SFSP Late Claims

There are two types of adjusted claims that can be submitted after the claim submission deadline:

1. Changes to meal data that result in no increase in reimbursement.
   
   
2. Downward adjusted claims. An adjusted claim must be submitted to correct an error that resulted in the sponsor being overpaid.

Adjusted claims that are submitted after the claim submission deadline and result in an increase in reimbursement cannot be processed. Upward adjusted claims submitted after the deadline will automatically be rejected for payment in the California Department of Education’s (CDE) Nutrition Information and Payment System and will not be processed unless the reasons for a late submission meet one or more of the criteria described below.

A late claim may be considered for payment in the following three instances:

1. Administrative Review or Independent Audit.
   The state agency (SA) may adjust claims to correct errors discovered on an earlier claim by an administrative review (AR) or an independent audit. The CDE processes AR reports for fiscal action and may adjust claims after agencies sign and acknowledge the report findings. In order to determine the fiscal action for independent audits, the sponsor’s authorized agent or representative must submit a copy of the audit to the CDE for processing and potential claim adjustments. If the resulting fiscal action from an AR report or independent audit generates an upward adjusted claim, the CDE will reimburse agencies without requiring them to utilize their One-time Only Exception option for late claims (see item number 2). Note: Unless the claiming error is identified in the AR report or the independent audit as a finding with required corrective action, additional payment cannot be approved.
   
   
2. One-time Only Exception.
   The SA may grant a one-time only (OTO) exception when a sponsor has not been granted an exception during the previous 36 months. OTO exception payment is at the state's discretion. To receive an OTO exception, a sponsor must submit an acceptable Corrective Action Plan (CAP) to the state agency. The Corrective Action Plan (PDF) must include the following items:
   
   
   1. A detailed explanation of the problems contributing to the lateness.
      
      
   2. Information about actions being taken to avoid future late claim submissions.
      
      
   3. A statement to the effect that the sponsor understands that if this exception request is granted, the one-time exception will be made by the Nutrition Services Division (NSD) based on the acceptability of the CAP.
      
      
   4. The signatures of the claim preparer and a sponsor’s authorized official, who must be an employee of the district or agency.

Note: Time restrictions apply when requesting an OTO late claim exception. Please read Management Bulletin CNP-01-2022 regarding deadlines for an OTO late claim exception.

3. Late claims approvable only by the U.S. Department of Agriculture (USDA).
   The SA may forward local agency (LA) exception requests to the USDA if the LA demonstrates to the SA’s satisfaction that the circumstances resulting in the missed claim deadline were beyond the LA’s control. Circumstances beyond a LA’s control include, but are not limited to:
   
   
   1. Major breakdowns in mechanical processing accompanied by an inability to manually process the data; for example, a major data processing failure.
      
      
   2. Natural catastrophes coupled with the sponsor's inability to manually process the data; for example, floods or earthquakes that destroy records, equipment, or facilities.
      
      
   3. Unusual postal delays that are verified by a postal receipt or other specific verification from the postal service.
      
      
   4. Death or severe illness of key staff members in situations where it is not possible to assume the sponsor could have used backup staff members.

Note: Missed claim deadlines that are the result of staffing changes are not typically considered to be outside the LA’s control, as part of the LA’s agreement to participate states that agencies will provide adequate supervisory and operational personnel for the effective management of the program.

The request for a USDA exception must include the claim and a letter that demonstrates that the reason for missing the claim submission deadline was clearly beyond the claim preparer’s control. The letter must explain in detail the extenuating circumstances that made it impossible to meet the deadline and that the deadline was not missed because of staffing issues, negligence, oversight, or workload backlog. Requests for a USDA exception must be submitted by Nutrition Services Division (NSD). The NSD will forward requests that meet the required criteria to the USDA for approval. Please submit requests to:

California Department of Education
Nutrition Services Division
Program Integrity Unit
OTORequest@cde.ca.gov