California Department of Social Services (CDSS)County Expense Claim Reporting Information System

6Business Requirements

This section contains all business requirements to support the design, development, testing, implementation, and maintenance of the CECRIS. The State will be responsible to fulfill the business requriements. The business requirements are divided into the following requirements sets:

6.1 CECRIS Claim Template

6.2 Capture County Allocations

6.3 Administrative and Assistance Claim Expenditure Coding Structure

6.4 Calculate and Distribute Advances

6.5 Submit Claim

6.6 Receive and Audit Claim

6.7 Process Payments

6.8 Year End Processing

6.9 State and Federal Fiscal Year Close Out

6.10Reporting

6.11User Access

6.12Data Migration

Each requirements set begins with a background discussion that provides the general information and context for the particular requirements set. The requirements are presented in table format, and there is a table for each requirements set. Some requirements sets are further subdivided as appropriate.

6.1CECRIS Claim Template

This section presents business requirements related to the claim format and associated data elements.

Where applicable, the specific claim type is identified. If claim or claims is used without specifying a type, it applies to all claim types.

The counties submit claims for assistance costs and administrative costs. Assistance costs refer to the actual benefit payments issued to recipients. Monthly claims for assistance costs are submitted monthly by the 20th following the reporting month. Approved, audited costs are paid within forty days after submission or the 20th.

The counties submit, on a quarterly basis, an administrative claim for expenses associated with managing these programs. Cost categories include, but are not limited to, staff salaries and benefits, training, information technology services and equipment, client services and facilities. Quarterly administrative claims are submitted no later than 30 days after the end of the reporting quarter. The audited costs are approved and paid within 75 days after submission.

In both claim types, costs are captured primarily by aid code (assistance) or program code (PC) (administrative). Depending on the assistance or administrative claim, additional information is needed such as caseload, person count, etc. In addition, each aid code or PC has a sharing ratio (federal share, state share, realignment share, reimbursement share and/or county share) and that sharing ratio can differ amongst aid code and PC. Finally, because not all counties are eligible for submitting costs for a specific aid code or PC, controls must be in place to prevent a county from submitting unallowable costs.

Due to changes in state and federal statute and regulations, the claim data elements can change. This can include the addition, deletion or modification of an aid code or PC, sharing ratio, eligible counties and other elements. The system mustallow authorized users to modify aspects of claim data elements.

Because counties may have missed costs in a previous claim or need to correct costs in previously submitted claims, the system must retain the entire history of an audited claim in the event costs must later be submitted for a period in the past (e.g., amend the quarterly administrative claim nine (9) months after the due date of the original claim, or amend the monthly assistance claim no later than 18 months after the submittal of the original claim). Therefore, the system must ensure the correct aid code or PC and their associated business rules are still present for previous periods. The system must also ensure the correct codes and business rules are present for the return of funds beyond this period in the event of an audit finding.

6.1.1Claim Template Requirements

# / Requirement
28 / The system shall implement monthly Claim Templates in a manner that allows dynamic addition, expirationand modification of fields and layout by authorized system users.
29 / Where possible, the fields and attributes described in following requirementsof the Claim Templates shall be implemented in a dynamic fashion, allowing addition, expiration and modification of the Claim Templates from month to month.
30 / Field codes shall be implemented in a manner that allows for dynamic addition, expiration and modification of codes.
31 / The system shall contain atemplate foreach of the following monthly assistance claim types, including at a minimum:
  1. Monthly assistance
  2. Supplemental monthly assistance
  3. Type of Program claim (i.e., CalWORKs, Foster Care, Extended Foster Care, etc.)Projected monthly assistance
  4. Year-end and close-out monthly assistance
i. Federal
ii. State
iii. Calendar Year
  1. Title IV-E Waiver claim
  2. Out of sequence claim (SOC 812, etc.)
  3. Pilot Project Claims (RBS, etc.)

32 / The system shall contain a template for each of the following quarterly administrative claim types, including at a minimum:
  1. Quarterly administrative expense
  2. Supplemental quarterly administrative expense
  3. Quarterly Pilot program (e.g. RBS, IV-E Waiver) and future pilot program expenses
  4. Quarterly Administrative Title IV-E Waiver claim
  5. Projected quarterly administrative expense
  6. Year-end and close-out administrative expense
  7. State Fiscal Year
  8. Federal Fiscal Year
  9. Calendar Year
  10. Out of sequence Claim (e.g., SOC 812, etc.)

33 / For each monthly assistance and quarterly administrative claim type, the system shall capture the following county data elements:
  1. County Name
  2. County Number
  3. Fiscalyear (State and Federal)andcalendaryear– 4 digit
  4. Claim month and year/quarter and year
  5. Submission date by county
  6. Claim type
  7. Name of county welfare directorincluding signature
  8. Name of county auditorincluding signature
  9. Name of county contact
  10. Name of county claim preparer
  11. Telephone number of county contact
  12. E-mail address of county contact
  13. County’s USPS mailing address
  14. Total expenditureby federal, state and county share

34 / For each monthly assistance and quarterly administrative claim type, the system shall capture the following reporting period information:
  1. Fiscal year (State and Federal) or Calendar Year
  2. Reporting period
  3. Claim type (e.g., original, adjustment, supplemental, etc.)

35 / The system shall allow a county to submit a positive or negative retroactive claim.
36 / The system shall limit the period and frequency in which a county may submit retroactive positive adjustment claims up to 18 months (assistance) or nine (9) months (administrative) after the original reporting period.
37 / The system shall allow an authorized user to override the claiming period if necessary
38 / The system shall not limit the period in which a county may submit a retroactive (or corrected) negative claim after the original reporting period.
39 / The system shall allow an authorized user to producea certification letter for the claim and allow that user to print the cover letter upon demand.
40 / The system shall retain an electronic copy of the certification letter and associate it to the specific claim.
41 / For each aid code within an assistance claim, the system shall capture one or more of the following data elements:
  1. Program name
  2. Aid code name
  3. Aid code number
  4. Aid code type (federal program/non-federal program)
  5. Benefit cost
  6. Administrative cost
  7. Cost by payroll
  8. Cost by cancelled payment
  9. Case type
  10. Person count
  11. Case count
  12. Time Study hours
  13. Funding source
  14. Summary by funding
  15. Sharing Ratio
  16. Rate calculation formula
  17. Recovery of aid / Overpayments
  18. Number of federal assistance units
  19. Assistance unit
  20. Costs by grant payments
  21. Costs by wage subsidy
  22. Costs by period
  23. Facility type
  24. Cost for prior month negative adjustment
  25. Cost for prior month positive adjustment
  26. Cost for monitoring adjustment by period
  27. Cost by overpayment status
  28. Budget allocation amount
  29. Overpayment code
  30. Waiver/Non-Waiver code
  31. Any new requirements as a result of regulatory or statutory changes
  32. State budgetary information/federal budgetary information

42 / For each facility within a monthly assistance claim, the system shall capture one or more of the following data elements:
  1. Facility/group home name
  2. Cost by Period
  3. Type of cost (admin/non-admin)
  4. Person count
  5. Sharing ratio (fed/non-fed)
  6. Program
  7. Payment type
  8. Location
  9. Aid code name
  10. Aid code number
  11. Case type
  12. Case count
  13. Group home facility number
  14. Foster Family Agency facility number
  15. Foster Family Agency Social Worker Time Study hours
  16. Transitional Housing Placement Program Plus (THP+FC)
  17. Facility rate
  18. Facility approved bed count
  19. Any new requirements as a result of regulatory or statutory changes

43 / For each quarterly administrative claim, the system shall capture costs for the following functions:
  1. Social Services
  2. CalWORKS (California Work Opportunity and Responsibility to Kids)
  3. Other Public Welfare
  4. Child Care
  5. Non-welfare
  6. Generic
  7. Any new function category as a result of regulatory or statutory changes

44 / The system shall allow a state authorized user to add, delete, activate, deactivate and/or modify an aid and/or program code.
45 / The system shall allow a state authorized user to add, delete and/or modify funding sources within an aid and/or program code.
46 / For each quarterly administrative claim, the system shall capture any of the following data elements for each function:
  1. Caseload type
  2. Caseload count (fed/non-fed)
  3. Person count (fed/non-fed)CFAP – Single count
  4. CalWork Case load
  5. Two parent families Caseload
  6. Public Asisstance Cal-Fresh Cases
  1. Support staff costs
  2. General administration
  3. Program administration
  4. Clerical
  5. SSTRP support staff hours
  6. Non-SSTRP support staff salaries
  7. Direct charge/cluster program codes
  8. Full time equivalent calculations
  9. Support operating costs
  10. Travel
  11. Space
  12. Other operating costs
  13. Purchase of service
  14. Public/private agency direct bill-non CCAP
  15. Information technology costs
  16. Program title
  17. Program code
  18. Development cost
  19. Maintenance cost
  20. SACWIS (Statewide Automated Child Welfare Information System)cost
  21. Non-SACWIS cost
  22. Staff development costs
  23. Personal services/operating
  24. Purchase of service/direct cost of trainees
  25. Extraneous costs
  26. Time study hours
  27. Caseworker Salary and Benefits
  28. Caseworker ratio
  29. Full-Time Equivalent Count
  30. Direct cost
  31. Program code
  32. Program name
  33. Program type
  34. Approved plans (e.g., A-87, SSTRP, APDs, ATPs, Training Plans, Letter of Intent) that must be received prior to incurring expenditures.
  35. Cluster codes for support staff
  36. Waiver/Non-Waiver cost
  37. Discount Ratio
  38. Any new requirements as a result of regulatory or statutory changes
  39. Addendums
  40. Emergency and Disaster costs and/or codes

47 / The system shall capture the following information for each county technology maintenance project:
  1. Project name
  2. Project number
  3. Project cost
  4. Project allocation (approved budget amount)
  5. Project time limit
  6. Project running balance
  7. Administrative cost

48 / The system shall capture the following information for each technology maintenance project:
  1. Project name
  2. Project number
  3. Project cost
  4. Project allocation
  5. Project time limit
  6. Project running balance
  7. Administrative cost

49 / The system shall capture APD approval letters to record authority to spend.
50 / The system shall allow for expandability in order to accommodate regulatory and statuory changes.
51 / The system shall capture the following for each aid or program code:
  1. Effective start date
  2. Effective end date
  3. Comment
  4. Date of addition, edit or deletion
  5. Program cost account code
  6. Federal Catalogue Number
  7. Funding sharing ratio
  8. Funding ratio validation
  9. Applicable program/claim
  10. Waiver identifier
  11. Eligible counties
  12. Title XX
  13. Differentiate and separate staff development and training from goods and services
  14. Function
  15. Maintenance of Effort (MOE) or Non-MOE
  16. Assistance or Non-Assistance
  17. Ledger(s) associated with the Program Code or Aid Code
  18. Time Study Codes associated with Program Code
  19. PINs associated with Program Code
  20. Single Funding Crosswalk Title
  21. Admin or Non-Admin
  22. County Welfare Department or Probation identifier
  23. Suspension Period
  24. Direct to Program costs
  25. Any new requirements as a result of regulatory or statutory changes

52 / The system shall record amounts in whole dollars.
53 / The system shall round calculations to the nearest whole dollar.
54 / The system shall based on the business rules calculate the appropriate ratio.
55 / The system shall based on business rules disburse the charges accordingly. For example should $99 be entered and the ratio is 50/50 then $49 shall be billed to the federal government and $50 to the State.
56 / The system shall allow overriding of calculated values to account for rounding errors.
57 / The system shall allow an authorized user to add, delete, activate, deactivate and modify data elements on a claim template. This includes the ability to add, delete, activate, deactivate and modify and disable cost allocation methodologies and case/persons counts and associated ratios.
58 / The system shall allow an authorized user to verify edits, additions, inactivations and/or deletions to claim before saving them.
59 / The system shall allow an authorized user to save a modified claim template.
60 / The system shall track changes to claim templates and data elements within a claim including, at a minimum:
  1. Type of change
  2. Date of change
  3. User making change
  4. Reason for change (including, at a minimum audit findings, state or federal statute change)

61 / Each version of a claim shall have an effective county completion and submission date.
62 / When an authorized user selects a claim reporting period, the system shall present the claim template that is effective for that reporting period.
63 / The system shall allow an authorized user to test a claim template with sample data. This includes testing Program Request Form changes to the system prior to implementation.

6.2Capture County Allocations

Each county is given a fiscal year allocation for most programs it provides. These budget allocations are calculated using a methodology that is jointly developed by the CDSS and the County Welfare Directors Association. The resulting allocations will be captured in CECRIS and used as the starting balance for future county costs that are claimed for the State or Federal fiscal year.

During the course of a fiscal year, there may be changes to the State budget thatmay result in changes to the county allocation. Changes to a county’s individual budget allocation can also occur as a result of redistribution of funds between counties.

6.2.1County Allocation Requirements

# / Requirement
64 / The system shall store the total statewide budget allocation for a program.
65 / The system shall store a county’s program budget allocation.
66 / The system shall record debits and credits to a county program budget allocation and maintain the running total of a county and statewide program budget allocation.
67 / Upon user request, the system shall identify budget allocations not being expended by:
  1. Program (statewide)
  2. County

68 / The system shall record and monitor a program budget allocation amount for state-level andfederal-level operations.
69 / The system shall allow a State user to add, delete and modify a county’s program budget allocation and capture:
  1. Amount
  2. Type of allocation (augmentation, calculated, redistribution, etc.)
  3. Date of journal entry
  4. Reason
  5. User
  6. Approved by

70 / The system shall allow anauthorized user to compare current fiscal year budget allocations to previous years’ budget allocations by:
  1. Program (statewide)
  2. County

71 / The system shall allow an authorized state user to upload budget allocations from a data file in formats including but not limited to CSV and Microsoft Excel.
72 / The system shall generate an automatic reminder to authorized users to update budget allocations annually.
73 / The system shall generate an automatic reminder to close out allocations.

6.3Administrative and Assistance Claim Expenditure Coding Structure

This section presents information on how expenditures are currently captured and associated requirements.

The highest level of how funds are budgeted is called an appropriation. Currently, the CDSS has at least 13 appropriations. Within an appropriation are one or more Program Cost Accounts (PCA) codes. Within a PCA, codes are either program or aid codes. A PCA code will never contain both a program and an aid code. Counties use program codes and aid codes to enter administrative expense and assistance claim costs, respectively.

Within a program code, there are several sub-codes that counties use to report expenditures:

  • Time study code: A program code may contain one (1) or more time study codes
  • Support staff code: A program code may contain one (1) or more support staff codes
  • Program identifier number code: A program code may contain one (1) or more program identifier number codes
  • Generic code: Costs that are general administrative in nature, have department-wide benefit, or costs that cannot be reasonably identified as benefiting a specific program or group of programs

Counties use aid codes to report assistance costs. Although aid codes currently do not have any sub-codes, solution must have the ability to configure to add sub-codes or an expanded field.

The table below presents information on the various codes used.

Table 6.1, Current Administrative and Assistance Claims Codes

Term (Acronym) / Administrative or Assistance / Definition / Current Structure
Appropriation / Both / The line item in the budget where the funding is. There are currently at least 13 appropriations. Expenditures are paid from the appropriation. / Fund (4 digits) +Ref number (3 digits) + Program (2 digits) + Element (3 digits)
Program Cost Account Code
(PCA Code) / Both / A code to track expenditures in CALSTARS.
A PCA code can have many program or aid codes. / 5 digits
Catalog of Federal Domestic Assistance Number
(CFDA number) / Both / A federal code used to identify a specific federal program.
The same CFDA number can have many PCA codes. / 5 digits
Program Code
(PC) / Administrative / A specific administrative expense. This code is used by counties. / 3 digits
State Use Only Code (SUO)
/ Administrative / A SUO program code. For example, Title XX or the MOE code do not have any sub-codes (i.e., time study, PIN, support or generic). / 3 digits
Aid Code / Assistance / A specific assistance expense. This code is used by counties. / 2 alphanumeric characters
Time Study Code / Administrative / A code used to account for county staff daily work activities during a specified period of time. This code is used by counties. / 4 digits
program code + 1 digit
Type of Expense Code
(TOE Code) / Administrative / An identifier that indicates a type of direct charge such as an activity or service provided including the following examples:
  • travel
  • transportation
  • medical costs
  • dependent care
/ 2 digits
Program Identifier Number Code
(PIN Code) / Administrative / A code established for direct costs. This code is used by counties. / 6 digits
time study code + TOE code
Support Staff Code / Administrative / Staff who perform generic or support-related activities, (e.g., personnel, administration, or direct support of the caseworker)The codes are:
A=Social Services
B=CalWORKS
C=Other public welfare
D=Child Care
This code is used by counties. / One alpha character and at least one, but no more than two, digits.

The diagrams below illustrate the hierarchy of the various codes used to capture administrative expense and assistance costs.