As part of their monthly child support obligations, the State of Washington orders most non-custodial parents (NCPs) to enroll their dependent children in a private medical insurance plan if the NCP has access to one at a reasonable cost. Enforcing these medical support orders (medical support enforcement) is among the most complicated task performed by Washington’s Division of Child Support (DCS). For most caseworkers—in Washington known as Support Enforcement Officers (SEOs)—medical enforcement is less emphasized than the collection of cash support. This is due, in part, to the federal government’s relatively new performance measurement system, which emphasizes dollars collected for child support and has no corresponding performance measure for medical support. Over the years, the State has developed training programs and work processes designed to improve medical support enforcement. However, State officials believe most Washington SEOs still lack the special expertise needed to effectively enforce the complex obligations.
Given these inherent complexities and barriers that face medical support enforcement, Washington’s IV-D officials have long considered devoting a special and separate effort to medical support enforcement. Broadly, this report’s purpose is to describe Washington’s efforts to address medical support enforcement and analyze initial results. (Edited author introduction)