Wisconsin Department
of Children and Families - Division
of Early Care and Education
Bureau of Child Care Subsidy Administration
Wisconsin Shares Handbook
The department investigates reports of provider program integrity violations. This Appendix is intended for department staff.
Provider Investigations
Provider investigations are conducted by the Bureau of Child Care Subsidy Administration (BCCSA) to determine if a provider follows Wisconsin Shares, licensing, certification, YoungStar, and Child Care Counts policies. An investigation must be completed prior to establishing any sanction.
During an investigation, an auditor/investigator may:
Make an unannounced site visit
Conduct interviews
Request and review attendance records
Request and review additional documents
Utilize surveillance services
Local agencies that are a Tier 1 for Provider Program Integrity for more than two (2) years may request provider investigation training by contacting the Child Care Help Desk at childcare@wisconsin.gov.
Provider Errors
Provider errors occur when a provider reports incorrect information, fails to report information, or violates any Wisconsin Shares, licensing, certification, YoungStar, or Child Care Counts policies. Provider errors often result in an overpayment.
| Type of Provider
Violations (not an exhaustive list) |
Definitions |
| Providing care at an unauthorized location | Providers who claim attendance for children at a location that is not authorized and/or regulated. |
| No access | The provider failed to provide access to the child care facility during the regulated hours of operation. |
| Overcapacity | A provider received payment for care when the provider was in violation of the limits on the maximum number of children in care. |
| Providing care outside of regulated hours | A provider was in violation of the terms of the provider’s license, such as the age of children served by the center or hours, days, and months of operation of the center. |
| Duplicate records | It is discovered that two (2) or more attendance records for the same date(s) with different attendance times. |
| Contradictory records | The attendance/classroom/tracking records demonstrate contradictions, such as: the times on the records for specific children overlap, there are gaps in care, or it is unclear whether they were in care. |
| Missing records | The provider received Wisconsin Shares subsidy funds and is unwilling or unable to provide attendance records that have been requested by the department or local agency. |
| Missing and/or illegible attendance times | Attendance records were missing an arrival or departure time or the time was illegible; therefore, the Department was unable to determine the actual hours children were in care as a result of incomplete attending times. |
| Submitting incorrect information to the Registry Program Profile linked to YoungStar Rating | When a provider misrepresents information on the Registry Program Profile that impacts the YoungStar rating, or when a provider fails to keep their Registry Program Profile current. |
| Failure to report if a child has not attended within the previous 30 days | A provider fails to notify the local agency when a child has not attended within the previous 30 days. |
| Retaining payment after refusal of care | A provider refused to care for a child and received and retained payment when the child did not attend in the previous 30 calendar days |
| Retaining payment for more than the cost of child care | A provider receives and retains payment for more than the cost of care for the child |
| Receiving and retaining payment for care not provided | A provider received funds for a child’s authorization and failed to provide the child care. |
| Receiving payment for unregulated days | A provider received payment for days when the provider was not regulated. |
| Provider with outside employment | A provider had children signed in on the attendance records while engaged in outside employment. |
| Improper possession of parent’s EBT card information | A provider is found in possession of EBT cards, card numbers, and/or PIN numbers. |
| No written payment agreements | A provider failed to have written payment agreements for all subsidized children. |
| YoungStar Registry Violation | The Registry Program Profile was inaccurate, resulting in a higher rating than the provider was entitled to. |
| Child Care Counts Violation | According to the Child Care Counts (CCC) applications, the provider submitted false or misleading information to the Department and/or failed to meet the terms and conditions. |
Provider Post-Investigation Activities
Provider Explanation Letter (7m Letter)
The 7m letter outlines all violations discovered and is sent out by the department after an investigation or audit. The 7m Letter provides details regarding the violated rules and policy(ies), and requests that the provider respond within 15 calendar days. The 7m letter must be sent via regular and certified mail.
If
a provider has not responded within 10 calendar days, the investigator
must attempt to contact the provider to confirm delivery and understanding
of the letter. The investigator should encourage the provider to submit
a response to the department. It is not required that a provider respond
to the 7m letter. An overpayment cannot be established before the 15 calendar
days if the provider has not responded.
Technical Assistance Letter
Local
agencies should document any Technical Assistance (TA) given to providers
via a TA letter. See the Program Integrity Resource Library for the Provider
TA Letter Template and Instructions document. This letter documents any
errors discovered and the local agency's recommended solution. It is recommended
that this letter be signed by the provider and returned to the local agency.
7m Provider Meeting
A child care provider must be given an opportunity to provide the department an explanation of any false, misleading, or irregular information submitted to the department or if a child care provider fails to comply with the terms of the program. The provider’s response may be verbal (an arranged meeting or via telephone), or in writing. It is encouraged that the providers give an explanation in person via a provider meeting.
Provider Sanctions
Overpayments
A provider overpayment occurs when a provider receives subsidy funds while they are out of compliance with Wisconsin Shares, licensing, certification, or YoungStar policies.
The department must take all reasonable steps necessary to recover provider overpayments after discovery.
To calculate a provider overpayment, agency workers must:
Identify the violation
Determine the overpayment period
Verify funds have not already been recovered from the client for the same time period
Verify that subsidy funds have been paid to a provider
Forfeitures
Forfeitures may be imposed on a provider if the provider intentionally or egregiously violates a provision of Wis. Admin. Codes.
The forfeiture amount is based on a progressive enforcement system of first, second, and third violations. If the violation is considered a serious violation, the forfeiture may be from $100 - $10,000.
Serious Violations include:
A provider is found to be in possession of a photocopy, photo, or other image of a parent's EBT card
A provider is found to be in possession of a parent’s subsidy account number or PIN
A provider fails to notify the local agency that a child who receives subsidy to attend their center has not attended within the previous 30 calendar days
| Violation Occurrence | Serious | Not Serious |
| First Violation | Provider is issued a forfeiture of $100 for each violation. | Department provides a signed Technical Assistance Letter regarding the issue(s) to ensure the provider understands all program requirements. |
| Second Violation | Provider is issued a forfeiture of $200 for each violation. | Department issues a warning letter |
| Third Violation | Provider is issued a forfeiture of $100-$10,000 for each violation and the provider may be suspended from the Wisconsin Shares program. | Provider is issued a forfeiture of $100-$10,000.
Department may follow up with the provider within the next six (6) months to determine if the violation(s) have been corrected. |
Stipulations
The BCCSA issues stipulations to providers. A stipulation is issued to a provider in lieu of a permanent suspension in cases where the violations meet the criteria for a permanent suspension, but the violations do not appear intentional, the provider is receptive to the corrections, and there is evidence that the provider will come into compliance in the future. If a stipulation is issued, an audit should be conducted after six (6) months. This allows the department or local agency to return and monitor progress of compliance for violations initially discovered and to offer additional Technical Assistance. This process assists in maintaining the department’s mandate for having accessible, high-quality child care centers. Overpayments must be assessed for any violations discovered in correlation with the stipulation.
Permanent Suspension
Providers may be permanently suspended when they intentionally make a false or misleading statement, misrepresent or withhold facts, or commit any act that constitutes a violation of state or federal law for the purpose of using, presenting, transferring, acquiring, receiving, possessing, or trafficking benefits. If the department approves the suspension, the provider will not be allowed to participate as a provider in the Wisconsin Shares program indefinitely and will receive an overpayment to recover any misappropriated funds.
Permanent Suspension FAQs
| Question | Answer |
| Who determines permanent suspensions? | The local agency or department may recommend a permanent suspension and provide the investigation report and details to support the recommendation. The DCF Division of Early Care and Education Division Administrator or designee makes the final determination to approve a permanent suspension. |
| What is a provider IPV? |
|
| What should local agencies do if they believe a permanent suspension is warranted? | Submit the case to BCCSA for review via the Child Care Help Desk. The local agency should provide a brief summary of reasons for the permanent suspension. Once received, a BCCSA team member will contact the requestor for additional information. The agency worker will have to complete and submit a recommendation document that will be provided by BCCSA. All requested permanent suspensions will be heard at the monthly permanent suspension meeting. The requestor must attend the permanent suspension meeting and present their findings to the panel for approval. |
Permanent Suspension Meeting
If an investigator recommends a permanent suspension, a meeting must be held with the lead investigator/auditor, BCCSA Managers, DCF OLC, and DECE administration. The investigator must explain why they are recommending permanent suspension. Additionally, they must explain and provide detailed evidence to support the accuracy of the overpayment period, the overpayment amount, and the egregiousness of the violations. The panel will then approve or deny the permanent suspension request. If a permanent suspension is granted, a notice will be sent within 48 hours or within two (2) business days. Any overpayments attached to the suspension must be entered in CSAW and coded as IV by the following week. An overpayment letter must also be mailed to the provider by the following week.
Provider Appeals
Providers may appeal:
Overpayment amounts
Issuance of a permanent suspension from receiving Wisconsin Shares payments
Providers
must submit appeal requests in writing to the Division of Hearings and
Appeals (DHA) and indicate which decision they wish to appeal within 30
calendar days of the date of the enforcement notice. The request must
include a copy of the enforcement notice.
The provider appeal process entails, but is not limited to:
Provider appeals decision
DHA notifies DCF Office of Legal Counsel
Exchange of Exhibits
Proposed Decision
Final Decision
Stipulation (if applicable)
Investigator completes action as directed by ALJ (if applicable)
This section last updated 10/1/2023