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

6 Business RequirementsThis 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 Template6.2 Capture County Allocations6.3 Administrative and Assistance Claim Expenditure Coding Structure6.4 Calculate and Distribute Advances6.5 Submit Claim6.6 Receive and Audit Claim6.7 Process Payments6.8 Year End Processing6.9 State and Federal Fiscal Year Close Out6.10 Reporting6.11 User Access6.12 Data 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.

6.1 CECRIS Claim TemplateThis 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 must allow 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.

6.1.1 Claim Template Requirements

# Requirement28 The system shall implement monthly Claim Templates in a manner that allows

dynamic addition, expiration and modification of fields and layout by authorized system users.

29 Where possible, the fields and attributes described in following requirements of 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.


# Requirement31 The system shall contain a template for each of the following monthly

assistance claim types, including at a minimum:a. Monthly assistanceb. Supplemental monthly assistancec. Type of Program claim (i.e., CalWORKs, Foster Care, Extended Foster

Care, etc.)Projected monthly assistanced. Year-end and close-out monthly assistance

i. Federalii. Stateiii. Calendar Year

e. Title IV-E Waiver claimf. Out of sequence claim (SOC 812, etc.)g. 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:

a. Quarterly administrative expenseb. Supplemental quarterly administrative expensec. Quarterly Pilot program (e.g. RBS, IV-E Waiver) and future pilot program

expensesd. Quarterly Administrative Title IV-E Waiver claime. Projected quarterly administrative expensef. Year-end and close-out administrative expense

i. State Fiscal Yearii. Federal Fiscal Yeariii. Calendar Year

g. Out of sequence Claim (e.g., SOC 812, etc.)


# Requirement33 For each monthly assistance and quarterly administrative claim type, the

system shall capture the following county data elements:a. County Nameb. County Numberc. Fiscal year (State and Federal) and calendar year– 4 digitd. Claim month and year/quarter and yeare. Submission date by countyf. Claim typeg. Name of county welfare director including signatureh. Name of county auditor including signaturei. Name of county contactj. Name of county claim preparerk. Telephone number of county contactl. E-mail address of county contactm. County’s USPS mailing addressn. Total expenditure by federal, state and county share

34 For each monthly assistance and quarterly administrative claim type, the system shall capture the following reporting period information:

a. Fiscal year (State and Federal) or Calendar Yearb. Reporting periodc. 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 produce a 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.


# Requirement41 For each aid code within an assistance claim, the system shall capture one or

more of the following data elements:a. Program nameb. Aid code namec. Aid code numberd. Aid code type (federal program/non-federal program)e. Benefit costf. Administrative costg. Cost by payrollh. Cost by cancelled paymenti. Case typej. Person countk. Case countl. Time Study hoursm. Funding sourcen. Summary by fundingo. Sharing Ratiop. Rate calculation formulaq. Recovery of aid / Overpaymentsr. Number of federal assistance unitss. Assistance unitt. Costs by grant paymentsu. Costs by wage subsidyv. Costs by periodw. Facility typex. Cost for prior month negative adjustmenty. Cost for prior month positive adjustmentz. Cost for monitoring adjustment by periodaa.Cost by overpayment statusbb.Budget allocation amountcc. Overpayment codedd.Waiver/Non-Waiver codeee.Any new requirements as a result of regulatory or statutory changesff. State budgetary information/federal budgetary information


# Requirement42 For each facility within a monthly assistance claim, the system shall capture one

or more of the following data elements:a. Facility/group home nameb. Cost by Periodc. Type of cost (admin/non-admin)d. Person counte. Sharing ratio (fed/non-fed)f. Programg. Payment typeh. Locationi. Aid code namej. Aid code numberk. Case typel. Case countm. Group home facility numbern. Foster Family Agency facility numbero. Foster Family Agency Social Worker Time Study hoursp. Transitional Housing Placement Program Plus (THP+FC)q. Facility rater. Facility approved bed counts. 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:

a. Social Servicesb. CalWORKS (California Work Opportunity and Responsibility to Kids)c. Other Public Welfared. Child Caree. Non-welfaref. Genericg. 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:

a. Caseload typeb. Caseload count (fed/non-fed)c. Person count (fed/non-fed)CFAP – Single countd. CalWork Case load


# Requirement

e. Two parent families Caseloadf. Public Asisstance Cal-Fresh Cases

g. Support staff costsi. General administrationii. Program administrationiii. Clericaliv. SSTRP support staff hoursv. Non-SSTRP support staff salariesvi. Direct charge/cluster program codesvii. Full time equivalent calculations

h. Support operating costsi. Travelii. Spaceiii. Other operating costsiv. Purchase of servicev. Public/private agency direct bill-non CCAP

i. Information technology costsi. Program titleii. Program codeiii. Development costiv. Maintenance costv. SACWIS (Statewide Automated Child Welfare Information

System) costvi. Non-SACWIS cost

j. Staff development costsi. Personal services/operatingii. Purchase of service/direct cost of trainees

k. Extraneous costsl. Time study hoursm. Caseworker Salary and Benefitsn. Caseworker ratioo. Full-Time Equivalent Countp. Direct costq. Program coder. Program names. Program typet. Approved plans (e.g., A-87, SSTRP, APDs, ATPs, Training Plans, Letter

of Intent) that must be received prior to incurring expenditures.u. Cluster codes for support staffv. Waiver/Non-Waiver costw. Discount Ratiox. Any new requirements as a result of regulatory or statutory changesy. Addendums


# Requirement

z. Emergency and Disaster costs and/or codes

47 The system shall capture the following information for each county technology maintenance project:

a. Project nameb. Project numberc. Project costd. Project allocation (approved budget amount)e. Project time limitf. Project running balanceg. Administrative cost

48 The system shall capture the following information for each technology maintenance project:

h. Project namei. Project numberj. Project costk. Project allocationl. Project time limitm. Project running balancen. 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.


# Requirement51 The system shall capture the following for each aid or program code:

a. Effective start dateb. Effective end datec. Commentd. Date of addition, edit or deletione. Program cost account codef. Federal Catalogue Number

i. Funding sharing ratiog. Funding ratio validationh. Applicable program/claimi. Waiver identifierj. Eligible countiesk. Title XXl. Differentiate and separate staff development and training from goods and

servicesm. Functionn. Maintenance of Effort (MOE) or Non-MOEo. Assistance or Non-Assistancep. Ledger(s) associated with the Program Code or Aid Codeq. Time Study Codes associated with Program Coder. PINs associated with Program Codes. Single Funding Crosswalk Titlet. Admin or Non-Adminu. County Welfare Department or Probation identifierv. Suspension Periodw. Direct to Program costsx. 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.


# Requirement58 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:

a. Type of changeb. Date of changec. User making changed. Reason for change (including, at a minimum audit findings, state or fed-

eral 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.

6.2 Capture County AllocationsEach 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 that may 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.

6.2.1 County Allocation Requirements

# Requirement64 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.


# Requirement67 Upon user request, the system shall identify budget allocations not being

expended by:a. Program (statewide)b. County

68 The system shall record and monitor a program budget allocation amount for state-level and federal-level operations.

69 The system shall allow a State user to add, delete and modify a county’s program budget allocation and capture:

a. Amountb. Type of allocation (augmentation, calculated, redistribution, etc.)c. Date of journal entryd. Reasone. Userf. Approved by

70 The system shall allow an authorized user to compare current fiscal year budget allocations to previous years’ budget allocations by:

a. Program (statewide)b. 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.

6.3 Administrative 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


Term (Acronym)

Administrative or Assistance

Definition Current Structure

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 digitsprogram 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 digitstime 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 ServicesB=CalWORKSC=Other public welfareD=Child CareThis 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.

Figure 1, CA 800 Assistance Claim Expenditure Hierarchy


Figure 6.2, CEC Administrative Claim Expenditure Code Hierarchy

Program and aid codes have a funding sharing ratio (federal share, state share, realignment share, reimbursement share, and, in some instances, county share). The sharing ratio can differ amongst aid and program codes. Finally, because not all counties are eligible for submitting costs for a specific aid or program code, controls must be in place so that a county welfare department does not submit an unallowable cost.


Depending on the assistance or administrative claim, additional information may be needed such as caseload, person count, etc.

Due to changes in state and federal statute and regulation, the claim data elements can change. This can include the addition, expiration or modification of an aid or program code, sharing ratios, eligible counties and other elements. The system shall support the ability to easily modify aspects of claim data elements.

It is also important to note that the structure of these elements may change as a result of the implementation of FI$Cal, the replacement system for CALSTARS.

6.3.1 Expenditure Coding Structure Requirements

# Requirement74 For assistance costs, the system shall maintain a hierarchical structure of aid

code to program cost account code to appropriation.

75 For administrative expenses, the system shall maintain a hierarchy of program identifier number codes, support staff codes, generic costs, and time study codes to program code and to program cost account code to appropriation.

76 The system shall maintain a crosswalk of program cost account codes to the Catalog of Federal Domestic Assistance codes.

77 The system shall maintain appropriation codes.

78 The system shall maintain program cost account codes that, at a minimum roll up to an appropriation.

79 The system shall maintain aid codes that, at a minimum:a. Roll up to a program cost account codeb. Have an embedded sharing ratio

80 The system shall maintain sub-codes that roll up to an aid code.

81 The system shall maintain program codes that, at a minimum:a. Are at least three (3) digitsb. Roll up to a program cost account codec. Have an embedded sharing ratio

82 The system shall maintain time study codes that, at a minimum roll up to a program code.

83 The system shall maintain all types of expense codes.

84 The system shall maintain program identifier number codes. At a minimum, based on business rules these codes shall roll up to a program code.


# Requirement85 The system shall maintain support staff codes. Based on business rules these

codes shall, at a minimum, roll up to a program code.

86 The system shall maintain generic cost codes. These codes shall, at a minimum:a. Capture general administrative costs that cannot be identified as

benefitting a specific program or group of programsb. Roll up to a program code based on business rules

87 The system shall maintain and track total expenditure amounts by program codes and program cost account codes.

88 For administrative expenses, the system shall collect expenditures by time study codes, program identifier number codes, support staff codes and generic cost code and roll up those amounts to the program codes and program cost account code.

89 For assistance costs, the system shall collect costs by aid code and roll up those amounts to the program cost account code.

90 The system shall maintain a Catalog of Federal Domestic Assistance (CFDA) numbers.

91 The system shall allow one or more program codes to be linked to a program cost account code.

92 The system shall allow one or more aid codes to be linked to a program cost account code.

93 The system shall allow one or more sub-codes to be linked to an aid code.

94 The system shall not allow an aid code and program code to be linked to the same program cost account code.

95 For each item listed below, the system shall allow one or more to be linked to a program code:

a. Time study codeb. Program identifier number codec. Support staff coded. Generic cost code

6.4 Calculate and Distribute AdvancesTo assist counties with cash flow, CDSS provides monthly cash advances for specific programs. These advances are recovered from the respective quarterly administrative


or monthly assistance claims’ audited expenditures. The net amount will result in either a payment to the county or a recovery of funds from the county.

The CDSS uses historical audited expenditure data to assist in calculating the amount of the advances. First a statewide total is developed and then allocated to each county.

For the quarterly administrative claims, CDSS will calculate the advance for each program by quarter. To do this, CDSS will look at the following:

For the respective quarter by each fund, gather the actual expenditures out of the quarterly administrative claim over the last three fiscal years.

Determine that quarter’s percentage of the total yearly expenditures for each of the last three fiscal years.

Determine the average percentage across the last three fiscal years (for allocated programs only).

Apply that average percentage to the current year’s allocated amount.

The CDSS policy dictates a ten percent holdback to prevent over advancing to one county at the expense of another county. To meet this policy the calculated advance amount is multiplied by 90 percent. This will be the statewide advance amount for the counties.

The advance is then divided by three to determine the amount of the advance to be paid out each month.

The example below illustrates how CDSS would calculate the allocated or capped advance amount for the CalFresh program for Los Angeles County for the March quarter. A similar process is used to determine the advance amount of a non-allocated (not capped) fund.


Figure 3, Calculation of General Fund Advance

Program CalFresh

Current year allocation (FY 2013-14) $2,000,000

Quarter March 2014

FY County Qtr Exp.% of Total

Total AnnualCalFresh Exp. for

One Approval

Qtrs % of

Total

2012-13 Alameda $10,000 8 $1,500,000 8

Los Angeles $50,000 40

(125,000/1,500,000)

Riverside $40,000 32

Sacramento $25,000 20

Total $125,00

02011-12 Alameda $8,000 8 $1,000,000 10


(95,000/1,000,000)



Total $95,0002010-11 Alameda $9,000 9 $1,000,000 11


(112,000/1,000,000)



Total $112,000

Average Qtr % 10

March 2014 Quarter Advance $180,000 Current year allocation times x


(Statewide)Average Qtr % x 90% =$2,000,000 x 10% x 90%

Los Angeles Advance (40%) $72,000

March Quarter Advance x FY 2012-13 L.A. county percentage of quarter =$ 180,000 x 40%

The State uses historical data from its quarterly administrative claim to provide the actual expenditure data which analysts then input into Excel spreadsheets to determine and track the advances and actual expenditure data.

Advances are not provided for Programs classified as Cash Claims, since annual projected cash needs or historical expenditures do not meet the minimum required threshold for an advance. The monthly assistance claim advance methodology is basically the same as the quarterly administrative claim methodology. The monthly assistance claims use the recent 11 months of audited expenditure data; whereas the quarterly administrative claim uses three years of historical data to determine the advance amount.

The methodology used for programs such as the California Work Opportunity and Responsibility to Kids (CalWORKs) assistance program is different due to the 2011 Realignment and the Maintenance of Effort (MOE) requirements.

6.4.1 Advances Requirements# Requirement

96 The system shall calculate the quarterly administrative expenditure advances by program by county.

97 The system shall calculate the monthly assistance advances by program by county.

98 The system shall allow authorized users to record/update the annual budget/allocation amounts by program by funds.

99 The system shall allow authorized users to modify the calculated advance.

100 After required state approvals, the system shall record the advance in the appropriate ledger with the appropriate chart of accounts.

101 The system shall allow authorized users to record supplemental advances and post them to the appropriate ledger with the appropriate chart of accounts.

102 The system shall allow authorized user to identify which programs are eligible for advances and which are classified as Cash Claims and not eligible for advances.

103 The system shall establish multi-level state approvers (e.g. spending authority, federal funds and management approval)


# Requirement104 The system shall allow authorized user to record in the budget/allocation

amounts for each program and then calculate the federal and state portions.

105 The system shall allow authorized users to generate, upon request, an AA190 – Statement of Cash Advance, detailed payment report for a county.

106 The system shall allow authorized user to record funds not provided to counties by CDSS (e.g., Realignment Subaccounts).

107 The system shall allow users to record or upload the claim schedule numbers and warrant release dates for advances paid and recovered.

108 The system shall allow an authorized user to suspend an advance payment:a. For an entire statewide amountb. A portion of a statewide amountc. An individual county amount

6.5 Submit ClaimThis section presents requirements related to the preparation and submission of county quarterly administrative claims and monthly assistance claims. Business rules for required fields and allowable values will enable a county to correct data entry errors during the claim preparation process.

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

6.5.1 Submit Claim Requirements# Requirement

109 The system shall allow an authorized user to create or complete a new quarterly administrative claim.

110 The system shall allow an authorized user to create or complete a new monthly assistance claim.

111 The system shall allow an authorized user to create or complete an amended quarterly administrative claim no later than nine (9) months after the due date of the original claim.

112 The system shall allow an authorized user to create or complete an amended monthly assistance claim no later than 18 months after the due date of the original claim.

113 The system shall auto-populate common data fields that are shared between the administrative and assistance claim (e.g., case count).

114 The system shall allow an authorized user to upload data to an assistance or administrative claim in lieu of entering the data manually.


# Requirement115 The system shall allow a user, at a minimum, the following formats for

uploading assistance or administrative claim data:a. Web form (entry)b. XML

116 The system shall run all business rules and data for an assistance or administrative claim that has been manually entered into the claim.

117 The system shall run all business rules and data for an assistance or administrative claim that has been uploaded into the claim.

118 The system shall display all errors, as a result of running the business rules and data, related to the assistance or administrative claim, allowing an authorized user to make corrections.

119 Following the upload of assistance or administrative claim data, the system shall allow an authorized user to preview the uploaded data in the claim template.

120 The system shall allow an authorized user to edit data on an assistance or administrative claim prior to submittal.

121 The system shall allow an authorized user to save an assistance or administrative claim that is in progress.

122 Upon saving an assistance or administrative claim, the system shall update all program ledgers, including funding shifts.

123 The system shall allow an authorized user to submit an assistance or administrative claim for an authorized user to review.

124 The system shall record the date and time of submission of an assistance or administrative claim.

125 The system shall allow a state or county user to withdraw an assistance or administrative claim that has been submitted in the system.

126 The system shall record the withdrawal date, time, and reason of a withdrawn assistance or administrative claim.

127 If an assistance or administrative claim is withdrawn and resubmitted, the system shall record the date and time of resubmission.

128 The system shall allow the county user to withdraw a claim prior to resubmission.

129 The system shall reject a claim if it is does not balance.


# Requirement130 If a claim is withdrawn and resubmitted, the system shall retain the original

date and time of submission in addition to the date and time of the resubmission. A history of all submission dates will be maintained by the system.

131 The system shall allow an authorized user to print an assistance or administrative claim that has been captured in the system.

132 The system shall allow an authorized user to print any assistance or administrative claim submitted by any county.

133 The system shall record an electronic signature of the county auditor and welfare services director when submitting and resubmitting an assistance or administrative claim.

134 The system shall allow an authorized user to print a signature page for each claim.

135 The system shall allow an authorized user to create a mock assistance or administrative claim that allows that user to see projected federal, state or county costs.

136 The system shall allow an authorized user to edit a county’s budget allocation for a program when preparing a mock assistance or administrative claim.

137 The system shall allow an authorized user to name the mock assistance or administrative claim.

138 The system shall enforce all business rules for a mock assistance or administrative claim for the period of time in which the claim is being created.

139 The system shall enable an authorized user to create and save no more than a total of 20 mock assistance and administrative claims at a time.

140 When creating a mock assistance or administrative claim, the system shall allow an authorized user to use a prior submitted claim for the mock claim’s data.

141 When creating an assistance or administrative claim that will be submitted, the system shall allow an authorized user to use a saved mock claim for the claim’s data.

142 The system shall allow an authorized user to delete an unsubmitted assistance or administrative claim or remind users that it has not been submitted.

143 The system shall perform all calculations and auto-populate fields.

144 The system shall allow an authorized user to see Maintenance of Effort and set up the appropriate relationships with the program and between programs.


# Requirement145 The system shall allow an authorized user to submit a negative adjustment

claim at any time.

146 The system shall allow an authorized user to delete a mock assistance or administrative claim.

6.6 Receive and Audit ClaimOnce a county has submitted its monthly assistance or quarterly administrative claim to the State, the next steps are to record receipt of the claim and conduct the audit of the submitted claim. The desk audit staff retrieves a claim and conducts the desk audit process.

Upon receipt of a claim, CECRIS will record the date and time of claim receipt and store the submitted claim in a work queue. At this stage, the claim is “locked” and may not be edited by the county that submitted it.

In the desk audit step, the objective is to identify information within the claim that is allowable and/or unallowable to ultimately approve or correct a claim. A CDSS desk auditor can deny specific costs, make comments and/or enter corrections (depending on user role). Once approved, the claim amounts for each program are updated to the program ledger for that county. Approved claims may not be altered.

6.6.1 Receive and Audit Claim Requirements# Requirement

147 The system shall retain a copy of the claim as originally submitted by each county.

148 The system shall record the date and time of claim receipt.

149 The system shall track and display which counties have and have not submitted a claim, by type.

150 The system shall not allow a county to submit a claim after its due date without state approval.

151 The system shall allow an authorized user to enable a county to submit a claim after its due date. Second level approval shall be required to make this submission

152 The system shall track the desk audit status of a claim.


# Requirement153 The system shall have the following features for the status of the desk audit:

a. Receivedb. Desk Audit Initiatedc. Desk Audit in Progress by Percentaged. Pending Response from Countye. Desk Audit Completedf. Approvedg. Approved with Revisionsh. Returned for Resubmittali. Denied

154 The system shall allow individual county claims to be assigned to specific desk auditors by a manager or lead staff person.

155 The system shall capture the following information for desk audit data:a. Name of desk auditor.b. Date when certification was received from the county welfare

department signed by the director and auditor controller certifying under penalty of perjury the accuracy of the costs claimed.

c. Date the Claiming/Cover Letter was received (only applies for adjustment claims – not needed if system can generate a summary report of the adjustments being made).

d. Date when authorized signatures were verified.e. Audit start date.f. Audit completion date.

156 The system shall calculate the difference between the Expenditures Certification Before Ledger Processing of the Current Audited Claim and the Adjustment quarter submitted by County (this applies to adjustment claims only).

a. The system shall validate the difference equal to the amount of the Scheduled difference certification pages before ledger processing.

b. The system shall display the original, adjusted and total claimed amount for the quarter for each adjusted PC and total expenditure claimed.

157 The system shall record person counts, case type, and assistance unit counts by program by reporting period for a county.

158 The system shall calculate the quarterly (three-month) person count by program for a county based upon data within the assistance claim and include that amount in that county’s administrative claim.

159 The system shall validate Public Assistance CalFresh (PACF) ratios by county.

160 The system shall compare costs from the previous reporting period with the current reporting period to identify an increase or decrease in a cost, time study hours and/or person count.


# Requirement161 The system shall allow an authorized user to set the variance percentage that

identifies an increase or decrease in a cost with second level approval.

162 The system shall require users to enter a justification for input of credits (or negative amounts) to current quarter or monthly claims.

163 The system shall require users to enter a justification for input of costs or amounts that result in a variance beyond that acceptable range.

164 The system shall compare expenditures from the adjustment administrative claim with the previously submitted claim for the same corresponding period to identify any increase or decrease in costs for each function. Prior period assistance claim shall be compared to expenditures and/or person counts to the corresponding current monthly assistance claim to identify any increase or decrease in costs for each aid code.

165 The system shall generate quarterly or as needed a Claim Summary Variance Report presenting all variances for a county and program.

166 The system shall enforce percentage of cost relationships between program codes.

167 The system shall allow an authorized user to modify data on a county’s claim.

168 The system shall allow an authorized user to disallow a specific cost on a claim.

169 The system shall allow an authorized user to create comments associated to a claim.

170 The system shall track changes to a submitted claim including:c. Type of changed. Date of changee. User making changef. Reason for change (e.g., audit finding, federal statute change)

171 The system shall provide, upon request, a report of changes to a county’s quarterly administrative claim and monthly assistance claim to authorized users prior to auditing each county claim.

172 The system shall capture and validate which foster care and group home facilities are active and licensed including the facility’s Data Universal Numbering System (DUNS) number. This requirement shall extend to out of state group homes.

173 The system shall capture and validate data based on foster care and group home levels of services.

174 The system shall allow an authorized user to approve a claim.


# Requirement175 The system shall allow a claim to be escalated for a second level review.

176 The system shall allow an authorized user to return a claim for correction.

177 The system shall generate a desk audit summary that includes:a. Desk auditor nameb. Date of claim submissionc. Desk audit dated. Bookmark on Status/Progress of Audite. Changes made to the claimf. Comments made to the claimg. Denied/Disallowed costs due to changes

178 The system shall verify all Reconciliations balance.

179 The system shall conduct an automated ledger analysis to validate no new data was entered or any data is missing from prior quarter.

180 The system shall generate a claim approval/denial letter which includes:a. Total amount of expenditures claimedb. Adjustments to expendituresc. Corrects made by state staffd. Total amount of approved expenditurese. Payment datef. Audit findingsg. Any other mandated verbiage

181 The system shall allow a state user to send the claim letter to the county electronically.

6.7 Process PaymentsThis section of the business requirements presents information and requirements on processing payments to counties for their approved, audited monthly assistance claim and quarterly administrative claim costs.

After a county has submitted a claim and the claim has been audited, it is then processed for payment by PCA and fiscal year. This payment process includes taking all audited and approved costs, including:

Subtracting any advances given to the county for the corresponding period

Subtracting reimbursement costs that are paid separately

Subtracting any deferral payments for the county


Subtracting any Local Revenue Fund counties received from the State Controller’s Office (SCO)

Adding any advances for the next reporting period. (Advances are program-specific. Not all programs have an advance payment. Programs meeting certain criteria/threshold may be advanced funds.)

These activities determine the final net payment due to or recovery from the county. The system will generate an AA-190 Statement of Cash Advance Report for each county presenting the final payment or recovery by program and the detail activities that results in that net payment/recovery. These must be reviewed and approved by authorized State personnel before the claim schedule is actually produced. The system will also generate a remittance advice for each county that details the net of the payments by program. After approval of the payment amounts, the system will generate a claim schedule with all payments and the funding source from which that payment should come from (CA 504). This claim schedule data is uploaded to CALSTARS (this will become FI$Cal in the future).

Payments for the administrative and assistance claims are made separately. Within the payments processes, the county could receive a separate payment for each program by appropriation or other criteria. The nature of some programs (e.g., Title IV-E Waiver) requires costs in this area to be paid separately.

If applicable, SCO will also receive a banking schedule that defines special handling requests such as courier pick-up, etc.

6.7.1 Process Payments Requirements

# Requirement182 The system shall track total expenditure amounts by county, PCA, program

and period (month and/or quarter).

183 The system shall track the advance amount disbursed to a county by program, PCA, period by month and quarter (administrative expense) and by month (assistance expense).

184 The system shall calculate the net amount to be paid to each county by quarter and by month.

185 The system shall be able to flag any negative net amount per county and record it as a credit.

186 The system shall allow authorized users to manually record amounts to be debited or credited to a program based on sources outside of CECRIS (e.g., new state or federal legislation that changes claim limits).

187 The system shall track payments to all counties that are to be issued via SCO warrants or Electronic Funds Transfer (EFT).


# Requirement188 The system shall generate monthly claim schedules according to a pre-

determined schedule that will be sent to SCO for payment.

189 The system shall allow an authorized user to generate a claim schedule upon request.

190 The system shall generate claim schedules specifically for EFT payments.

191 The system shall allow an authorized user to add or modify payment methods (e.g., warrant vs. EFT) and which financial institution each county uses.

192 The system shall allow an authorized user to update county treasurer, county auditor controller, county mailing and physical addresses, contact phone numbers and email addresses.

193 The system shall allow an authorized user to control the release of a payment.

194 The system shall allow an authorized user to schedule payments in accordance with SCO requirements.

195 The system shall generate monthly Claim Schedule face sheets (STD 218) on a predetermined schedule for SCO and State Treasure Office warrant payments.

196 The system shall allow an authorized user to generate a claim schedule face sheet (STD 218) upon request.

197 The system shall generate monthly EFT Claim Schedule face sheets (STD 218EFT) on a pre-determined schedule for EFT payments.

198 The system shall generate an EFT Claim Schedule face sheet (STD 218 EFT) upon request.

199 The system shall generate a Transfer Request Form (CA 504) on a pre-determined schedule for SCO warrant payments or EFT payments.

200 The system shall generate a Remittance Advice (RA) that meets the format and guidelines defined by SCO for individual payments processed through CECRIS and recorded on a claim schedule.

201 The system shall track and display the status of the payment from the point the audited claim is sent to the CDSS Payment Section for processing, to the stages of generating a claim schedule package and sending to SCO, to the final warrant/EFT payment being sent by SCO.

202 The system shall generate and assign an annually prescribed claim schedule number and Welfare Payment Unit (WPU) number to a payment when processing the payment transaction.

203 The system shall assign the claim schedule number and record the SCO payment date to the county.


# Requirement204 The system shall generate an AA190 per claim schedule, per county and

statewide.

205 The system shall allow authorized users to generate a county listing which summarizes the total amount of payments to each county by claim schedule.

206 The system shall allow an authorized user to access reimbursement data for billing purposes.

207 The system shall allow an authorized user to access pending payments by county and by period (monthly or quarterly).

208 The system shall allow an authorized user to access pending reimbursement by program and by period (monthly or quarterly).

209 The system shall allow an authorized user to generate the electronic direct claim schedule, face sheet and RA to be printed and/or downloaded for electronic submission.

210 The system shall allow end users to generate and assign a batch number for a series of payments made within a reporting month and generate a batch for every schedule.

211 The system shall maintain all payment history required for business operations.

212 The system shall maintain appropriation balances including payments to the counties.

213 The system shall allow end users to generate a payment summary for each generated claim schedule.

214 The system shall allow end users to generate a federal draw report by claim schedule, CFDA and by reporting period.

6.8 Year End ProcessingAt the end of each state fiscal year, the State is responsible for “closing the books.” This closing of the books involves two main processes:

1. Determining accruals.

2. Preparing year-end statements.

Accruals refer to expenditures incurred that are not yet paid. Both quarterly administrative and monthly assistance claims have accruals. Accruals are recorded by state fiscal year. An accrual can be for current or prior state fiscal year expenditures. Because not all claims have been submitted and/or audited, the State must estimate the


expenditures for the un-submitted and/or unaudited claims less the amount of advances. To estimate these expenses, the following methodologies are used:

Quarterly Administrative Claim: The prior three fiscal year expenditure trends and allocation balances.

Monthly Assistance Claim: The prior 11 most recent monthly claim submissions.

This accrual data is included in the State’s Financial Statements. Therefore, CECRIS must generate reports that capture all expenditures by Program Cost Account (PCA) code.

6.8.1 Year End Processing Requirements

# Requirement215 The system shall allow an authorized user to define the methodology used to

calculate the June quarterly administrative claim and the monthly assistance claim that includes, but is not limited to the following:

a. Three (3) fiscal years audited expenditure trends by quarter for the administrative claim and prior six (6) month paid for the assistance claims.

b. By programc. By fundd. By PCAe. By state fiscal year

216 The system shall automatically assign a unique accrual identification number by fiscal year, program, fund and PCA.

217 The system shall allow an authorized user to analyze the accrual data and make appropriate actions.

218 The system shall total all estimated outstanding administrative expenses by program less the amount of any un-recovered advances by PCA and by fiscal year.

219 The system shall total all estimated monthly assistance claim expenses by program less the amount of any un-recovered advances by PCA and by fiscal year.

220 The system shall allow users to create a statewide year-end administrative claim expenses report by program code and PCA code.

221 The system shall allow an authorized userusers to create a statewide year-end assistance claim report of expenditures by aid code and PCA code.

222 The system shall, for the purpose of transmitting required data with CALSTARS, create data data and reports which in CALSTARS’ file format which can be exported and uploaded to CALSTARS.


# Requirement223 The system shall, for the purpose of transmitting required data to Fi$Cal, create

data and reportsin Fi$Cal’s file format which can be uploaded to Fi$Cal.

6.9 State and Federal Fiscal Year Close OutThe Close Out process redistributes surplus funds to eligible counties for both the administrative and assistance claims. CECRIS will maintain each county’s expenses or credits via a redistribution calculation.

The Close Out process for administrative claim commences nine months after the last quarter of each fiscal year. Counties who have a surplus allocation (unused funds) are redistributed to counties which have exceeded their allocation. Different distribution methodologies are used by each program to redistribute the surplus allocations.

The Close Out process for assistance claim commences two months after the last month of each fiscal year. At the end of each state fiscal year, the monthly assistance claim is used to determine if each county has expended its full assistance allocation by program.

6.9.1 Close Out Requirements

# Requirement224 The system shall allow an authorized user to create a close out claim

template.225 The system shall determine which ledgers require close out and which

sequence of the ledgers to close226 The system shall reconcile expenditures with the ledgers that require close

out.227 The system shall calculate which counties are surplus for each program

ledger.228 The system shall calculate which counties are deficit for each program ledger.

229 The system shall generate and update ledgers with redistributed fund amounts.

230 The system shall provide a report of all funds redistributed.

231 The system shall provide a report of all ledgers that may be closed out by State and federal fiscal year.

232 The system shall generate close-out claim letters to counties that include the amount redistributed by programs.


6.10ReportingThis section presents reporting requirements for CECRIS. The state’s reporting needs are significant as they relate to the data retained in CECRIS. The range of report users is large and their reporting needs vary. Many user groups will benefit from standardized reports and an equal number of users are seeking a powerful ad hoc reporting tool.

6.10.1 Reporting Requirements

# Requirement233 The system shall generate all reports currently produced by the State and new

reports as defined by the State. Refer to the Reports Inventory in the Bidders’ Library.

234 Where possible, the system reports shall conform to a standardized report template that includes a standard header and footer, title page, report content and location for summary data.

235 The system shall provide a browser-based reports application that allows authorized users to view, create and download reports.

236 The reports application shall allow authorized users to download reports in Portable Document Format (i.e., PDF), text or Microsoft Excel.

237 The reports application shall maintain online descriptions and definitions of each report that are easily accessible by authorized users.

238 The reports application shall provide a statewide and county version of each standard report.

239 The reports application shall provide a county version of each standard report containing county-level data for a single county selected by the user. Multiple counties may be selected for a report.

240 Monthly and quarterly reports shall be available in the reports application within five business days after the last day of the reporting period.

241 The reports application shall allow access to standard reports for at least three years.

242 The reports application shall allow authorized users to easily add and stop production of reports, as required by federal, state and local laws, rules, regulations, ordinances, guidelines, directives, policies and procedures.

243 The reports application shall produce reports that include duplicated and/or unduplicated counts, as specified by CDSS, and include a clear identification of the report run date, “as of” date, period of system data date and print date.

244 The reports application shall include the ability to produce standard and ad hoc reports for any time period back to the commencement date of implementation of the system.

245 The reports application shall include the ability to export a report in CSV XML, PDF, and MS Excel.


# Requirement246 The reports application shall include an ad hoc reporting component that allows

an authorized user to execute a custom query or report that can be made available to other authorized users.

247 The reports application shall allow access to ad hoc reports for at least three months.

6.11User AccessCECRIS is expected to have approximately 350 users. Users include:

Counties: county users are anticipated to create and submit claims. These same users would check on the status of a claim and access county-level reports.

CDSS: The range of CDSS users varies. There will be users who review and approve claims and/or execute payments. Some CDSS users will only use reports and others will serve as system administrators.

External: The group of external users is expected to use reports only.

o Department of Health Care Services

o State Controller’s Office

Public: There will be no public access to the system for users outside of those defined above.

User access refers to identifying CECRIS users, gathering the needed information to establish the individual as a CECRIS user and developing and assigning a security role. The system shall capture user information and create all initial users. During Maintenance and Operations, the State will add or modify any users.

6.11.1 User Access Requirements

# Requirement248 User accounts including a log-in and password shall be created for all initial

CECRIS users.

6.12Data Migration Data migration is widely considered to be a critical activity in any information technology project. The importance of the quality of the incoming data and its ability to work with processes in the new system should never be underestimated. The migration of data into CECRIS is no exception and, therefore, the Contractor must migrate only the most recent three fiscal years of data migrate the three state fiscal years of CEC and CA 800 summary data. The stored data will encompass the three most recent full claiming


cycles and will enable the State to begin calculating advances through the new system using historical data.

6.12.1 Data Migration Requirements

# Requirement249 The most recent three (3) fiscal years of data in the existing administrative (CEC)

and local assistance (CA800) toolsets shall be migrated for use with CECRIS.

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