Form OCSE-75 Annual Data Report

DRAFT

ACTION TRANSMITTAL: AT-XX-XX

DATE:

TO: TRIBAL AGENCIES ADMINISTERING CHILD SUPPPORT ENFORCEMENT PLANS UNDER TITLE IV-D OF THE SOCIAL SECURITY ACT AND OTHER INTERESTED INDIVIDUALS

SUBJECT: The Tribal Child Support Enforcement Annual Data Report, Form OCSE‑75 and Tribal Narrative Reports

CONTENT: This Action Transmittal contains instructions for completing the above form, which is to be used to report program status and accomplishments under Title IV‑D of the Social Security Act as required by 45 CFR 309.170(b). Tribes administering Child Support Enforcement Programs under Title IV‑D of the Social Security Act are required to submit the OCSE-75 report annually, 90 days after the end of the Federal Fiscal Year, or by December 29^th of each year.

Please send the report to the following address:

Department of Health and Human Services

Administration for Children and Families

Office of Child Support Enforcement

Division of Planning, Research, and Evaluation

Fourth Floor West

370 L'Enfant Promenade, SW

Washington, DC 20447

RELATED MATERIAL: AT-04-01, Final Rule on Tribal Child Support

Enforcement Programs

SUPERSEDED AT-10-07, AT-07-03

MATERIAL:

ATTACHMENTS: Form OCSE-75 and instructions for completing the report.

EFFECTIVE DATE: Tribes are to begin using this revised Form OCSE- 75 to report Title IV-D Tribal Program status and accomplishments for Federal Fiscal Year 2013. The first report is due by December 29, 2013.

INQUIRIES TO: OCSE Division of Planning, Research, and Evaluation

ACF/OCSE Regional Offices

Vicki Turetsky

Commissioner

Office of Child Support Enforcement

Cc: Tribal Leaders

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Administration for Children and Families

Office of Child Support Enforcement

TRIBAL CHILD SUPPORT ENFORCEMENT ANNUAL DATA REPORT

Form Approved

OMB No: 0970-0320

Expires:XX/XX/XXXX

(This report consists of one page)

TRIBE: SUBMISSION: New  Revised  FISCAL YEAR: FISCAL YEAR:

ITEMS

 NARRATIVE REPORT: Place X in box to confirm narrative report is attached.

SECTION A: CASE INVENTORY

TOTAL

1. Total Number of Cases Open at Any Time During the Fiscal Year

a. Total Number of Open TANF Cases

b. Total Number of Open Non-TANF Cases

2. Total Number of Cases Open at Any Time During the Fiscal Year with a Support Order

SECTION B: PATERNITY ESTABLISHMENT

3. Total Number of Children Ever Needing Paternity Established in Cases Open at Any Time During the Fiscal Year

4. Total Number of Children With Paternity Concluded in Cases Open at Any Time During the Fiscal Year

SECTION C: COLLECTIONS

5. Total Amount of Current Support Due on Tribal Cases

6. Total Amount of Current Support Collected on Tribal Cases

7. Total Amount of Past Due Support Owed on Tribal Cases

8. Total Amount of Past Due Collected on Tribal Cases

9. Total Amount of All Support Collected During the Fiscal Year on All Cases

SECTION D: PROGRAM COST

10. Total Amount of Fees and Costs Recovered

11. Total Amount of Laboratory Costs for Paternity Establishment

SECTION E: OPTIONAL TRIBAL REPORTING

12. Total Amount Collected from Tribal Sources (Optional)

a. Percentage Collected

13. Tribal Unemployment Rate (Optional)

14. Tribal Joblessness Rate (Optional)

Paperwork Act Notice: Tribes are required to provide the information requested to receive a grant award under the provision of Title IV-D, Part 309 of the Social Security Act. This is public information. The responses to this collection are mandatory. This information is not considered confidential, therefore, no additional safeguards are considered necessary beyond that customarily applied to routine government information.

Reporting Burden Notice: Public reporting burden for this collection of information is estimated to average 60 hours per response, including the time for reviewing instructions, gathering and compiling the data needed, and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding either this burden estimate or other aspect of this request for information to: the Administration for Children and Families, Office of Child Support Enforcement, 370 L’Enfant Promenade, S.W.,Washington, D.C. 20447

This is to certify the information provided on this report is accurate to the best of my knowledge and belief.

Signature: Title IV-D Director or Other Official

Agency Name

Typed Name, Title,

Date:

FORM OCSE-75

INSTRUCTIONS FOR COMPLETING FORM OCSE-75,

THE TRIBAL CHILD SUPPORT ENFORCEMENT

ANNUAL DATA REPORT

GENERAL REPORTING INSTRUCTIONS

Tribes use the OCSE‑75 to report statistical and some financial information on their Title IV-D Child Support Enforcement (CSE) program to the Department of Health and Human Services (HHS). Information provided by the Tribes allows HHS to report such information in the Annual Report to Congress and will provide HHS with information on tribal program performance. The authority to collect this information is set forth in regulations at 45 CFR 309.170(b).

1. Submittal and Due Dates

The OCSE-75 report is completed by the Tribal IV-D Child Support Enforcement Program every Federal Fiscal Year (FY) which begins October 1^st and ends September 30^th. Tribal CSE Programs must submit this report by December 29^th of each year, which is 90 days after the end of the FY. This report can be submitted by mail or by using the Online Data Collection (OLDC). See #3 for more details on how to report via OLDC.

If reporting by mail, an orignal signed OCSE-75 must be submitted to the OCSE Central Office at the address below. It is recommended to send a courtesy copy to your Regional Office.

Department of Health and Human Services

Administration for Children and Families

Office of Child Support Enforcement

Division of Planning, Research and Evaluation

Fourth Floor West

370 L'Enfant Promenade, SW

Washington, DC 20447

2. Signature

The OCSE‑75 must be signed and dated by the Director of the Tribe’s CSE Program or by another appropriate official. For reporting on OLDC, the person who is designated by the Tribe to sign electronically will be assigned a special ID and password. Approving the electronic OCSE-75 under these IDs and passwords indicates that the appropriate person has reviewed and approved the report and is certifying that the information is accurate, to the best of his or her knowledge.

3. Online Reporting

Tribes are encouraged to use the Online Data Collection (OLDC) system because it is the quickest way to submit reports. The web address is https://extranet.acf.hhs.gov/ssi. If you need to obtain a user ID and password, please contact the OCSE, Division of Planning, Research and Evaluation at (202) 401-5599 or your Regional Office.

4. Public Reporting

THE PAPERWORK REDUCTION ACT OF 1995

The public reporting burden for this collection of information is estimated to average about 60 hours per response, including the time for reviewing instructions, gathering and compiling the data needed, and reviewing the collection of information.

An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.

Send comments regarding this burden estimate or any other aspect of this request for information, including suggestions for reducing this burden, to Reports Clearance Officer, Administration for Children and Families, Department of Health and Human Services, 370 L'Enfant Promenade, SW, Washington, DC 20447.

5. Narrative Reports

Tribal CSE Programs must submit a narrative report with the OCSE-75 on activities, accomplishments, and progress, including success in reaching their performance targets established by the Tribe, or Tribal Organization. Please place an “X” in the the box at the top of the form that reads “Narrative Report” to indicate the report is attached.

Tribes are encouraged to provide OCSE with detailed information regarding the results of their program operations in their narrative reports. Tribes are also asked to identify the performance targets and discuss whether these targets were met for the reporting Fiscal Year.

Providing results statements and not just activities helps to provide more substantial information for the Annual Report to Congress.

Examples:

1. Activity statement:

We sent 30 children for genetic testing.

2. Result statements:

1. We collected more than $20,000 in current support; a 5% increase over last year.

2. We collected more than $440,000 in total support; a 7% increase over last year.

3. Of 1,560 child support cases, 1,290 had a child support order established (more than 80%).

DEFINITIONS TO USE IN COMPLETING FORM OCSE‑75, TRIBAL CHILD SUPPORT ENFORCEMENT

ANNUAL DATA REPORT

The following definitions of terms are to be used in completing the OCSE‑75. For reporting purposes, these definitions have been modified and condensed. To obtain definitions as they appeared in the regulations, please refer to section 309.05 of the regulations. Definitions in 301.1 and 305.1 may also be helpful.

Case Inventory Definitions

1. Case¹ – A case where the parent (mother, father, alleged father, adopted parents) who is or may be obligated to support their child(ren) who are receiving services under the Child Support Enforcement Program, either through referral (TANF, foster care, or Medicaid), where the parent has filed an application for services, or intergovernmental cases.

2. TANF Case – A case where the child(ren) is/are currently receiving Tribal or State Temporary Assistance for Needy Families (TANF).

3. Non TANF Case – A case where the child(ren) formerly received Tribal or State TANF or a case where no assistance was provided. This includes Title IV-E federal foster care cases, and Medicaid cases.

4. Child Support Order – The legal establishment of (1) an amount of money that is due and owed by a parent for the support of the parent’s child(ren); and/or (2) the responsiblility to provide health insurance and/or medical support for the child(ren).

5. Paternity – The legal establishment of fatherhood for a child, by tribal custom, court determination, administrative process, or voluntary acknowledgment.

6. Tribal Case – Tribes may choose how they define a Tribal case for purposes of lines 5 – 8. Tribal cases may typically include cases where the child support obligation is established by the Tribe, but may also include foreign orders such as those being enforced for Tribal/Community members. The methodology should be consistent for reporting each line 5 – 8, and also consistent from year to year.

SECTION A: CASE INVENTORY

Line 1 – Total Number of Cases Open At Any Time During The Fiscal Year

1. Report all cases that were open at any time during the Fiscal Year that ends September 30^th. This includes counting any cases that were closed during the same Fiscal Year.

2. Report cases the same way every year to be consistent. Report as a separate case, each family with a dependent child(ren) that the parent is or may be obligated to pay child support.

Examples:

1. A mother goes on Tribal TANF and has two children from two different fathers. How many cases would you count? You will count two cases, one for each father.

2. A mother has two children from two different fathers and the children were placed with relatives. One child went to live with Grandma and the other one went to live with Aunty. How many cases will you count? You will count four cases, one for each father and two for the mother.

3. Include in your case count any cases that were referred to your Program by another State, Tribe or Country.

4. Note that Line 1 is the total of Lines 1a and 1b (Line 1 = Lines 1a+1b)

Line 1a – Total Number of Open TANF Cases

1. Report the number of cases where the child(ren) received Tribal or StateTANF at any time during the Fiscal Year. This number includes any cases you may have closed during that same Fiscal Year.

Examples:

1. The Fiscal Year is October 1 – September 30. A child received Tribal TANF in March and went off TANF in August. Would you count this as a TANF Case? Yes!

2. The Fiscal Year is October 1 – September 30. A father went on State TANF with three children three years ago and continues to be on TANF as of September 30^th of this year. Would you count this as a TANF Case for this year’s report? Yes!

2. Line 1a is a subset of Line 1.

Line 1b – Total Number of Open Non-TANF Cases

1. Report the number of cases where the child(ren) formerly received Tribal or State TANF and where the child(ren) never received TANF. (Remember, don’t count the case if the child(ren) were on TANF at any time during the same reporting year.)

2. Report IV-E Foster Care and Medicaid-only cases as Non-TANF cases.

3. If you are unsure if the child(ren) received TANF count this case as Non-TANF.

Example:

The Fiscal Year is October 1 – September 30. A child was on Tribal TANF last Fiscal Year in August, but hasn’t been on TANF this Fiscal Year. Would you count this as a Non-TANF Case? Yes!

4. Line 1b is a subset of Line 1.

Line 2 – Total Number of Cases Open at Any Time During the Fiscal Year with a Support Order

1. Report all cases that have a child support order open any time during the Fiscal Year that ends September 30^th. This includes counting any cases with a child support order that were closed during the Fiscal Year.

2. Include cases with orders for child support or medical support. Only count the case once even if there are multiple orders on a case.

3. Include cases with orders that were established prior to the case coming to the Tribal Program.

4. Include cases with a judgment for arrears.

5. Line 2 is a count of every case in the Tribal Caseload that has a support order, not just a count of the support orders that the Tribe established.

Example:

The Tribe reported on Line 1 that there were 300 cases open at any time during the Fiscal Year. You have 200 cases where a support order has already been established (such as foreign orders and support orders established previous years). The Tribe established 50 support orders this FY. How many support orders do you have? Report 250 support orders on Line 2.

6. Line 2 is a subset of the total open cases in Line 1. Therefore, Line 2 can not be more than Line 1.

SECTION B: PATERNITY ESTABLISHMENT

Line 3 – Total Number of Children Ever Needing Paternity Established in Cases Open at Any Time During the Fiscal Year.

1. The Tribe defines “children ever needing paternity established”.

2. Report all children who ever needed paternity established as defined by the Tribe, in the case load you reported on Line 1. Stated another way, “How many children in the cases you reported on Line 1 ever needed paternity established?”

3. Paternity can only be counted once. Don’t count cases. Count children.

4. Report children who ever needed paternity established even if they are now over 18.

Line 4 – Total Number of Children with Paternity Concluded.

1. The Tribes define “paternity concluded”. This term may include children whose father has acknoweldged or established paternity and cases where a Tribe has attempted to establish paternity but the alleged father was excluded and no other alleged fathers are under the Tribe’s jurisdiction.

2. You should report all children where the case was open at any time during the Fiscal Year, which ends September 30^th , where paternity was concluded. This includes counting any children where the cases were closed during the same Fiscal Year.

3. Paternity can only be counted once. Don’t count cases. Count children.

4. Report children where paternity was concluded by the Tribe or by another jurisdiction.

5. Report children where paternity was concluded even if they are now over 18.

6. Line 4 is a subset of line 3. Line 4 can not be more than Line 3.

SECTION C: COLLECTIONS

Line 5 – Total Amount of Current Support Due on Tribal Cases

1. Report the Total amount of current support due on Tribal Cases during the Fiscal Year.

2. Tribes may choose how they define a Tribal case for purposes of Lines 5 through 8.

3. Tribal cases will typically include cases where the child support obligation is established by the Tribe but may also include foreign orders such as those being enforced for Tribal/Community members.

4. The methodology should be consistent for reporting each Line 5 through Line 8 and also be consistent from year to year.

5. Include voluntary collections as amount due (voluntary collections are those made without a support order or payments made that exceeded the ordered amount where no arrears are due).

6. Remember to include amounts due for the months that the case was open during the Fiscal Year, even if the case closed during the Fiscal Year.

7. These amounts may be computed monthly and the total of all months reported at the end of the Fiscal Year (September 30^th).

Example:

A parent’s child support obligation is $100 per month, and the case was open for all 12 months of this fiscal year. You would report $1,200 for current support due (12 months X $100).

Line 6 – Total Amount of Current Support Collected on Tribal Cases

1. Report the Total amount of current support collected on Tribal Cases during the Fiscal Year. (See definition above).

Example:

A parent’s current child support obligation is $100 per month ($1,200 for the Fiscal Year). He paid $1,000 in current support during the reporting Fiscal Year.   The amount of curent support collected is $1,000.

2. Include voluntary collections as amount due (voluntary collections are those made without a support order or payments made that exceeded the ordered amount where no arrears are due).

3. These amounts may be computed monthly and the total of all months reported at the end of the Fiscal Year (September 30^th).

4. Line 6 is a subset of line 5.

Line 7 – Total Amount of Past-Due Support Owed on Tribal Cases

1. Report the total amount of all past-due support owed on those Tribal Cases that are opened as of September 30.

2. Interest, if charged, may be included in the amount.

Examples:

1. A parent’s child support obligation is $1,000 per month ($12,000 for the Fiscal Year). He paid $2,000 in current support this reporting Fiscal Year, and he did not owe any past-due support from prior fiscal years. The amount of past-due support owed is $10,000 ($12,000-$2,000) for this Fiscal Year.

2. The Fiscal Year is October 1 – September 30. A parent owes $20,000 from last FY. The parent paid the full amount of current support every month this Fiscal Year. Report past-due support of $20,000 on the report for this Fiscal Year.

Line 8 – Total Amount of Past-Due Support Collected on Tribal Cases

1. Report the total amount of past-due collected on Tribal Cases during the Fiscal Year.

2. Line 8 is a subset of line 7.

Example:

The Fiscal Year is October 1 – September 30. A parent owed $20,000 last FY. The parent paid current support every month and paid an additional amount of $250 toward his past support. The amount of past due collected is $3,000 ($250 X 12 months).

Line 9 – Total Amount of All Support Collected During the Fiscal Year on All Cases

1. Report the total amount of current and past due support collected on ALL cases as of the end of the Fiscal Year (September 30^th).

2. This includes all collections on all support cases reported on Line 1, not just Tribal Cases.

SECTION D: PROGRAM COST

Line 10 – Total Amount of Fees and Cost Recovered

1. Report the total amount of fees and costs obtained by the Program during the Fiscal Year that are used to offset administrative costs.

2. Count all mandatory or optional fees collected from recipients of child support services such as application fee or collection fee, not inconsistent with Federal law.

3. Do not include fees for laboratory paternity testing (these fees are included with the entry on Line 11).

Line 11 – Total Amount of Laboratory Cost for Paternity Established

1. Report the total amount of laboratory costs associated with the process of determining paternity that was paid in that Fiscal Year.

2. The entry on this line will be the “net” amount of expenditures, reduced by any fees collected by the Tribe to recoup the cost of these services.

SECTION E: OPTIONAL TRIBAL REPORTING

Line 12 – Total Amount Collected From Tribal Sources (Optional)

1. Report collections that the Tribe obtained from Tribal Sources as defined by the Tribe that were collected during the Fiscal Year, which ends September 30^th.

2. This is an optional reporting element.

Line 12a – Percentage Collected from Tribal Sources (Optional)

1. Report the percentage collected from Tribal Sources by dividing Line 12 by Line 9 (total current and past due collected).

2. This is an optional reporting element.

Line 13 – Tribal Unemployment Rate (Optional)

This is an optional reporting line, and may be obtained from an actual study or report such as the Bureau of Indian Affairs (BIA) Labor Force Report, or other Tribal calculations based on Tribal members, Tribal child support caseload, or other appropriate group.

Line 14 – Tribal Joblessness Rate (Optional)

This is an optional reporting line.

1 These are cases receiving services under Title IV of the Social Security Act.

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OCSE-75 Final Revised Form and Instructions xx-xx-xxxx