation which decreases the level of
assistance for which the assistance group is eligible. Paragraph (J) of this
rule sets forth the provisions for calculating the amount of the erroneous
payment.
(B)
How are aid to families with dependent children
(ADC)/TANF cash assistance and/or OWF overpayments that occurred and were
discovered prior to July 1, 1998 collected?
All ADC/TANF cash assistance and/or OWF
overpayments that occurred and were discovered prior to July 1, 1998 are
subject to the provisions set forth in rule
5101:1-23-70.1 of the
Administrative Code.
(C)
How are erroneous payments that are discovered on or
after July 1, 1998 collected?
All cash assistance under the former aid to
families with dependent children (ADC) or TANF programs and/or OWF erroneous
payments that occurred on or after July 1, 1998, or that occurred prior to July
1, 1998, but were discovered on or after July 1, 1998, shall be collected in
accordance with the provisions set forth in this rule.
(D)
How are work
allowance overpayments that occurred prior to October 1, 1997 collected?
Work allowance overpayments that occurred prior
to October 1, 1997 are subject to the provisions set forth in rule
5101:1-23-70.2 of the
Administrative Code.
(E)
Are agency-caused
overpayments that occurred prior to October 1, 1997 and that are discovered on
or after July 1, 1998 required to be collected?
The county agency has the option of whether to
collect agency caused overpayments that occurred prior to October 1, 1997, and
that are discovered on or after July 1, 1998. If the county agency chooses not
to collect the overpayment, the debt will remain and can be recovered in
accordance with the provisions set forth in this rule. Failure to repay
erroneous payments as a result of an agency error does not result in
ineligibility for OWF.
(F) What
are the responsibilities of the county agency?
(1) Provide the assistance group with
frequent and complete explanations of program eligibility, the factors that
cause ineligibility and erroneous payments, and the assistance group's
responsibility to report changes in income, need, and other circumstances
affecting eligibility, as set forth in rule
5101:1-2-20
of the Administrative Code.
(2)
Take action to terminate or adjust the OWF payment as soon as
the county
agency learns of a change in circumstances which affects the assistance
group's future eligibility for assistance, in accordance with the hearing
provisions set forth in division 5101:6 of the Administrative Code.
(3) Take action to recover the erroneous
payments in accordance with the provisions set forth in this rule and sections
5107.05 and
5107.76 of the Revised
Code.
(4) When the assistance group
has a change, and the change results in the decrease in or termination of OWF
cash assistance, the county agency shall issue a notice of adverse action
within ten days of the date the change was reported or the county agency
becomes aware of the change, unless one of the exceptions to the notice of
adverse action in Chapter 5101:6-2 of the Administrative Code
applies.
(G) What are
the reporting requirements for an assistance group?
(1) The reporting requirements and timeframes
are described in rule
5101:1-2-20
of the Administrative Code.
(2) Not
withstanding the requirements in rule
5101:1-2-20
of the Administrative Code, the assistance group is not required to report any
other changes in circumstances until the next reapplication. In such
situations, no erroneous payments exist between the date that the unreported
change occurs and the date that the change is reported or the
county
agency otherwise becomes aware of the change.
(3) The assistance group's report of an
impending change in circumstances does not negate its responsibility to report
any change identified in rule
5101:1-2-20
of the Administrative Code within ten days from the date that the change
actually occurs.
(H)
What is the effective date of a budget adjustment?
(1) When a notice of adverse action is
issued, the decrease in the benefit level shall be made effective with the OWF
benefit for the month following the month in which the notice of adverse action
period has expired, provided a fair hearing and continuation of benefits have
not been requested.
(2) When a
notice of adverse action is not issued due to one of the exceptions of rule
5101:6-2-05 of the Administrative Code, the decrease shall be made effective no
later than the month following the change. This applies for all reporting
requirements listed in rule
5101:1-2-20
of the Administrative Code.
(3)
When the change is new employment of an assistance group member,
the budget adjustment does not become effective until the later of:
(a) The first day of the month following the
month in which the assistance group receives earned income from employment,
consistent with the application of the earned income disregard set forth in
rule
5101:1-23-20
of the Administrative Code; or
(b)
The month following the month in which the notice of adverse action period has
expired.
(I)
When is an assistance group liable for an erroneous payment?
(1) When the county agency discovers that the
assistance group failed to report a required change within the required
timeframes as set forth in rule
5101:1-2-20
of the Administrative Code and as a result of the change, the assistance group
received benefits it was not entitled to receive;
(2) When the county agency failed to act on a
change timely and as a result, the assistance group received benefits it was
not entitled to receive;
(3)
When an erroneous
payment occurs because an adverse action was proposed, payments continued
without change due to a timely hearing request, and the hearing decision
affirmed the county agency proposal; or
(4)
The assistance
group is not liable for an erroneous payment because of a failure to report a
change that is not a part of the required reporting requirements as set forth
in rule
5101:1-2-20
of the Administrative Code.
(J) How is an erroneous payment calculated?
The amount of the erroneous payment is the difference between the
amount of benefits the assistance group should have received for a calendar
month, and the amount of benefits the assistance group actually received for
that month. In determining the amount of an erroneous payment, the agency
shall
consider the federal Fair Labor Standards Act (FLSA) (5/2007) applicable
requirements and/ or any other federal labor laws which may apply. When the
county agency becomes aware of a change in the assistance group's
circumstances, the county agency shall determine the following:
(1) The date on which the change occurred,
and whether the change was due to one of the reporting requirements listed in
rule
5101:1-2-20
of the Administrative Code.
(2) The
date on which the change was reported by the assistance group to the county
agency, or the county agency became aware of the change.
(3) In
accordance with the provisions set forth in paragraph (H) of this rule, the
date on which the decrease or termination of benefits should have been
effective had the assistance group reported the change in accordance with the
timeframes as set forth in rule
5101:1-2-20
of the Administrative Code and/or had the county agency acted timely on
reported and/or discovered
change(s).
(4) The dates and amounts of any erroneous
payments, by month.
(a) When the assistance
group has earned income, the earned income disregards set forth in rule
5101:1-23-20
of the Administrative Code, shall be deducted as appropriate in computing the
amount of the erroneous payment.
(b) For any month that the assistance group
failed to timely report a change in earned income
as set forth in rule
5101:1-2-20
of the Administrative Code, the earned income disregards shall not be deducted
from the assistance group's gross earned income in accordance with rule
5101:1-23-20
of the Administrative Code when computing the erroneous payment.
(c) When an erroneous payment occurs because
an adverse action was proposed, payments continued without change due to a
timely hearing request, and the hearing decision affirmed the county agency
proposal, the amount of the erroneous payment is the difference between the
amount the assistance group actually received each month, and the amount the
assistance group should have received for each month. When specific amounts of
erroneous payments are stipulated in the hearing decision, those amounts are
binding, in accordance with the rules set forth in division 5101:6 of the
Administrative Code.
(d) Child
support that is assigned to
the Ohio department of job and family services
(ODJFS) and which is paid through the child support enforcement agency
(CSEA)
shall be included in the calculation of the erroneous
payment. The county agency shall determine the exact amounts of the following
categories prior to computing the erroneous payment:
(i) Child support collected on current
obligation.
(ii) Child support used
to reimburse assistance paid to the family.
42 U.S.C.
657 (01/02/06) defines what is reimbursable
for child support distribution purposes.
(iii) Assistance provided to the assistance
group.
(iv) Correct amount of OWF
benefits the assistance group should have received. For purposes of this rule
only, this amount shall be referred to as the OWF entitlement.
(v) Erroneous payment prior to child support
adjustment. The erroneous payment will always equal the difference between OWF
actually paid to the assistance group and the OWF entitlement.
(vi) Collectible erroneous payment after
child support adjustment.
(vii) The
erroneous payment to be collected after child support adjustment is computed
using the table in this paragraph and one of the two formulas in the
paragraphs immediately following the table.
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(1)
Child support collected on current obligation/child support
used to reimburse OWFcase grant.
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(2)
Amount of OWF cash assistance actually paid to the AG for the
month.
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(3)
Actual OWF "entitlement" as defined in paragraph (4)(d)(iv) of
this rule.
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(4)
Amount of OWF erroneous payment [column (2) minus column (3)]
prior to child support adjustment.
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(5)
Collectible erroneous OWF payment after child support
adjustment. See below.
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The determination of the amount in column (5) is made using the
one of the following 2 formulas:
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- If the amount in column (3) is greater than or equal to the
amount in column (1), the amount of the collectible erroneous OWF payment to be
reflected in column (5) is the difference reflected by subtracting the amount
in column (3) from the amount in column
(2);
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- If the amount in column (3) is less than the amount in column
(1), the amount of the collectible erroneous OWF payment to be reflected in
column (5) is the amount in column (4) less the difference calculated by
subtracting the amount in column (3) from column (1).
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(K) What is a grant reduction?
Grant reduction is one of the collection methods set forth in section
5107.76 of the Revised Code. If
the method of recovery chosen by the county agency is grant reduction, the OWF
cash payment is reduced each month until the total amount of the erroneous
payment is repaid.
(1) The OWF cash
payment may be reduced, provided that for any payment month, the assistance
group shall retain from its combined income (without disregards) and assistance
payment an amount equal to ninety per cent of the payment standard (as set
forth in rule
5101:1-23-20
of the Administrative Code) for an assistance group of the same composition
with no other income, unless the assistance group volunteers to pay more. The
monthly recovery amount shall be computed from the income and assistance
payment available in the payment month. Liquid assets may be explored as
well.
(2) If recovery of the
erroneous payment through grant reduction reduces the amount payable to the
assistance group to zero, the members of the assistance group are considered to
be OWF participants.
(3) When an
assistance group is eligible for a monthly OWF payment of at least ten dollars,
but recovery of an erroneous payment reduces the monthly payment to less than
ten dollars, the minimum payment provision set forth in rule
5101:1-23-40
of the Administrative Code does not apply because the assistance group was
eligible for a cash payment of at least ten dollars prior to adjustment of the
overpayment.
(4) All grant
reductions shall be effected with due regard for the fair hearing provisions,
including prior notice, set forth in division 5101:6 of the Administrative
Code.
(5) If the assistance group
becomes ineligible to participate in OWF, the balance of the erroneous payment
shall be recovered in accordance with the provisions set forth in section
5107.76 of the Revised
Code.
(L) What if an
assistance group has an erroneous payment and an underpayment?
When an assistance group has both a current erroneous payment and
underpayment as defined in rule
5101:1-23-60
of the Administrative Code, one may be offset against the other provided the
erroneous payment is not being challenged under the state hearing procedures as
set forth in division 5101:6 of the Administrative Code. There will be no delay
in the issuance of the underpayment in this instance.
(1) The county agency will notify the
assistance group when an underpayment occurs concurrently with the discovery of
an erroneous payment or when there is an outstanding delinquent balance from a
previous erroneous payment. The notice will advise the assistance group of the
underpayment and the amount the county agency proposes to use to offset the
reported or delinquent erroneous payment balance. The assistance group may
exercise its right to a state hearing if it disagrees with the decision of the
county agency to offset the underpayment against the erroneous payment using
the notice. All proposed actions shall be suspended pending the hearing
decision.
(2) In a situation in
which the underpayment amount is greater than the amount of the erroneous
payment, the assistance group shall be issued the difference.
(M) Can an erroneous payment be
recovered from a minor child?
As set forth in section
5107.76 of the Revised Code, if
a minor child was a member of an assistance group that received an erroneous
payment but becomes a member of a new assistance group that does not include a
minor head of household or adult who also was a member of the previous
assistance group, a county agency shall not take action against the new
assistance group to recover the erroneous payment the previous assistance group
received.
(N) IV-A/IV-D
overpayments
(1) Payments made directly to
the assistance group on support orders established or modified prior to
December 1, 1986, constitute a IV-D overpayment.
(2) All support orders established or
modified on or after December 1, 1986, shall be paid
through the CSEA. Payments on such orders which are made directly to the
assistance group are not considered child support payments, but are considered
a gift to the assistance group. The overpayment created by the assistance
group's retention of direct payments constitutes a IV-A overpayment.
(3) In all cases, regardless of the date of
the order, payments sent to the assistance group erroneously by the CSEA also
constitute a IV-D overpayment.
