Adoption Assistance Program Overpayments

[EAS 45-808]

An overpayment occurs when an adoptive parent(s) receives payments in excess of the amount he/she was not entitled to for an AAP child. Per AAP rate regulations [22 CCR 35333] the AAP benefit is a negotiated amount based upon the needs of the child and the circumstances of the family. Any payment received in an excess of the “Payment Instructions AAP” form (AAP 2) is considered an overpayment. There are two types of overpayments: Administrative and Non-Administrative.

Administrative Overpayments

Administrative overpayments occur when an adoptive parent(s) has done nothing to cause or contribute to the overpayment. One example of an Administrative Overpayment is when the AAP 2 states $400 effective 1/1/14 and the benefit paid is $500. The FC EW notices the error on 6/1/14 which results in a $600 overpayment. This overpayment is collectable only if the adoptive parent(s) agree to refund the overpayment.

Non-Administrative Overpayments

A non-administrative overpayment occurs when an adoptive parents request for benefits and have not reported that they are no longer supporting their adopted child. One example of an non-administrative overpayment is when adoption SW discovers the adoptive parents failed to report that they are no longer supporting their adoptive child (ex. youth marries or joins the military).

Identification of an Overpayment

Identifying an AAP Overpayment must be researched collectively with the Service Program Post Adoption Social Worker. An overpayment of AAP benefits exist in the following situations:

• Child has aged out of the program and benefits continue.
• It is discovered that the Adoptive parent(s) are no longer providing support to the child.
• It is discovered Adoptive parent(s) are no longer legally responsible for the child/youth (the youths marries or enters the military).
• Adoptive parent(s) commit fraud on their application for AAP benefits (requesting benefits that was not used for the adoptive child).
• Child(s) actual benefit exceeds what he/she would have received if the child had not been placed for adoption. When an adopted youth is eligible for Tier 1 payment and the rate paid is a Tier 2 payment, when discovered this is an overpayment and the payment can be reduced to the correct rate. This an example of Administrative Overpayment.

Note: There is an additional situation when the adoptive parent fails to utilize assistance provided to pay the cost of an out of home placement, but Santa Clara County has a policy to pay the out of home placement directly, therefore minimizing the chance of an overpayment in this situation.

The county shall not demand an overpayment collections when the overpayment was due to a county error.

Recoupment of Non-Administrative Overpayments

[EAS 45-808]

When a non-administrative overpayment occurs the FC EW must contact the adoptive parent to discuss a Repayment Agreement. Repayment will be requested from an adoptive parent(s) through either of the following methods:

• Grant Adjustment (recoupment),
• Demand for repayment, or
• Civil Judgement.

Grant Adjustments

Grant adjustments must begin the subsequent month following the discovery of the overpayment. The adjustment must be completed within a six-month period or before the case discontinues due to the age of the child. A longer period may be requested by the adoptive parent(s) as long as the case will remain active long enough to complete the repayment.

The request must be made in writing unless otherwise agreed. Every attempt to collect the overpayment within the six month period must be made. If the overpayment balance is not recouped within the six month period it must be referred to collections.

ExampleExample

• If the Overpayment Agreement Is received, Grant adjustment is updated for the first day of the following month based on agreement amount.
• If the Overpayment Agreement Is not received, Reduce the payment using the following formula: (O/P)/ 6 months, starting 1st of the month following discovery of O/P.
• If the Overpayment Agreement Is not paid within 6 months, Refer remaining balance to collections.

To initiate a grant adjustment based on a repayment agreement, the FC EW will perform the following entries in CalWIN:

• Update the Record Repayment Agreement
  • Date Agreement Received- The date the adoptive parents made the agreement,
  • Status- Signed,
  • Recovery Type- Recoupment,
  • Status Date- Current Date,
  • Date Returned to Client- Date advised client of the agreement,
  • Repayment Begin Date- The first day of the month following month,
  • Amount- Agreed amount or
  • Percentage- Agreed percent.

If the Record Repayment Agreement window in CalWIN does not initiate the Recoupment the FC EW will perform the following entries in CalWIN:

• Update the AAP Detail Window with the adjusted rate
  • When the current rate is $657, and the adoptive parent agrees to pay $100 each month, the new rate effective the first day of the following month is $557.
• Send a monthly e-mail to FC EWS to have the overpayment adjusted each month.
• When the overpayment has been recovered, update the AAP Detail Window resuming the negotiated rate.

Demand for Repayment

Non-Administrative demand for repayment occurs when the overpayment, or remaining balance of the overpayment, is referred to collections or the overpayment was paid to a facility.

Note: Collections or Recovery and Legal completes the demand for repayment.

Civil Judgement

A civil judgement is sought out by the county recovery and legal department when necessary.

Note: In very limited instances a non-administrative overpayment may be “forgiven” due to a hardship that it would create for an AAP parent. This consideration must only be authorized by the Adoption Supervisor or DFCS SSPM. [Refer to “Administrative Overpayment,” ]

Non-Administrative Overpayment Procedure

The following are the required steps to complete a non-administrative overpayment to an adoptive parent(s):

1. Review eligibility to determine the correct overpayment amount.
2. Contacts AAP parent by phone or in writing to workout a repayment agreement for a grant reduction for the next 6 months. Set up grant reduction in CalWIN.
3. Verify the correct information is displayed on the NA 791. Once verified, send to AAP parent.
4. When the overpayment is not recouped or paid within the agreed period of time the remaining balance must be manually referred to collections in CalWIN. Open case are not automatically referred to collections.

Note: The adoptive parents may contact the adoption SW to discuss a repayment agreement. When this occurs the post-adoption SW will notify the FC EW of the repayment agreement.

If the overpayment is a result of a out-of-home placement in a facility:

1. Complete the SCD 13 and enter a CalSAWS journal. The documentation must include the following:
   1. The overpayment periods,
   2. The amount of the overpayment,
   3. The name of the facility responsible for the debt, and
   4. The SCD 13 was completed with the date it was it to collections.
   5. There will not be an open claim in CalWIN. There is no CalWIN functionality for AAP overpayments against a facility. However, if the overpayment is against the Wraparound provider, a Non-System Determined Claim (NSDC) can be generated in CalWIN and manually referred to collections.
      1. Note: Recovery and Legal will create the OP claim. AAP overpayments against facilities are always collectible 
2. Forward the SCD 13 as follows
   1. Signed and dated original to collection, and 
   2. Copy for the case record.

Related Topics

Underpayments/Overpayments