218-RICR-20-00-4
218-RICR-20-00-4. Child Care Assistance Program Rules and Regulations (version Technical Revision, 04/29/2010 to 07/21/2011)
0850 STARTING RIGHT CHILD CARE ASSISTANCE PROGRAM
0850.01 GENERAL PROVISIONS: PREAMBLE FOR CCAP
REV:01/2004
PART I. General Provisions: Preamble -- Starting RIght Child Care Assistance
Program (CCAP) 0850.01. The Rhode Island Family Independence Act of 1997,
recognized the importance of access to affordable child care for families making
the transition from welfare to economic self- sufficiency. Since then, Rhode
Island has become one of the few states in the nation to establish that all
families trying to balance the responsibilities of work and family are entitled
to affordable, quality child care services.
The Starting RIght Initiative, adopted in 1998, reaffirmed and extended this
commitment to include expanding access to developmentally appropriate, early
childhood education and support services programs for young children at-risk and
their families. The Rhode Island Department of Human Services (DHS) administers
the child care programs and the initiatives established to serve these purposes
under the auspices of Starting RIght.
0850.01.02 SCOPE AND PURPOSE
REV:09/2007
A. Scope and Purpose of the Starting RIght Child Care Assistance
Program:0850.01.02. R.I.G.L. 42-12-23 designates the Department of Human
Services as the agency responsible for State programs subsidizing child care
services provided to Rhode Island Works Program(RIW) beneficiaries and income
eligible working families. The Child Care Assistance Program (CCAP) was
established by DHS as part of a broader effort to redesign the State's existing
child care subsidy programs (i.e., RIW, low income child care (LICC), and
special purpose programs) to further the goals of Starting RIght. Accordingly,
the purpose of the Child Care Assistance Program is to:
1) Create an integrated system of child care assistance programs that ensures
the seamless delivery of services to eligible children from one week up to
thirteen (13) or nineteen (19) years of age, depending on the program
requirements;
2) Assist families in obtaining child care assistance by standardizing the CCAP
eligibility requirements, streamlining enrollment and payment procedures, and
expanding the range of child care providers approved to participate in the
program;
3) Ensure that all children participating in the CCAP receive age appropriate
and safe child care;
4) Facilitate the development of a network of child care facilities and
providers capable of delivering early education and enhanced child care services
to young children from income eligible families; and
5) Respond to the diverse needs of children and families by supporting the
development of a diverse array of high quality and affordable program models and
services.
0850.01.03 DEFINITIONS
REV:01/2004
B. Definitions - 0850.01.03. For the purposes of this administrative rule, the
following definitions apply unless otherwise noted.
"Approved child care provider" means an individual or program that: (1) has met
the requirements established by the Department of Human Services to participate
in the CCAP; and (2) entered into a signed and valid agreement with the
department specifying the terms and conditions for enrolling eligible children
and receiving payment for CCAP allowable child care expenses.
"Central Provider Directory" means the information source maintained by the
department about all the child care providers in the State that have met the
requirements to be approved to participate in the CCAP and receive payment for
authorized child care expenses.
"Child Care Assistance Program or CCAP" means the program administered by the
Rhode Island Department of Human Services that provides financial assistance for
authorized child care services rendered to eligible children by approved child
care providers. The CCAP consolidates DHS's child care subsidy programs for RIW
beneficiaries, income eligible working families (formerly known as the Low
Income Child Care Program), teens participating in the Youth Success Program
(YS), and special approval cases.
"DHS or department" means the Rhode Island Department of Human Services.
"DHS Code of Administrative Rules and Regulations or DHS Code" means the
compendium of rules and policies governing the programs administered by the
department. The DHS Code was formerly referred to as the DHS Policy Manual.
"Eligible Child" means a child that meets the requirements to receive authorized
child care services from a CCAP approved child care provider. A foster child
who is eligible for child care services provided through the Rhode Island
Department of Children, Youth and Families (DCYF) shall not be deemed an
eligible child for the purposes of the CCAP.
"Office of Child Care" means the unit within DHS responsible for administering
the CCAP, approving child care providers participating in the program, and
maintaining the CCAP Central Provider Directory.
"Rhode Island Works Program or RIW" means the State program, authorized by
R.I.G.L. 40-5.1 et. seq., that provides cash assistance and support to families
who meet certain requirements. RIW beneficiaries are categorically eligible for
fully-subsidized CCAP services if they meet the requirements established in
Sections 0850.02.02.- 0850.02.04.
"Youth Success Program or YS" means the State program that provides assistance
to teenage parents engaged in approved education and training programs.
0850.02 ELIGIBILITY AND AUTHORIZATION OF SERVICES
REV:09/2007
PART II. Eligibility and Authorization of Services -- 0850.02.
Families with incomes at or below 180 percent of the federal poverty level (FPL)
who meet the requirements for the Starting RIght Child Care Assistance Program
are eligible to receive full or partial payment for child care expenses when
delivered by a CCAP approved child care provider. There are two avenues for
qualifying for payment of child care expenses through the CCAP: categorical
eligibility and income eligibility. Rhode Island Works Program (RIW)
beneficiaries, including Youth Success Program (YS) participants, who meet all
the general requirements established in this rule, are categorically eligible to
receive CCAP authorized child care services. Working families and YS
participants who are not RIW beneficiaries may be income eligible for the CCAP
if they meet the requirements set forth in Section 0850.02.05.
0850.02.01 DEFINITIONS
REV:10/2007
A. Definitions: 0850.02.01. For the purposes of this section, the following
definitions apply:
"Allowable child care expense" means the total cost of CCAP authorized child
care services paid by DHS to an approved provider, after deducting the amount
the family is required to pay the provider as its share of the cost (or family
share) for authorized services.
"Applicant child(ren)" means the dependent child(ren) in the financial unit for
whom CCAP authorized child care services are being requested.
"Application date" means the date that a signed application for CCAP is stamped
as received by a DHS office.
"Authorized child care services" means the child care a CCAP eligible child is
approved to use in a given time period based on the department's assessment of
the family's need for services. CCAP authorized child care is categorized as
full-time (FT), three-quarter time (3QT), half-time (HT), or quarter-time (QT).
"Categorically eligible" means that eligibility for the CCAP has been conferred,
by either State law or DHS policy, based on receipt of, or participation in, a
particular public benefit/program. Both RIW cash assistance and YS program
participants receiving RIW cash assistance are categorically eligible for the
CCAP if they have met all other general requirements and established a need for
services.
"CCAP automated enrollment system" means the DHS system through which an
approved provider shall enroll eligible children.
"Certification period" means the actual period of time that an eligible child
may obtain CCAP authorized child care services.
A certification period shall not exceed twelve (12) months in duration.
"Child Care Assistance Unit or CCAU" means the operational unit within the Rhode
Island Department of Human Services that determines eligibility, the need for
services, and the periods of authorized child care services for income eligible
working families and YS participants who do not receive RIW cash assistance.
"Dependent child" means any child who is under the age of eighteen (18) years,
or nineteen (19) years if an individual with a documented disability, who is not
emancipated legally by a court of appropriate jurisdiction.
"Excluded income" means certain money, goods or services that are not considered
countable for the purposes of determining whether a family meets the
requirements for CCAP income eligibility. Excluded income includes, but is not
limited to, the following:
* The value of U.S. Department of Agriculture donated foods;
* Any payment received under Title II of the Uniform
Relocation Assistance and Real Property Acquisition Policies
Act of 1970;
* Any grant or loan for an undergraduate student for
educational purposes made or insured under any programs
administered by the U.S. Commissioner of Education;
* Payments distributed per capita to, or held in trust for,
members of any Indian tribe under Public law 92-254, Public
Law 93-134 or Public Law 94-540;
* Any benefits received under Title VII, Nutrition Program for
the Elderly, of the Older Americans Act of 1965, as amended;
* Payments for supportive services or reimbursement of out-of-
pocket expenses made to individual volunteers serving as
foster grandparents, senior health aides or senior
companions, and to persons serving in the Service Corps of
Retired Executives (SCORE) and Active Corps of Executives
(ACE) and any other program under Title II and Title III of
the Domestic Volunteer Service Act of 1973;
* The value of supplemental food assistance received under the
Child Nutrition Act of 1966, as amended, and the special
food service program for children under the National School
Fund Act, as amended, (Public Law 92-433 and Public Law 93-
150);
* Payments of Experimental Housing Allowance Program made
under Annual Contributions Contracts entered into prior to
January 1, 1975, under Section 23 of the U.S. Housing Act of
1937, as amended;
* Receipts distributed to members of certain Indian tribes
which are referred to in Section 5 of Public Law 94- 114
that became effective October 17, 1975;
* Tax exempt portions of payments made pursuant to the Alaska
Native Claims Settlement Act, Public Law 93-203;
* Foster care payments made by the Rhode Island Department for
Children, Youth and Families;
* The value of food stamp benefits;
* The value of government rent or housing subsidies;
* Income from college work study programs;
* The earned income of a dependent child who is included in
the financial unit;
* A transportation allowance paid under the auspices of a work
or training program, such as Job Search, or a WIA program;
* In accordance with PL 100-485, the refund of taxes under the
earned income tax credit (EITC), or the advance payment of
the EITC;
* Loans and grants, such as scholarships, obtained and used
under conditions that preclude their use for current living
costs;
* Monies received under the federal Social Security Persons
Achieving Self-Sufficiency (PASS) program or the Income
Related Work Expenses (IRWE) program;
* The income of the parents with whom a teen parent(s)
resides;
* Section 8 Utility Payment; and
* Veterans Aid and Attendant Allowances
"Family share" means the amount a family is expected to contribute in co-
payments to the cost of child care services.
"Financial unit" means the dependent children, including both applicant and non-
applicant child(ren), and the parent(s) and the legal spouse(s) of the parent(s)
who live with them in the same household. The financial unit may also include
applicant children that DHS has determined, upon verification, to be a relative
of acceptable degree to the parent(s) requesting CCAP authorized services. The
financial unit determines family size for the purposes of determining income.
"Income" means any money, goods or services available to the financial unit
used to calculate eligibility for the CCAP. For the purposes of the CCAP,
countable income includes, but is not limited to, any of the following:
* Monetary compensation for services, including gross wages, salary,
commissions, and any work-based fees, stipends, tips or bonuses;
* Adjusted gross income from self-employment;
* Social Security Benefits (RSDI);
* Supplemental Security Income (SSI);
* Dividends or interest on savings or bonds;
* Income from estates or trusts;
* Adjusted Gross Rental Income;
* Adjusted Gross Room and Board Income;
* Public assistance or RIW cash assistance payments;
* Unemployment Compensation;
* Temporary Disability Insurance (TDI);
* Workers' Compensation;
* Government civilian employee or military retirement;
* Cash payouts for waiving employer sponsored health
insurance;
* Private pensions or annuities;
* Adoption subsidies;
* Alimony;
* Child support payments;
* Regular contributions from persons not living in the
household;
* Royalties;
* Strike Benefits;
* Trade Readjustment Allowance;
* VA Compensation Payments;
* VA Educational Benefits;
* Spousal/Dependent Allowances;
* Military Allotments;
* In-Kind Assistance; and
* Alien Sponsor Income.
"Income eligible" means that CCAP eligibility is determined on the basis of
income, within the limits prescribed in State law, as well as certain general
requirements and the need for services.
"Infant" means a child from at least one (1) up to, and inclusive of, eighteen
(18) months of age.
"Initial eligibility date (or Care Start Date)" means the actual first date that
CCAP authorized child care services, rendered to an eligible child by an
approved provider, can be paid by DHS.
"Non-applicant child" means any dependent child living in the household up to
age eighteen (18), who is not included in the family's request for CCAP
authorized child care services.
"One-parent home" means a family in which there is only one parent living in the
household with financial responsibility for the eligible child(ren).
"Parent" means any person in the household who is legally and financially
responsible for the routine care of the applicant child(ren) including, but not
limited to, providing income, resources or other forms of support. A person
seeking CCAP authorized services for a dependent child is considered to be a
parent for CCAP eligibility purposes if so deemed for any other Department of
Human Services program(s). The term parent is used broadly in this rule to
refer to biological, adoptive, or stepparents, as well as legal guardians or
caretaker relatives of an acceptable degree under the RIW rules of relationship
as defined in Section 0806.15 of the DHS Code.
"Pre-school age child" means a child from age three (3) up to entry into the
first grade of a public or private elementary school program. A child who will
reach age seven (7) on or after September 1 in a given school year shall not be
considered a pre-school age child under any circumstances.
"RIW unit" means the operational arm of the Rhode Island Department of Human
Services responsible for determining whether categorically eligible RIW
beneficiaries, including those who are also YS participants, meet the CCAP
general and need for services requirements. The RIW Unit also determines CCAP
eligibility for families making the transition off RIW cash assistance.
"School-Age child" means a child up to the age of thirteen (13), enrolled in at
least the first grade in a public or private school program. Certain children
with special needs may be categorized as school age up to the age of nineteen
(19) and qualify for CCAP child care services.
"Short-term Special Approval or SSACC" means CCAP child care authorized for an
otherwise ineligible child or parent as a result of a documented serious health
condition or related circumstance in the family that creates an immediate need
to initiate or continue CCAP authorized child care services on a temporary
basis, as provided in Section 0850.02.06 of this rule.
"Toddler" means a child over the age of eighteen (18) months, up to the age of
three (3) years.
"Two-parent home" means a family in which the two parents live in the same legal
household as, and share financial responsibility for, the applicant
child/children.
0850.02.02 GENERAL ELIGIBILITY REQUIREMENTS
REV:09/2007
B. General Eligibility - 0850.02.02: For a child to be eligible to participate
in the Child Care Assistance Program, the family applying for CCAP services
shall meet the general requirements set forth in this section as well as the
specific requirements pertaining to categorical and income eligibility.
1) Base Eligibility Requirements. To be eligible for the CCAP, all applicants
must provide the documentation to show the following requirements have been met:
a) Age of applicant child(ren). The child to receive CCAP services shall be
over one (1) week old and below the age of thirteen (13) years unless the
following circumstances apply:
i) The child is thirteen (13) up to nineteen (19) years old and has a
documented physical or mental disability which makes the child incapable of
self-care; or
ii) The child is under age thirteen (13) and would be considered a
dependent child for the purposes of RIW except for the receipt of Supplemental
Security Income, or foster care services under Title IV-E. This subrule applies
only in those instances in which child care is necessary for a parent to accept
or retain employment or to participate in a RIW approved education or training
program.
b) Relationship. The applicant child(ren) must live in the home of the
parent requesting CCAP services. The relationship between the adult applying
for CCAP services and each applicant child must meet the broad definition of
parent as set forth in this rule.
c) Cooperation with the Office of Child Support Services. The Social
Caseworker must refer all families with any absent parent(s) to the Office of
Child Support Services. As a condition of eligibility, the parent/caretaker
relative is required to cooperate in establishing paternity, and in establishing
and/or enforcing child support and medical support orders for all children in
the family, unless the parent/caretaker relative is found to have good cause for
refusing to comply with these requirements.
An explanation must be given by the agency that the parent/caretaker relative
must assist DHS and the Office of Child Support Services by providing all
relevant information in seeking support from a person who has a legal duty to
support the child(ren) and/or in establishing paternity and seeking support from
the putative father unless good cause for refusing to do so is determined to
exist. An AP-35-CCAP containing this information is included with all CCAP-1
Applications for Assistance.
The DHS agency representative refers the applicant's case to the Office of Child
Support Services after approval of eligibility via completion of an Absent
Parent (ABSP) panel for each absent parent. If a good cause for refusal has
been determined in accordance with the requirements outlined in sub-section d)
below, the DHS agency representative codes the appropriate fields in the ABSP
panel.
i) An applicant or recipient must cooperate with the agency for all
children in the family (unless good cause for refusing to do so has been
determined to exist) in:
Identifying and locating the parent of each child;
Establishing the paternity of any child born out of
wedlock;
Obtaining support payments for the applicant or
recipient and for all children; and
Obtaining any other payments or property due the
applicant or recipient or the child(ren) of any
absent parent.
ii) In order for the applicant to be found cooperative in achieving the
above objectives, the applicant must, at the request of the Office of Child
Support Services:
Appear, as necessary, to provide verbal or written
information or documentary evidence, known to,
possessed by, or reasonably obtainable by her/him.
Appear as a witness at court or other hearings or
proceedings, as necessary.
Provide information, or attest to the lack of
information, under penalty of perjury.
d) Consequences of Non-cooperation with OCSS. The failure of a
parent/caretaker relative to cooperate with the Office of Child Support Services
in establishing paternity or in establishing, modifying, or enforcing a support
order with respect to a child, when the applicant does not qualify for good
cause, results in the closure or denial of all CCAP benefits.
All applicant children are found to be ineligible for benefits, if the
parent/caretaker relative fails to cooperate with OCSS with regards to any child
in the household.
The Office of Child Support Services notifies the DHS representative of failure
to cooperate with that agency and the DHS representative must take the necessary
action on the case.
The closure or denial of the CCAP case and the ineligibility of the applicant
child(ren) in all subsequent CCAP applications, shall continue until the
parent/caretaker relative who refused to comply with child support cooperation
requirements consents to and cooperates with the agency in satisfying those
requirements. Once the applicant has satisfied the requirements of cooperation
with the Office of Child Support Services, the applicant may re-apply for CCAP.
The Office of Child Support Services will notify DHS of such compliance for
appropriate follow-up by the DHS representative. A pending letter will not be
generated for any application filed by a client who is currently non-cooperative
with OCSS.
e) Good Cause for Refusing to Cooperate. Every applicant is given an
opportunity to claim good cause for refusing to cooperate. CCAP applicants may
claim good cause for refusing to cooperate by checking the appropriate box on
the CCAP-1 application and by sending in the WVR-CCAP form, which is included
with the application.
If good cause is claimed, the applicant is referred to the Domestic Violence
Advocate who will conduct the Family Violence Option Assessment as soon as
possible (as described in sub- section e) below); or, if the client refuses the
referral, s/he is advised that s/he must state the basis of the claim and
present corroborative evidence within twenty (20) days of the claim; or, s/he
must provide sufficient information to enable the investigation of the existence
of the circumstance; or, provide sworn statements from individuals to support
the claim as specified on the AP-35-CCAP.
A determination of good cause is based on the findings of the Domestic Violence
Advocate; or, evidence supplied which establishes the claim; or, an
investigation by the agency of the circumstance which confirms the claim; or, a
combination of evidence and investigation; or, when the claim is one of
anticipated physical harm without evidence, the investigation supports the
credibility of the claimant. The determination as to whether good cause does or
does not exist should be made within thirty (30) days of the good cause claim
unless the record documents that the agency needs additional time because the
information required to verify the claim cannot be obtained within the time
standard.
If the reason that the information is not available is that the client did not
present the corroborative evidence within twenty (20) days of the claim, the
record must document that the agency determined that the applicant required
additional time to obtain the evidence, the amount of additional time allowed,
and that this decision had supervisory approval. The final determination that
good cause does or does not exist, including the findings and basis for the
decision, must be included in the CLOG.
The DHS representative will obtain verification and/or conduct an investigation
in order to make the determination. If sufficient information to conduct an
investigation is provided, an otherwise eligible applicant is provided
assistance (or assistance is continued) pending the final determination on the
good cause claim.
i) When Cooperation Not in Best Interest. Cooperation is determined to be
against the best interest of the child(ren), if:
The applicant's cooperation is reasonably
anticipated to result in physical or emotional harm
to the child, mother, or other relative with whom
the child is living. (Physical or emotional harm
must be determined to be of a genuine and serious
nature. The mere belief that cooperation would
result in harm is not sufficient basis for a finding
of good cause. The emotional harm to the mother
must be of such a serious nature that the capacity
to care for the child adequately would be reduced.);
or
It would be harmful to the child for whom support
would be sought because the child was conceived as a
result of incest or forcible rape; or
Legal proceedings for adoption of the child are
pending before a court of competent jurisdiction; or
The applicant is currently being assisted by a
public or licensed private social agency to resolve
the issue of whether to keep the child or release
him/her for adoption and the discussions have not
gone on for more than three (3) months; or
There is anticipated physical harm to the parent
without corroborative evidence.
ii) Corroborative Evidence of Good Cause. Corroborative evidence upon which
a determination of good cause is based without further agency investigation is
limited to documents similar to the following, which must be presented within
twenty (20) days of the claim:
Birth certificates, medical, or law enforcement
records which indicate that the child was conceived
as a result of incest or forcible rape.
Court documents or other records which indicate that
legal proceedings for adoption are pending before a
court of competent jurisdiction.
Court, medical, criminal, child protective services,
social services, psychological, or law enforcement
records which indicate that the putative father or
absent parent might inflict physical or emotional
harm on the child or caretaker relative.
Medical records which indicate emotional health
history and present emotional health status of the
caretaker relative (parent or loco parentis) or the
child for whom support is sought or, written
statements from a mental health professional
indicating a diagnosis or prognosis concerning the
emotional health of the caretaker relative or the
child for whom support is sought.
A written statement from a public or licensed
private social agency that the applicant is being
assisted by the agency to resolve the issue of
whether to keep the child or release him/her for
adoption, and the discussions have not gone on for
more than three (3) months.
If the evidence is insufficient, the DHS agency representative will promptly
notify the applicant that additional corroborative evidence is needed and
specify the type of document needed. The DHS representative will assist in
obtaining the needed evidence if requested to do so by the applicant. This
assistance might be in the form of advising the applicant how to go about
obtaining the documents, or, if requested, undertaking reasonable efforts to
obtain the evidence, if s/he is not reasonably able to obtain it by him or
herself.
When sufficient information to permit an investigation is given or when the
claim is one of anticipated physical harm without corroborative evidence and the
DHS representative considers the claim credible and corroborative evidence is
not available, the DHS representative will conduct an investigation. In
conducting the investigation, the DHS representative will not contact the absent
father or putative father unless such contact is determined to be necessary to
establish the claim. Prior to making any contact, the applicant or recipient
will be notified in order for her to present additional evidence or information
that the contact is unnecessary or she can withdraw the application, or the good
cause claim can be denied.
On the basis of the evidence or the results of the investigation, the DHS agency
representative makes a decision on the applicant's good cause claim as described
in d) iv), below.
iii) Emotional and Physical Harm. Physical harm and emotional harm, as
defined, must be of a serious nature. It must be demonstrated to the DHS agency
representative that there exists an emotional impairment that substantially
affects the applicant's functioning for a finding of good cause for emotional
harm to be made.
If a determination is based in whole or in part upon the anticipation of
emotional harm to the child, parent, or other caretaker relative, consideration
is given to the following:
the present emotional state of the applicant subject
to emotional harm;
the emotional health history of the applicant;
intensity and probable duration of the emotional
upset;
degree of cooperation to be required; and
the extent of the involvement of the child in
paternity establishment or support enforcement
activity to be undertaken.
The DHS agency representative can find good cause on the basis of anticipated
physical harm without corroborative evidence if the agency considers the claim
credible without corroborative evidence and if such corroborative evidence is
not available.
For example, battered women are often too afraid or ashamed to tell anyone of
the beatings they have received and would therefore be unable to corroborate a
valid good cause claim.
In this case, the claimant has the burden of establishing her credibility as
well as explaining why no evidence is available.
The agency is required to investigate this type of claim and while it may not
establish the good cause circumstance, it should establish the credibility of
the claimant.
iv) Good Cause Decision. If the DHS representative has made a determination
that good cause exists, the case does not need to be referred to the Office of
Child Support Services. The case will be sent to OCSS, at a later date, should
the good cause exception be lifted due to new circumstances.
v) Review of Good Cause Finding. A review of the good cause decision must
be made at each redetermination by the DHS agency representative. If it is
determined that circumstances have changed such that good cause no longer
exists, there must be enforcement of the cooperation requirements.
The failure of a parent/caretaker relative to comply with child support
enforcement cooperation requirements without good cause results in the closure
or denial of the case as outlined in sub- section f), below. The Office of
Child Support Services notifies the DHS representative of any failure to
cooperate with that agency and the DHS representative must take the necessary
action on the case.
f) Referral to the Domestic Violence Advocate. If an applicant discloses a
domestic violence situation to DHS, the agency representative refers the
applicant to the Domestic Violence Advocate who is on-call. The Domestic
Violence Advocate conducts the Family Violence Option Assessment as soon as is
practicable.
If the applicant involved is a minor parent/pregnant minor, an immediate report
at the time of disclosure must be made to DCYF as specified in Section 0118 as
well as referral made to the Domestic Violence Advocate for assessment. If such
disclosure is made by a minor parent/pregnant minor to the YS worker, s/he may
elect to conduct the Family Violence Option Assessment alone, refer the parent
to the Domestic Violence Advocate for assessment, or collaborate with the
Domestic Violence Advocate in the assessment process as necessary.
If the applicant refuses referral to the Domestic Violence Advocate, eligibility
for CCAP is not affected. However, if the applicant requests a good cause
exception to cooperation with the child support enforcement requirement, that
exception will not be granted unless the applicant can provide evidence to
support the good cause exception as detailed in sub-section e) above.
From the Family Violence Option Assessment, the Domestic Violence Advocate
determines whether the applicant should be waived from the child support
cooperation requirements, and forwards the Findings on the Recommended Waivers
portion of the Assessment (Form WVR-2) regarding which waivers, if any, the
applicant should be granted to the appropriate supervisor.
The appropriate supervisor reviews all such recommendations and makes the final
determination of any such waiver. The Chief Supervisor and/or Regional Manager
are available for consultation in these situations as needed. The agency
representative then effects the waiver(s) as appropriate and notifies the
applicant.
In the case of an adolescent parent/pregnant adolescent, if an YS worker did not
conduct or collaborate in the Family Violence Option Assessment, a copy of the
final Findings document is forwarded to the appropriate YS.
For adolescent parents/pregnant adolescents, after the Family Violence Option
Assessment, the YS case manager must ensure that safety planning, crisis
counseling, appropriate referrals, and follow-up services are provided. The YS
representative may choose to do this her/himself or collaborate with the
Domestic Violence Advocate, as necessary.
For all other applicants who disclose domestic violence, the Domestic Violence
Advocate is responsible for safety planning, resource information, and follow-up
for the applicant.
The Domestic Violence Advocate must review the suitability of any or all waivers
at the end of the specified waiver period(s), or earlier if the applicant's
circumstances change. The maximum time period for the granting of a waiver is
six (6) months renewable only with the Regional Manager's consultation and
approval. After notification from DHS that the waiver period is about to
expire, the Domestic Violence Advocate (and/or YS representative, for teen
parents) completes a Family Violence Option Re-Assessment (Form WVR-2a) of the
applicant's circumstances and notifies the appropriate supervisor of the
recommendation for extension or discontinuance of any waiver and/or change(s) in
status through a new Findings document. The agency representative then follows
up on the recommendation(s) as appropriate and notifies the applicant.
2) Categorical Eligibility. The Rhode Island Family Independence Act (FIA)
extends eligibility for the CCAP to Rhode Island Works Program (RIW) cash
assistance beneficiaries who meet the need for services (i.e. engaged in an
approved education or employment related activity that necessitates child care
services) and other criteria established in Section D - 0850.02.04 - of this
rule.
3) Income Eligibility. A family seeking income eligibility for the CCAP shall
provide the documentation required by DHS indicating that the following
requirements have been met:
a) Income. Countable income of the financial unit shall not exceed 180
percent of the Federal Poverty Level (FPL).
To assist in determining income eligibility, a Social Security Number (SSN) must
be provided for any member of the financial unit. An SSN for all other members
of the household may be provided on a voluntary basis. Proof that a request for
an SSN has been made will be accepted as documentation, but only for the initial
determination of eligibility. At the time of recertification for authorized
services, a permanent SSN shall be required for all members of the financial
unit. In accordance with applicable federal and state laws, SSN will be used
only to assist in verifying income and the need for services.
b) Residency. As defined in DHS Code Section 0106, the applicant parent(s)
and any applicant children in the financial unit shall be documented legal
residents of the State of Rhode Island.
c) Citizenship. The applicant shall be either a citizen of the United States
or a non-citizen lawfully entitled to reside in the United States, as specified
in Section 0104 of the DHS Code. The citizenship status of the parent(s) shall
not be a bar to participation in the program.
d) Need for Services. The parents of the applicant child(ren) shall be
employed and unavailable to provide routine care for the child(ren) while
working in accordance with the criteria established subsection 0850.0205 of this
rule.
4) Limitations and Exclusions. Both categorical and income eligibility for CCAP
services are subject to the following limitations and exclusions:
a) One CCAP Household Per Applicant Child. CCAP services shall only be
authorized for one household per applicant child during any given certification
period.
i) In general, the CCAP household is the parent's home which serves as
the principal place of residence of the applicant child - i.e. where the child
lives the majority of the time. This rule applies whenever an applicant child's
parents live in separate households or have an acceptable need for services
independently of, or in tandem with, one another. A household other than the
child's principal place of residence may only be considered a CCAP household if:
(a) The parent in the household where the child lives the majority of
the time does not qualify, or have a need for CCAP services; and
(b) The parent in the household where the child lives less than a
majority of the time applies and meets the requirements for CCAP authorized
services.
ii) If the parents of an applicant child live in different households,
but share legal custody and physical possession of a child due to a court
order/agreement, then neither parent's household may be the child's principal
place of residence. When both parents apply separately for the same child, only
one household shall be considered a CCAP household when determining authorized
services. In such instances, the department shall request the documentation
from the applicant parents required to make a factual determination as to which
is the CCAP household.
b) Self-Employment as a Child Care Provider. Any parent whose income is
derived solely from self-employment as a child care provider shall not be
eligible for CCAP authorized services.
However, a parent who is self employed as a child care provider on a part time
basis may be eligible to receive CCAP authorized services for an eligible child
for a period of time while working in some other capacity or participating in a
RIW- approved activity, if all requirements established in this rule are met.
0850.02.03 APPL PROCESS FOR DETERMINING ELIGIBILITY
REV:01/2004
C. Application Process for Determining Eligibility - 0850.02.03: The application
for CCAP consists of the required application or request for CCAP services form,
the documentation necessary to verify eligibility and establish the need for
services, and/or the most current information available on the applicant from
other DHS program sources.
Families seeking eligibility for the Child Care Assistance Program shall apply
to DHS in accordance with the following:
1) Application Requirements. The parent shall make application for the CCAP by
submitting a signed RIW request for services or CCAP application form, along
with the documentation required to verify eligibility and the need for services.
In a two-parent home, both parents must sign the application. Both the type of
form and the documenta- tion that must be submitted vary, depending on whether
the family qualifies to apply for the CCAP on the basis of categorical or income
eligibility. Specific information about the appropriate forms and sources of
verification required are contained in the CCAP application packet and made
available, upon request, by contacting any DHS office.
2) Point of Application. RIW beneficiaries, including those who are YS
participants and families making the transition off cash assistance, shall make
CCAP application through their social caseworker in their local RIW office.
All other YS participants and working families shall make application to a Child
Care Assistance Unit (CCAU) representative.
3) Application Date. The date a signed application or request for services form
is date stamped as received by DHS is the application date.
4) Application Period. The application period is the period when eligibility for
the CCAP is determined by DHS staff.
The period begins on the application date and extends for thirty (30) days. An
application is considered incomplete until DHS has all the information and
documentation required to make an eligibility determination. Once an
application is complete, every effort will be made to determine eligibility in
the most expeditious manner possible. An application that remains incomplete on
the last day of the application period shall be denied unless DHS is responsible
for the delay in processing the application.
5) Application Review. Department representatives shall first review
applications for completeness. If a determination of eligibility cannot be made
in conjunction with this initial review, a letter or letters shall be sent to
the family applying for the CCAP containing one or more of the following as
appropriate:
a) A statement acknowledging receipt of the appropriate application form and
indicating the application date-that is, the date the signed form was date-
stamped as received by DHS;
b) The unique CCAP certificate number assigned to the family. This is the
identification number that shall be used by approved child care providers when
enrolling eligible children for CCAP authorized child care services;
c) The names of the children in the family for whom child care assistance is
being requested; and
d) A statement indicating that the applicant may request services from an
approved child care provider pending final determination of eligibility by DHS.
The statement shall include a disclaimer indicating that:
i) DHS shall only make payment for allowable child care expenses when
rendered by a CCAP approved provider;
ii) An approved child care provider is not required to accept a child during
the period when an application is pending. If a child is accepted, the provider
must enroll the child either prior to or during the first week of care; and
iii) DHS shall not guarantee payment for any child care expenses incurred
while an application is pending. A family requesting to enroll a child for
services prior to the final determination of eligibility shall disclose to the
approved child care provider that their application for child care assistance is
pending and that no payment shall be made by DHS for any child care expenses if
the application is denied.
e) If necessary, a list of any missing information or documentation required
to determine eligibility, the appropriate DHS location to send the information
to, and a deadline for submitting any information requested. This list shall
identify:
i) Any missing documents necessary to verify that the family meets the
requirements for categorical or income eligibility;
ii) Any information required to assess the need for services that is
incomplete or cannot be verified through another DHS program source; and
iii) For RIW beneficiaries, the list shall specify if any components of an
employment plan have not been completed or approved prior to the submission of
the application for child care assistance.
6) Determining the Basis for Eligibility. Upon determining that the general
requirements for the CCAP have been met, RIW Unit or CCAU representatives shall
assess the scope of CCAP services to be authorized on the basis of the criteria
for categorical or income eligibility, as specified in sections 0850.02.04 and
0850.02.05 of this rule, respectively.
7) Initial Eligibility Date. The date DHS determines to be the earliest date a
family can begin receiving CCAP authorized child care services is the initial
eligibility, or care start date. This date may or may not be the same as the
application date.
a) The certification period for CCAP authorized services shall begin on the
initial eligibility date and shall continue for a period not to exceed twelve
(12) months.
b) Any child care services utilized prior to the initial eligibility shall be
deemed unauthorized and shall not be considered allowable child care expenses
for the purposes of making CCAP payments.
8) Application Restrictions. Applicants shall provide complete and accurate
information and all documentation required for verification listed on the CCAP
application or request for services form. Submitting false or inaccurate
information for the purposes of obtaining CCAP eligibility shall result in
denial of the application.
a) Non-cooperation. Failure to provide the documentation required to verify
any eligibility requirement, including the source of income or need for services
is acceptable grounds for a delay in the processing of an application. If such
failure continues beyond the thirty(30)day application period, the application
shall be deemed incomplete and denied on the basis of non-cooperation.
b) Limits. CCAP eligibility determinations shall be based on the
application, including any required forms and documentation submitted by the
applicant and/or available from other DHS program sources. The application is
valid until eligibility is determined DHS within the prescribed application
period of thirty (30) days unless the application is withdrawn voluntarily.
After thirty 30) days, submission of a new application may be required.
i) If CCAP eligibility is denied, the application is invalid after the
thirty (30) day appeal period expires.
ii) If CCAP eligibility is approved, the application is presumed valid from
the application date to the end date of the certification period unless there is
a change in the family's status or circumstances that might in any way affect
CCAP eligibility.
c) Duty to Report. Applicant and recipient parents shall report to DHS any
changes in the information or documentation included in, or submitted in
conjunction with, the CCAP application related to the general requirements
(0850.02.02) or criteria for categorical (0850.02.04) or income eligibility
(0850.02.05) within ten (10) days from the date the change occurs. The duty to
report begins on the application date and remains in effect while the
application is valid. Failure to report changes in a timely manner may be
grounds for denying eligibility to an applicant or discontinuing authorized
services for CCAP beneficiaries. The responsibility to report changes to DHS,
within specific time limits, is established in greater detail in Section
0850.02.09 of this rule.
9) Periodic Redetermination. The eligibility of CCAP beneficiaries shall be
redetermined on a periodic basis through either recertification or case review.
Families shall be notified in writing of the date their eligibility shall be
redetermined, no later than the first day of the last month of the family's
certification period. Income eligible families and RIW families who have
employment as their approved activity, shall be sent a renewal form prior to the
end of the current certification period. In order for CCAP authorized child
care services to continue without interruption, the completed and signed form
must be submitted to DHS by the renewal date specified. The frequency and
nature of recertification varies in accordance with the basis for eligibility.
a) Categorically eligible families are subject to a case review that assesses
compliance with applicable RIW program requirements. Authorization periods
shall not to exceed twelve (12) months in one (1) certification period.
b) Income eligible families are subject to recertifi- cation every six (6)
months, or more frequently, depending on the period of CCAP authorized services.
c) Change of CCAP application type from one program to another (example RIW
to Income Eligible) within a certification period may result in a new
authorization period in accordance with CCAP rules for the new program under
which eligibility is determined.
10) Notice of Approval, Notice of Denial, Right to Appeal and Hearing.
Applicants for the CCAP shall receive adequate notice of DHS eligibility
determinations and the right to appeal. DHS shall also provide timely and
adequate notice of any adverse decisions terminating or reducing benefits.
As indicated in Section 0850.02.08, DHS also sends a letter confirming
enrollment of an eligible child by an approved child care provider. Notices and
correspondence sent by DHS related to CCAP eligibility and enrollment are
specified in full in Section 0850.02.09.
0850.02.04 CRITERIA FOR CATEGORICAL ELIGIBILITY
REV:01/2004
D. CCAP Criteria For Categorical Eligibility: 0850.02.04 RIW beneficiaries who
fulfill the general requirements stated in section 0850.02.02, shall meet the
following criteria to be eligible for the CCAP:
1) Need for Services. CCAP authorized services shall only be approved for RIW
beneficiaries who have an acceptable need for services related to fulfilling
program requirements.
a) General Criteria: RIW Eligible. The following shall constitute an
acceptable need for services for RIW eligible families:
i) Approved Plan. The parent(s) or caretaker relative shall have an
approved, signed and current employment plan on file and shall need CCAP
authorized child care services during periods of time when engaged in one or
more of the component activities required to comply with that plan.
ii) Activity Requirements. RIW families receiving CCAP services shall meet
the employment plan component activity requirements outlined in Section 1412.05
and 1412.05.05 of the DHS Code. Such component activities include those
specified therein, as well as any combination of education and work-related
activities contained in an employment plan approved by a RIW caseworker.
Volunteer activities or time spent in any capacity in which no wages are earned,
paid, or expected, shall not count toward the hours required to meet an
acceptable need for services unless expressly approved as a component of an
employment plan.
iii) Two Parent Home. In a two-parent home, both parents shall have signed and
approved current employment as is specified in Section 1412.05.15 of the DHS
Code.
b) Program-Specific Criteria: YS Participants. To have an acceptable need
for services, YS participants who are RIW cash assistance beneficiaries shall
meet the following program-specific criteria:
i) Age and Completion of High School. YS parents shall be under twenty
(20) years of age and not yet in possession of a high school diploma or
equivalency.
ii) Activity Requirements. The parent shall be actively working with the
Youth Success Program (YS) and participating in an approved education activity,
as specified in a current RIW Employment Plan. The applicant child must be
living with the YS participant and the need for child care services must be
directly related either working or obtaining a high school education.
iii) Period of Authorization. The period of authorization for CCAP services
will coincide with the end date for the parent's component school program.
iv) Teen Parent Under the Age of Sixteen (16). A teen parent who is under
age sixteen (16) may not obtain authorized CCAP child care services on their
own, unless documentation of emancipation exists. CCAP child care services
extended to a teen parent under the age of sixteen (16) shall be authorized
under a parent or legal guardian of the teen parent and may also include that
teen parent as a child care recipient.
2) Limitations. CCAP child care services shall not be authorized for an
otherwise categorically eligible family under the following circumstances:
a) In a one-parent home, the parent has failed to complete or comply with a
RIW employment plan;
b) One of the parents in a two-parent home does not have an approved
employment plan;
c) One of the parents in a two-parent home is statutorily barred from
receiving RIW and is not working;
d) The parent of the eligible child is a self-employed child care provider
and is requesting CCAP payment for care provided to the child during the hours
when employed in that capacity. This limitation shall not apply if the parent
is an employee of a child care provider;
e) A parent of the eligible child is providing the child care, irrespective
of whether the parent lives in the same legal residence as the eligible
child(ren);
f) A person living in the same legal residence of the eligible child(ren) is
providing the child care; or
g) There is an active sanction in place.
3) Exceptions. The following exceptions apply to the general and program-
specific criteria for categorical eligibility set forth in this section:
a) RIW beneficiaries whose RIW cash assistance is scheduled to close, and who
are requesting child care assistance due to employment, will have their CCAP
eligibility determined using income eligibility rules.
b) CCAP services may be authorized if one of the parents in a two-parent home
does not have an approved employment plan when the family provides written
verification from a licensed health care practitioner, program or facility,
qualified to make such a determination, indicating that the parent without an
approved employment plan cannot provide appropriate, routine care of the child
due to a neuro- physio-logical, psychological or emotional disorder, physical
impairment, or serious health condition. Requests for an exception shall be made
on forms approved by the department and submitted along with the required
medical documentation for review and approval by a RIW Unit supervisor. Any
health information requested or obtained for the purposes of this section shall
be subject to the privacy protections established in state law and the Health
Insurance Portability and Accountability Act of 1996 (HIPAA).
0850.02.05 CRITERIA FOR INCOME ELIGIBILITY
REV:09/2007
E. CCAP Criteria for Income Eligibility: 0850.02.05. YS participants not
receiving RIW cash assistance and working families who meet the general
requirements in section 0850.02.02 and the following criteria may be CCAP income
eligible:
1) Financial Determination. The countable income of the financial unit shall be
at or below 180 percent of the federal poverty level, based on family size. The
income of self-employed families shall be calculated as outlined in Section
1424.20.10 of the DHS Code.
2) Resource Limit. A determination of eligibility requires a review of the
family's liquid resources. The value of liquid resources must be counted toward
the ten thousand dollar ($10,000) liquid resource limit. If the combined value
of the child's or the family's liquid resources exceeds the ten thousand dollar
($10,000) liquid resource limit, the family is ineligible and the application is
denied or eligibility for assistance is discontinued.
a)Liquid resources are defined as any interest(s) in property in the form of
cash or other financial instruments or accounts that are readily convertible to
cash or cash equivalents. These include, but are not limited to: cash, bank,
credit union or other financial institution savings, checking and money market
accounts, certificates of deposit or other time deposits, stocks, bonds, mutual
funds, and other similar financial instruments or accounts.
These do not include educational savings accounts, plans, or programs;
retirement accounts, plans, or programs; or accounts held jointly with another
adult, not including a spouse, living outside the same household but only to the
extent the applicant/recipient family documents the funds are from sources owned
by the other adult living outside the household, plus the proportionate share of
any interest, dividend, or capital gains thereon.
In addition to the evaluation of resources at the time of the CCAP application,
resources are reviewed when a change occurs, or when information is received
which indicates that unreported resources may exist. If, at the time of the
liquid resource evaluation, countable liquid resources exceed the liquid
resource limit, resources are assumed to be in excess of the limit for the
entire month. Liquid resources are evaluated at the point in time at which the
application or recertification is completed.
b) Documentation of Resources. The information the individual supplies on
the CCAP-1, both at application and recertification is documented through bank
statements and similar documentary sources.
The individual may provide photocopies of documents to verify resources. If
there is a question as to the validity of the photocopies, a DHS-91 should be
sent to the bank to verify the resource. The source used for verification of
the liquid resource is recorded in the appropriate area of the CCAP-1.
Photocopies of the documentation must be kept for the case file.
Resources must be reported but do not need to be documented at the
recertification if:
1. The recipient is active on another program, i.e. Food
Stamps, RIte Care, and/or RIW; and
2. A recertification was completed for the other program
within the previous six (6) months; and
3. The resource was reported and verified at the
recertification for the other program, and
4. The amount and source of the resources have not changed
since they were reported and verified by the other
program.
Households are required to report a change in resources during the period
between recertification dates only when the change in resource would increase
the amount of the household's resources in excess of ten thousand dollars
($10,000).
Bank accounts are liquid resources and, as such, must be verified for CCAP
households, both at initial certification and at recertification. The same
procedures employed at certification are used at recertification.
c) Availability of a Resource. In order to be countable in the determination
of CCAP eligibility, a resource must be available to the individual. The
individual must be able to use the resource to provide food, shelter, clothing,
or convert it into a form in which it can be used to meet needs:
o A resource is considered to be available both when
actually available, and when the applicant has the
legal ability to make such sum available for support
and maintenance;
o Resources are not available when a legal impediment
exists which precludes the applicant from making the
resource available for support, maintenance or child
care payments.
Applicants/Recipients are required, as a condition of eligibility, to cooperate
with the Department in making resources available.
d) Availability of Funds. Funds maintained in checking or savings accounts
are usually payable on demand. An individual should be able to withdraw money
from a checking account on the same day s/he presents a check.
Funds can usually be withdrawn from a savings account the same day the request
is made.
However, some unusual circumstances may occur which prevent the immediate
withdrawal of money, and may result in the resource being unavailable. For
example, if there is a joint account with only one individual having authority
to withdraw money and that individual dies, a prolonged period may elapse before
the surviving owner can withdraw the money.
Certain time deposits (e.g. savings certificates or certificates of deposit) may
not be legally available to the applicant until a specific point in time. If
so, the policy in Subsection c) above, regarding availability of resources, is
applied to determine if the resource is not countable until the maturity of the
certificate.
e) First Moment of the Month Rule. Countable liquid resources are determined
as of the FIRST MOMENT OF THE MONTH (FOM). The determination is based on the
liquid resources the individuals own, their value, and whether or not they are
excluded as of the first moment of the month. The FOM rule establishes a point
in time at which to value liquid resources; what a person owns in countable
liquid resources can change during a month but the change is always effective
with the following month's liquid resource determination.
The kinds of changes that can occur are:
o CHANGES IN VALUE OF EXISTING LIQUID RESOURCES
The value of an existing liquid resource may increase
or decrease. For example, the value of a share of
stock may decrease by thirty dollars ($30) or increase
by twenty dollars ($20).
o DISPOSITION OR ACQUISITION OF LIQUID RESOURCES
An individual may dispose of an existing liquid
resource (e.g., close a savings account and purchase
an item) or may acquire a new liquid resource (e.g.,
an inheritance which is subject to the income-counting
rules in the month of receipt).
o CHANGE IN EXCLUSION STATUS OF EXISTING LIQUID
RESOURCES
An individual may replace an excluded resource with
a non-excluded liquid resource (e.g., sell an excluded
automobile for non-excluded cash) or vice versa (use
non-excluded cash to purchase an excluded automobile).
Similarly, a time-limited exclusion (such as the
period for exclusion of retroactive Title II benefits)
may expire.
Changes such as SSI, SSA, and Lump Sums do not affect the countable value of
liquid resources in the month in which they occur. Any change does not affect
countable liquid resources until the first moment of the following month.
If countable liquid resources exceed the limit as of the first moment of a
month, the recipient is not eligible for that month, unless the liquid resources
are reduced by expenditure on certain allowable expenses. Expenses that may be
used to reduce liquid resources, to attain or retain eligibility, in CCAP are:
1. Any and all expenses related to payment for education or
child care for members of the family unit;
2. Contributions to educational savings accounts, plans or
programs owned by any member of the family unit; and
3. Contributions to retirement accounts, plans or programs
owned by any member of the family unit.
f) Joint Accounts and Rebuttal of Ownership. Whenever the applicant is a
joint account holder who has unrestricted access to the funds in the account,
ALL of the funds in the account are PRESUMED to be the resources of the
applicant. The applicant is offered the opportunity to submit evidence in
rebuttal as described below.
A successful rebuttal results in finding that the funds (or a portion of the
funds) in the joint account are not owned by the applicant and, therefore, are
not the resources of the applicant.
Rebuttal of Ownership of a Resource:
In order for a household member to demonstrate a lack of ownership, or only
partial ownership of a resource, two (2) of the following sources of
documentation must be presented as evidence:
* Documents showing the origin of the resource. For example,
if a bank account was opened, who opened it or whose money
was used to open the account;
* Documentation through federal or state tax records as to
which of the joint account holders declares the tax on the
interest credited to the account as income;
* Records of who makes deposits and withdrawals and, if
appropriate, of how withdrawn funds are spent. The person
claiming a lack of ownership (or accessibility) should not
have made any withdrawals.
* A notarized affidavit that details a written or oral
agreement made between the parties listed on the resource
or by someone who established or contributed to the
resource, with respect to the ownership of the funds in the
resource;
* When the household member states that s/he does not own a
bank account but is listed as a co-holder solely as a
convenience to the other co-holder to conduct bank
transactions on his/her behalf, evidence of the age,
relationship, physical or mental condition, or place of
residence of the co-holder must be provided;
* A signed, notarized statement from the household member and
from either other individual(s) listed in the joint
account, or the person who established or contributed to
the account, stating that the applicant or recipient had no
knowledge of the existence of the account.
A document or piece of evidence submitted to verify a particular fact does not
count as more than one verification under the above subsections. However, a
document, piece of evidence or a statement may address more than one fact needed
for verification.
If a household member cannot demonstrate that s/he is not the owner of the
account through the submission of two (2) of the above listed documents, the
rebuttal must be denied.
3) Family Cost Sharing Requirement. Eligible families with countable income
above 100% of the FPL shall pay a share of the expense for the child care
services authorized in Section 0850.02.07. The family shall be assessed a share
of the cost for authorized services (formerly referred to as co-payment) based
on a percentage of the gross countable income for families at each level. The
family share and income guidelines are set in accordance with the CCAP Cost-
Sharing Payment Rate Table located in subsection 0850.05 of this rule.
a) The family share shall be determined without regard to the number of
eligible children who are enrolled or the total of services utilized. The
family share shall be assigned to the first or youngest eligible child enrolled
in care--that is, the eligible child who receives authorized services paid at
the highest rate. The family share shall only be distributed among providers
when the total amount of the family share assigned exceeds the rate paid for the
first, or youngest, eligible child enrolled.
The income levels and percentage range of family shares are as follows:
FAMILY SHARE/CO-PAYMENT
FAMILY SHARE INCOME RELATIVE TO THE
FAMILY SHARE
LEVEL FEDERAL POVERTY LEVEL AMOUNT
------------ -------------------------- --------------- Level 0 Less than
or
equal to 100% No Family Share
Level 1 Above 100% up to and 2% of Countable
Including 125% Gross Income
Level 2 Above 125% up to and 5% of Countable
Including 150% Gross Income
Level 3 Above 150% up to and 8% of Countable
Including 180% Gross Income
(Refer to complete Cost Sharing Table in Section 0850.05)
b) A family's share of the cost for child care services approved for CCAP
payment shall be recalculated any time that the family submits a new application
and supporting documentation, or reports a change to DHS that may affect
eligibility prior to the end of the family's certification period. DHS shall
recalculate the family's share of the cost for CCAP authorized services anytime
there are changes in the family's income or size of the financial unit;
c) The Notice of Approval for child care assistance shall indicate whether a
family is required to pay a share of the cost for authorized child services
based on countable income. The Approval Notice shall indicate to the family the
exact amount of their family share and the calculations used to determine that
amount. The family shall also be informed of the amount of their family share
and which provider(s) to pay in the Confirmation of Enrollment letter.
4) Need for Services. To be authorized for income-based CCAP child care
services, the parent(s) shall have an acceptable need for services related to
employment or participation in an approved educational program.
a) General Criteria: Income Eligible. For there to be an acceptable need for
services in a two-parent home, each parent shall be employed a minimum of an
average of twenty (20) hours per week in a month and require CCAP child care
services during periods of time when working. In addition, the parents shall
each earn, per hour, an average of the greater of either the state or federal
minimum wage. For there to be an acceptable need for services in a one-parent
home, the parent living in the household shall be employed a minimum of an
average of twenty (20) hours per week in a month, earn per hour an average of
the greater of either the state or federal minimum wage, and require CCAP child
care services during periods of time when working.
b) Program-Specific Criteria: YS Participants. To obtain CCAP authorized
services, non-RIW teens applying for income eligibility shall meet the
applicable general criteria as well as the following program-specific criteria:
i) The applicant parent shall be an YS participant, under twenty (20)
years of age, and without a high school degree or its equivalent;
ii) The applicant YS parent shall be employed, attending school or
participating in education related activities, or engaged in some combination
thereof for a minimum of twenty (20) hour per week, on average, in a month.
CCAP child care services for YS participants who meet this requirement may be
authorized for a period of up to twelve (12) months, with the end date set to
correspond to completion date of the educational activity - e.g., date high
school diploma or GED is received;
iii) Teen Parent Under the Age of Sixteen (16). A teen parent who is under
age sixteen (16) may not have a child care case in their own name, unless
documentation of emancipation exists.
Child care services extended to a teen parent under the age of sixteen (16)
shall list the case in the name of the parent or legal guardian of the teen
parent and may also include that teen parent as a child care recipient.
5) Limitations. The need for child care services shall be related to the periods
of time in which no parent is available to provide care for the child as a
result of employment and/or education commitments. In addition, CCAP child care
services shall not be authorized for an otherwise income eligible child under
the following circumstances:
a) A parent of the eligible child is a self-employed as a child care
provider, and is requesting payment for care provided to the child during the
hours they are employed in that capacity. This limitation shall not apply if
the parent is an employee of a child care provider;
b) A parent is providing the child care, irrespective of whether the parent
lives in the same household as the eligible child(ren);
c) A person living in the same legal residence of the eligible child(ren) is
providing the child care;
d) The applicant parent's sole source of income is derived from rental and/or
room and board income, and the need for services is based on activities related
to obtaining or collecting that income.
Such activities shall not be considered employment for the purposes of this
section and, as such, shall not count toward the minimum number of hours of work
required to establish a need for CCAP authorized child care services; or
e) The applicant parent's need for services is based in part or in whole on
time spent working as a volunteer, or in any similar capacity in which no wages
are earned, paid, or expected. Unpaid work of this kind also shall not count
toward the minimum number of work hours required for CCAP income eligibility.
6) Exceptions. In certain circumstance, families unable to meet the need for
services requirements may qualify for an exception that allows authorization of
CCAP services. The exceptions are as follows:
a) One parent in a two-parent family has a documented disability that states
that parent is unable to care for the child. Exceptions may be granted if the
family provides written verification to a department representative from a
qualified licensed health care practitioner, program or facility indicating that
the parent cannot provide appropriate care of the child due to a neuro-
physiological, psychological or emotional disorder, physical impairment, or
serious health condition.
Requests for an exception shall be made on forms approved by DHS, and submitted
along with the required medical documentation for review and approval by a CCAU
representative. Any health information requested or obtained for the purposes
of this section shall be subject to the privacy protections established in state
law and the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
b) Parents with disabilities. Employed parents determined to have
disabilities may be exempt from meeting the minimum number of hours of work and
the minimum wage requirements required to establish a need for services set
forth in this subsection. An exemption shall not be granted until an assessment
by an appropriate entity or provider of the parent's condition is complete, a
final determination of disability is made, and the documentation verifying the
parent's disability is submitted to DHS.
Final decisions on whether an exemption is warranted, shall be made by a CCAU
supervisor. Notice of the decision shall be provided to the parent requesting
the exemption in accordance with the requirements of Section 0850.02.09 of this
rule.
c) Short Term, Employer Authorized Absences. Short- term, employer
authorized, absences from work for family/medical leave, vacations, or annual or
personal leave are considered to be within the parameters of employment and will
not adversely affect the scope of eligibility or ability to utilize CCAP
authorized care, as long as the parent retains "employee" status during such
absences. In addition, the following criteria must be met:
i) The parent's absence from work does not exceed twenty- one (21)
consecutive days in a certification period.
Absences that extend beyond these time limits must be reported in accordance
with Section 0850.02.09(3) and may result in a change in the scope of CCAP
authorized services. CCAP payment for parent absences from work shall not
exceed two (2) weeks as outlined in Section 0850.02.07 of this rule.
ii) There is an expectation on the part of both the parent and the employer
that the parent will return to work once the authorized absence or period of
leave is over.
d) Job Loss/Temporary Unemployment. An eligibility grace period may be
granted in cases when a parent of a child receiving CCAP authorized services is
unable to meet the minimum number of work hours required to maintain a need for
CCAP services due to temporary unemployment as a result of job loss or the
transition between jobs. In addition, the following criteria must be met:
i) The eligibility grace period shall not exceed twenty- one (21)
consecutive days in a certification period from the date the period of temporary
unemployment begins.
ii) The grace period shall not be extended or renewed.
iii) A parent who does not report a change in employment in accordance with
the requirements established in 0850.02.09(3) shall not be granted a CCAP
eligibility grace period unless good cause for the failure to report is shown.
iv) The department reserves the discretion to require a temporarily
unemployed parent to submit any documentation deemed necessary to verify that
continuation of CCAP eligibility during the grace period is warranted.
v) New applicants do not qualify to request a CCAP eligibility grace
period.
0850.02.06 CRITERIA FOR SHORT TERM SPECIAL APPROVAL
REV:01/2004
F. Criteria for CCAP for Short-term Special Approval Child Care Assistance
(SSACC): 0850.02.06. In a limited range of circumstances, families who are
unable to CCAP categorical or income eligibility criteria related to employment
plan or work requirements may be approved for Short Term Special Approval
(SSACC) child care assistance. SSACC may be approved for instances when there
is documented evidence indicating that either the child (child-based SSACC) or
the parent (parent-based SSACC) has a serious health condition that constitutes
a temporary "special" need for services based on the inability of the parent to
provide the necessary level or kind of child care. When applying for SSACC
services, the available countable income of the financial unit shall be used in
determining an applicant's eligibility. Determinations of requests for child-
based SSACC shall be made, on a case-by-case basis, by the appropriate RIW or
CCAU supervisor. The criteria for approval of SSACC for income and
categorically eligible CCAP families differ, as specified below:
1) SSACC Criteria for Income Eligible Families. When the requirements of this
subsection have been met, SSACC may be approved for otherwise income eligible
families who no longer meet the need for services requirement established in
section 0850.02.02 due to a change in the employment status of the parent(s).
As such, requests for SSACC shall only be considered for income eligible
families who have been receiving authorized CCAP services and have, or are in
jeopardy of losing them because of the change in the need for services.
a) Child Based. For approval of child-based SSACC in an income eligible
family, there must be documented evidence that, although the parent's employment
no longer meets the need for services requirement, the continuation of
authorized CCAP services is necessary for the health and well being of the
eligible child. In the case of an YS family, it is understood that school
attendance can replace the work hours needed for eligibility. The determination
of whether a continuation of CCAP authorized care is warranted, and as such
constitutes a special need for services, shall be based on a CEDARR
(Comprehensive Evaluation, Diagnosis, Assessment, Referral and Re- evaluation)
of the eligible child. Accordingly, child- based SSACC for an income eligible
family shall only be approved when:
i) There is a special need for services based on a CEDARR finding that the
discontinuation of CCAP services will have a direct adverse effect on the
eligible child's health and well-being; and
ii) All other income eligibility requirements have been met.
b) Parent Based. For approval of parent-based SSACC in an income eligible
family, there must be documented evidence from a qualified health care provider
or practitioner that the health condition of the parent prohibits both
employment and the routine child care activities necessary to maintain the
health and safety of the child. The special need for services is the result of
a change in the parent's health status that temporarily prevents the parent from
meeting the work requirements in section 0850.02.05. A parent hospitalized as
a result of an acute illness or condition, or bedridden while recovering from an
illness or condition for a limited period may receive partial or full payment of
child care expenses until able to resume employment subject to the general
restrictions of this subsection.
2) SSACC Criteria for Categorically Eligible Families.
SSACC may be approved for categorically eligible families who have not met their
RIW employment plan requirements or who do not have a signed employment plan
when the condition or health of the child or parent constitutes a special need
for services.
a) Child Based. For approval of child-based SSACC for categorically eligible
families, the special need for services must be established by either:
i) Documented evidence from a physician, qualified licensed health
practitioner, program, facility or responsible government authority, that the
child has a serious health condition that is not currently being treated or
accommodated either because access to an appropriate program that meets the
child's special needs has been denied or delayed, or is unavailable. Payment of
child care expenses shall be provided under such circumstances while permanent
placement in an appropriate program for the child is being arranged or located;
or
ii) A CEDARR finding that the continuation of CCAP authorized services is
necessary for the health and well being of the eligible child.
b) Parent Based. For approval of parent-based SSACC for categorically
eligible families, documented evidence must be provided from a qualified
licensed health care practitioner, program, facility or responsible government
authority indicating:
i) The disorder or impairment of the parent poses a serious barrier to
appropriate child care/rearing. Payment for CCAP authorized child care may be
made while the parent is participating in an appropriate remediation or
rehabilitation protocol, such as substance abuse treatment, parenting skills
training, therapy or counseling, that will lead to the alleviation of the need
for services and progress toward great self-sufficiency. In such cases, DHS may
require the applicant to provide documentation of a family assessment, conducted
by a qualified provider, when evaluating the need for SSACC services. However,
in no instance shall DHS authorization of SSACC for a categorically eligible
child include, or otherwise be based upon, an assessment of whether the parent
can successfully complete the remediation/rehabilitation protocol; or
ii) The health condition of the parent both prohibits employment or
participation in a RIW employment plan and routine child care activities
necessary to maintain the health and safety of the child. A parent hospitalized
as a result of an acute illness or condition, or bedridden while recovering from
an illness or condition for a limited period, may be eligible to receive partial
or full payment of child care expenses until able to resume employment, subject
to the general restrictions of this subsection.
3) Limitations. The scope of SSACC shall be limited as follows:
a) SSACC shall not be authorized for more than full-time in any twenty-four
(24) hour period as defined in section 0850.02.07;
b) SSACC authorized services shall be approved, upon initial request, for up
to three (3) months, and may only be approved for an additional three (3) months
period in any twelve (12) month period, if the family provides documentation to
DHS indicating that:
i) The parent's condition will improve during the additional time to the
extent necessary for the parent to return to work or participate in their RIW
employment plan, once the extension is over; or
ii) The child's permanent placement in a long-term treatment or special
needs program cannot be arranged without additional time.
c) In no case shall child-based SSACC serve as an adjunct to or a substitute
for services, administered by other government agencies or their designees that
provide long-term treatment or otherwise address the special needs of a child.
Similarly, authorization of parent-based SSACC is not based on an assessment of
whether the successful remediation/rehabilitation can be achieved and shall not
be portrayed as such for any purpose. Accordingly, authorization of SSACC under
the requirements set forth in this section shall not be construed to or in any
way mitigate, or otherwise address, the underlying cause -- e.g., impairment,
serious health condition, etc.--creating the need for services.
4) Notices, Rights, and Responsibilities. Families applying for SSACC are
accorded the same right to timely and adequate notice, to appeal DHS decisions
and to be informed of application and enrollment status applicable to all other
CCAP applicants/beneficiaries set forth in Section I. Except as the special
need for services requirements for the SSACC established in this section apply,
the responsibilities of DHS, approved providers, and the families of an eligible
child related to application, enrollment and payment of allowable child care
expenses shall also be the same as those specified for the CCAP.
0850.02.07 AUTHORIZATION OF CHILD CARE SERVICES
REV:10/2007
G. Authorization of Child Care Services: 0850.02.07. Upon determining that a
family is either categorically or income eligible for the CCAP, the RIW or CCAU
representative shall make an assessment of the scope of authorized child care
required to meet a family's need for services.
1) Assessment of Need for Services. The authorization for CCAP child care
services is based on an assessment of the following factors related to the need
for services:
a) The number of hours each day per week that the parent(s) of an eligible
child is employed or engaged in a RIW or YS approved activity that requires
child care services. One (1) hour per day of child care may be added to the
daily total to cover travel time from the child care location to place of
employment/approved activity and return. Additional travel time may be allowed
if there is a documented need, related directly to meeting work or employment
plan commitments.
b) In cases where the parent is requesting CCAP services under either
subsection 0850.02.04 or, 0850.02.05, or the SSACC, the allowable child care
expense is based on total number of hours each day per week that a parent is not
available to provide routine child care for the child.
Documentation provided by the parent that verifies the work schedule or approved
activities establishing the need for services shall be used in assessing the
total amount of child care services authorized.
2) Scope of CCAP Authorized Child Care Services. Upon completing the assessment
of a family's need for services, the RIW or CCAU representative determines the
scope of CCAP child care services appropriate for each eligible child in the
family. CCAP child care services are then authorized as follows:
a) Full-time (FT) child care, for thirty (30) or more hours per week;
b) Three-quarter time (3QT) child care from twenty (20) up to thirty (30)
hours per week.
c) Half-time (HT) child care, from ten (10) up to twenty (20) hours per week;
and
d) Quarter time (QT) child care, for less than ten (10) hours per week.
3) Limitations. Authorized child care shall be utilized within the following
parameters:
a) Certification Period. The department authorizes CCAP child care for a
specific period of time that begins on the initial eligibility date, and
continues until the next scheduled date, as specified in 0850.02.03, unless it
has been predetermined by the RIW or CCAU representative that the family's need
for services can be met by authorizing CCAP child care for a shorter period of
time.
b) Need for Services. CCAP authorized child care corresponds to, and is
generally expected to be utilized during, the hours when a family has a need for
services as defined in Section 0850.02.02 of these rules.
c) Multiple Providers. An eligible child may receive CCAP authorized services
from multiple providers if necessary for a family to meet a need for services
due to split shifts or non- traditional employment schedules, but only in
instances in which the hours of authorized child care rendered by each provider
do not overlap. In no case, shall DHS pay more than one provider for the same
hours of child care services authorized for a particular eligible child.
d) Hours for School Age Children. CCAP services shall not be authorized for
school age children during hours when school is in session, which are defined as
from 9:00 AM to 2:00 PM.
Further, CCAP services will not be authorized for youths aged thirteen (13) to
sixteen (16) years old, who have no approved disability, for the hours from 5:00
AM to 9:00 AM.
e) Payment. Payment for CCAP authorized services shall only be made when
rendered by child care providers approved by DHS, who meet the requirements
established in section 0850.03.02, of this rule.
f) Age Restrictions. Before school care shall not be authorized for eligible
school age children age thirteen (13) and over unless a child has a documented
disability that requires the child to have adult supervision. Non-certified
approved providers shall not receive CCAP payment for care provided to children
age thirteen (13) or over unless the child has a documented disability as
specified in this subrule.
g) Authorized Absence. An eligible child, enrolled with an approved provider,
shall not be absent for more than two (2) full weeks of authorized child care in
a given twelve (12) month period, unless granted a good cause exemption by DHS
as a result of a serious health condition or unusual family circumstance.
Parents shall make requests for good cause exemptions, in writing, to the unit
of DHS that determined eligibility for the CCAP. Timely notice, including a
statement of appeal rights, shall be sent to the family by DHS explaining the
basis for granting or denying the request for an exemption to the two week limit
on absences from authorized CCAP child care.
i) Once the two (2) week limit has been reached, no payment shall be made
for periods of authorized child care in which the eligible child is not in
attendance unless a good cause exemption has been granted.
ii) The department reserves the right to consider repeated extended
absences of an eligible child when making recertifications of CCAP eligibility.
0850.02.08 ENROLLMENT FOR CCAP AUTHORIZED SERVICES
REV:01/2004
H. Enrollment for CCAP Authorized Child Care Services: 0850.02.08. Through the
enrollment process, the family of an eligible child and the CCAP approved child
care provider of choice make the arrangements necessary for the delivery of CCAP
authorized services, in accordance with the requirements established by the
department for payment of allowable child care expenses. The child care provider
is required to transmit the pertinent information about these arrangements to
DHS using the CCAP automated enrollment system. All CCAP approved providers
shall have access to the CCAP automated enrollment system and are required to
enroll all eligible children through that system as a condition of receiving
payment for CCAP authorized child care services. Enrollment responsibilities for
CCAP authorized services are delineated as follows:
1) DHS Responsibilities. DHS is responsible for providing the families of
eligible children with the following documentation necessary to complete and
confirm enrollment:
a) CCAP Certificate Number. DHS shall issue each family applying for child
care assistance a CCAP certificate number, to serve as a unique identifier for
the purpose of enrolling an eligible child for authorized services and
establishing a basis for payment to a CCAP approved provider. Both the letter
acknowledging that an application for the CCAP is pending, and a certificate
(Certificate of CCAP Approval) appended to the notice approving CCAP eligibility
shall display prominently a family's CCAP certificate number. In order to
enroll an eligible child the family is required to present the CCAP approved
provider of choice with the certificate number to verify either that application
for CCAP services has been made or eligibility for services has been approved.
The approved provider uses the certificate number to enroll the family for
authorized services via DHS's secure CCAP automated enrollment system.
Enrollment must be completed before or during the first week that CCAP
authorized services are provided.
b) CPD. The CPD contains the names of all child care providers that have
applied for and met the minimum requirements to be approved to participate in
the CCAP. A family choosing to use a non-certified provider, or a DCYF licensed
or certified provider that is not listed in the CPD, shall be provided with
information explaining DHS approval requirements as specified in Part III of
this rule. Types of approved providers are defined in section 0850.03.01.
c) Confirmation of Enrollment. Once the enrollment process has been
completed, a letter shall be sent from the department to both the family and
provider that confirms enrollment of the child(ren) and indicates the assignment
of the family's share of the cost for authorized services, if any. DHS also
sends a letter confirming enrollment when there is a change in approved
providers. In addition, a written letter discontinuing services is sent by DHS
to the previous provider, and copied to the family, in such cases as well.
d) Authorization for Payment. DHS shall initiate the process for authorizing
payment to a provider for allowable child care expenses upon receipt of the
notification that an eligible child has been enrolled in accordance with
subsection (3), as specified below. DHS reserves the right to deny payment for
services to providers who fail to enroll eligible children within the first week
that an eligible, or potentially eligible, child begins care with that provider.
2) Responsibilities of the Family. To initiate the process of enrolling an
eligible child for CCAP authorized child care services, the family of the child
shall contact a CCAP approved provider and present the Certificate of Approval
for CCAP services or, their CCAP certificate number.
a) Enrollment During The Pending Period. As indicated in section
0850.02.03(5), some approved child care providers may be willing to enroll a
child, using the CCAP certificate number, while their application is still
pending and before the final determination of eligibility.
The certificate number may first be issued to the family in the pending letter,
which acknowledges that the application has been received and is pending further
review. If no pending letter is sent and the application is approved, the
certificate number is issued to the family in the Notice of Approval. In such
instances, the following conditions apply:
i) If the application for CCAP child care services is subsequently denied
by the department, no payment shall be made for any child care services rendered
during the period when the application was pending and before the final
determination of eligibility.
ii) If a family does not give their DHS certificate number to a provider,
the provider may hold the family liable for payment for any child care services
used.
b) Providing Information to Approved Providers. CCAP Approved Providers. The
family of the child shall present the CCAP certificate number to an approved
provider when making arrangements for authorized child care services.
The family shall also provide any information required for CCAP web or telephone
enrollment requested by the provider.
c) Enrollment with Multiple CCAP Approved Providers.
DHS shall not make payment to more than one approved provider for any one hour
or set period (e.g., before school care) of CCAP authorized child care services.
A family choosing to enroll a child for authorized services with multiple
providers shall advise each provider accordingly when making arrangements for
child care. The CCAP automated enrollment system prevents enrollment of, and
payment for, services to an eligible child during overlapping hours. No more
than one (1) provider shall be authorized to provide full time services to an
eligible child for a specific period of care.
d) Changing Providers. The family of an eligible child may choose to change
approved child care providers at any time while authorized for CCAP child care
services.
However, DHS is permitted to make payment to only one approved provider for a
particular hour or set period of CCAP authorized child care once the week
begins.
Accordingly, families are best served when changes in providers are arranged to
take effect at the start of the week (Sunday). To the extent time and
circumstances allow, notification of the change should be made by the parent to
any providers involved. In general, however, to change approved child care
providers a family is required to present the CCAP certificate number to the new
provider of choice and make the arrangements necessary for authorized child care
services. Enrollment information sent to DHS by the new approved provider
through the CCAP automated enrollment system shall automatically disenroll the
eligible child from, and thereafter prohibit payment for, child care services
rendered by the child's previous care provider. Families may change approved
providers at anytime during the CCAP eligibility period.
e) Services in Excess of CCAP Authorized Child Care. A family may choose to
enroll an eligible child for services in excess of the CCAP period authorized.
No CCAP payment shall be made for any unauthorized hours of child care even with
an approved provider.
3) Responsibilities of CCAP Approved Providers. It shall be the responsibility
of the CCAP approved provider selected by the family of an eligible child to
officially enroll a child for authorized services before or during the first
week that CCAP authorized services are provided.
Only child care providers who have been approved and entered into a signed and
valid DHS-Approved Provider Agreement, have access to the DHS CCAP automated
enrollment system. Both DHS approval and access to the CCAP automated
enrollment system are necessary preconditions for provider participation in the
CCAP. (See section 0850.03 of this rule for requirements for approval.)
a) Provider Enrollment Procedures. The approved child care provider collects
the information necessary to officially enroll a child for the CCAP services in
the process of making arrangement for child care with the child's parent(s).
Such information includes: the CCAP certificate number; the child's full name
and date of birth; and, the start and, if known, end dates for the authorized
services requested. The enrollment process varies somewhat depending on whether
the application for the CCAP is under review and eligibility is pending or
eligibility has been approved as follows:
i) Eligibility pending. The approved provider shall use the CCAP
certificate number issued by DHS in the letter acknowledging receipt of the
application, as specified in section 0850.02.03(5), when enrolling a child whose
eligibility for authorized services is pending. The enrollment process is not
completed unless and until CCAP eligibility has been approved. Any provider
that has not been approved by DHS shall not initiate enrollment of a child for
the purposes of seeking CCAP payment, irrespective of whether a final
determination of eligibility has been made. If the application for CCAP
services is subsequently approved, payment for any CCAP authorized services
rendered while the application is pending shall be made by DHS to the approved
provider as long as the child was appropriately enrolled. Upon receipt of
payment from DHS, the approved provider shall refund the family for any
allowable child care expenses paid by the family during the period in which the
application was pending. The approved provider shall not apply any refund due
the family to cost-sharing obligations the family may incur for CCAP authorized
services that may be rendered at a later date, unless expressly requested, in
writing, by the eligible child's family.
ii) Eligibility approved. An approved provider enrolls a child using the DHS
CCAP automated enrollment system.
The enrollment process is complete when DHS receives notification from the
provider via DHS's CCAP automated enrollment system. DHS sends a letter
confirming enrollment to the family and provider. The letter shall serve as
notification to the approved provider that DHS has accepted the eligible child's
enrollment. The approved provider may begin to bill DHS for allowable child care
expenses.
b) Dis-enrolling Children. The approved provider shall dis-enroll a child
immediately upon receiving notice that an eligible child shall not be using
services any longer, for any reason. Upon receiving notification from the
family of an eligible child that alternative child care arrangements have been
made, the eligible child shall be disenrolled, as appropriate, and the relevant
information sent to DHS via the CCAP automated enrollment system.
Failure of the parent to properly notify a provider of the child's
disenrollment, shall not constitute grounds for continued payment.
c) Provider Capacity. CCAP approved child care providers shall monitor
enrollment patterns to ensure that the number of children receiving services at
any one time remains within the provider's authorized maximum capacity; that is,
the total number of children in a provider's care- -both CCAP eligible and non-
eligible children.
i) The Rhode Island Department of Children, Youth and Families (DCYF)
establishes the maximum capacity for all state regulated child care centers, and
family child care homes in the applicable standards for licensure and
certification. CCAP approved providers subject to DCYF regulations shall not be
permitted to enroll an eligible child through the DHS CCAP automated enrollment
system when at full capacity.
ii) Approved non-certified providers, though not directly regulated by
DCYF, are prohibited by the State from caring for more than three (3) unrelated
children or up to six (6) children related to the provider at any one time
without obtaining DCYF certification as a family child care home. Any children
of the non-certified provider are excluded from the count until enrollment
reaches the limit of three (3) unrelated children. The children of the non-
certified provider who are under six (6) years of age count toward the maximum
limit of six (6) related children. DHS shall not make payment for an eligible
child once the maximum number of unrelated children allowed for a non- certified
provider has been reached.
iii) Approved child care providers cannot retroactively enroll an eligible
child. Approved providers must enroll both eligible and pending children before
or during the first week that care is delivered if DHS payment is anticipated.
0850.02.09 NOTICES, RIGHTS AND DUTIES
REV:08/2008
To ensure that the Child Care Assistance program (CCAP) is administered in an
equitable, effective and efficient manner, the following requirements have been
established:
1) Notices. Applicants for the Child Care Assistance Program shall receive
timely and adequate notice from DHS of eligibility determinations. The
department shall also provide timely and adequate notice of any adverse
decisions that terminate or reduce benefits.
a) Notice of Approval. Upon determining that an applicant meets the general
requirements for the CCAP in Section 0850.02.02 and the criteria for either
categorical (0850.02.04) or income (0850.02.05) eligibility, Notice of Approval
shall be sent by DHS informing the family of the eligibility start and end dates
and the scope of services authorized. The notice shall also indicate whether an
income eligible family is required to pay a share of the cost for CCAP
authorized services and the amount of that family share in accordance with the
table included in Part IV of this rule. In addition, the Notice of Approval
shall state that any eligible children in the family shall only be enrolled for
CCAP authorized child care services by a CCAP approved provider, who has a
signed and valid DHS-CCAP Approved Provider Agreement and is listed,
accordingly, in the Central Provider Directory (CPD). Notices of approval are
also sent when there are additional children in the family approved for the
CCAP. An approval notice may include, as an attachment or separate enclosure,
any information about the CCAP that DHS deems necessary and appropriate to
assist families in making arrangements to enroll an eligible child for
authorized services.
B) Notice of Adverse Actions. DHS shall send timely and adequate notice of
any decisions that adversely affect a family's CCAP eligibility or the scope of
authorized services.
All notices of adverse action shall contain:
(1) acknowledgment of a client's request for withdrawal of
an application, or discontinuance of benefits, if
applicable;
(2) the reason for the proposed adverse action and
citation of the applicable rule herein;
(3) a statement indicating that the family may discuss the
pending adverse action with the appropriate RIW or
CCAU representative and, if further review is deemed
necessary, schedule an Adjustment Conference to the
discuss the action further with the designated
supervisor; and
(3) and explanation of the family's right to request a
hearing within thirty (30) days of the date of the
notice. Notices in this category include those
indicating denial or discontinuation of CCAP
eligibility, or change in CCAP authorized
services.
i) The notice of denial shall be sent by DHS to a
family when a department representative determines
that a case, or an applicant in a case, is
ineligible for the CCAP.
ii) The notice of eligibility discontinuation shall be
sent when a decision made by the department results
in the discontinuance of CCAP eligibility
for a particular child or for the family as a
whole.
iii) A notice of change in authorized services shall be
sent to a family in situations in which a DHS
decision results in change in the scope of
authorized services or the family share obligation
that reduces the level of CCAP benefits or
otherwise adversely affects the family.
(a) When a change in the family's eligibility or
need for services results in a reduction,
suspension, or discontinuance of DHS payment to
the provider, a notice of adverse action shall
be sent to the family at least ten (10) days
prior to the effective date of the action.
However, not all changes in the scope of CCAP
authorized services are considered
adverse actions. A notice is also sent, for
example, when a change in family income results
in a decrease in the family's cost-sharing
obligation.
(b) Notice of Eligibility Redetermination.
Eligibility for the CCAP shall be redetermined
by DHS on a periodic basis in accordance with
the applicable program requirements if the
recipient is categorically eligible;
or at no more than six (6) month intervals if
the recipient is income eligible. DHS shall
provide families with notice, in writing, of the
date of the recertification and by no later than
the first day of the last month of the current
eligibility period. The Notice shall indicate
that the family must make re-application for
CCAP eligibility by submitting the appropriate
signed form and any documentation required for
the purposes of verifying eligibility or the
need for services, as indicated in section
0850.02.03(1)-(3). Once the eligibility
recertification process has been completed, DHS
sends either a Notice of Approval, or Denial, or
a Notice of Adverse Action, as specified in this
subsection.
2) Rights Applicants for, and beneficiaries of, the Child Care Assistance
Program have rights during the determination of eligibility, and during the
receipt of benefits.
A) Right to Appeal and Request a Hearing.
In conjunction with notices informing
applicants/beneficiaries of initial
eligibility determinations, adverse actions, and
recertifications, DHS shall inform the family of the
right to appeal and request a hearing. The Notice of
Approval shall include information pertaining to the
right to appeal the eligibility date, the amount or type
of authorized services, the family's cost-sharing
obligations, and any other matters related to the scope
of CCAP benefits approved. Notice of adverse actions
shall include information pertaining to the right to
appeal DHS's decision (e.g., denial, discontinuation,
change in authorized services), the scope of its impact,
and the basis on which the decision was made. Appeals
shall be sent to the office or unit of the department
that made the determination of eligibility or decision
resulting in an adverse action.
3) Duties Both DHS and the family of the eligible child have a duty to provide
certain kinds of information, as follows:
A) DHS: Confirmation of enrollment. It is the duty of DHS to
provide the family of an eligible child with written
Confirmation of Enrollment for CCAP authorized services.
Accordingly, upon receiving notification of enrollment of
an eligible child from an approved provider, DHS shall
send a client written confirmation of an eligible child's
enrollment for authorized services by the provider. The
Confirmation of Enrollment shall specify the approved
provider who enrolled the eligible child and, as such, who
shall receive payment, if any is required, from DHS for
CCAP authorized child care services. Any cost-sharing
obligations for an income eligible family shall also be
specified in the Approval Notice and the Confirmation of
Enrollment.
B) Applicant: Reporting requirements. It is the duty of the
client requesting for parent of the applicant
child to make accurate, complete, and timely disclosure of
all information necessary for DHS to determine the
following:
- The family's eligibility for child care benefits.
- The family's authorized hours for child care
services.
- The family's child care co-payment.
Such disclosure shall be made at the time of initial
application and determination of eligibility, at
redetermination of eligibility, and within ten (10) days of
any change in the following information: address,
household composition, wages and salaries, other household
income such as Child Support, TDI, Unemployment Insurance,
SSI, etc, schedule of work hours, resources, employers,
employment commitments and any related approved activities,
citizenship, health status (if SSACC eligible), and any
other matters related to the general requirements and
criteria for CCAP categorical or income eligibility, the
authorization of services, and the payment of
allowable child care expenses relating to the requirements
and criteria included in Sections 0850.02.02 - 0850.02.06.
Changes should be reported and documented to the unit of
the department responsible for determining CCAP
eligibility.
In addition, RIW cash beneficiaries shall report absences
of a dependent child from the home, expected to exceed
thirty (30) days, within five (5) days of the date the
parent becomes aware of the child's anticipated absence.
If the agency representative discovers that the household
failed to report a change as required by Section
0850.02.09. and as a result, received child care benefits
to which it was not entitled,the agency representative
refers an improper payment claim to the CCR/Fraud Unit.
An improper payment occurs when the child care benefit
amount paid exceeds the benefit that would have been issued
if the payment were calculated correctly based on accurate
information that was reported , verified, and acted on in a
timely manner.
The CCR/Fraud Unit establishes whether the improper payment
was agency caused, household caused, or intentional fraud
violation and recovers the improper payment in accordance
with Section 0850.11.
4) When information provided to DHS in conjunction with the duty to report
requires a change in CCAP authorized services, the following apply:
(a) If the resulting change in CCAP authorized services does
not adversely affect the family, implementation will
begin, in most circumstances, on the first Sunday
following the date the report was made to DHS;
(b) If the resulting change in CCAP services has an adverse
impact on the family, notice of the change shall be
provided by DHS to the family at least ten (10) days
prior to the implementation date.
5) Any change in the amount of income by any member of the financial unit must
be reported to DHS within ten (10) days of the date the change takes effect.
Upon receipt of the report, CCAP eligibility shall be recalculated based on the
reported change in income.
(a) For income eligible families, changes in the amount of
gross monthly income of twenty-five ($25) dollars or
less need not be reported until the next certification
period. This exception accommodates occasional bonuses,
overtime and seasonal changes in employment.
(b) Changes in sources of income and in household
composition must also be reported within ten (10) days
of the date the change takes effect.
6) Any change in the amount of countable resources (See Section 0850.02.05,E,2)
available to the financial unit must be reported to DHS within ten (10) days of
the date the resource level changes, if the change would affect eligibility.
Upon receipt of the report, CCAP eligibility shall be recalculated based on the
reported change in resources.
0850.02.09.05 Underpayments
REV:08/2008
If the household was eligible to receive child care assistance benefits, but
received a benefit that was less than that to which they were entitled, an
underpayment has occurred. The failure to issue a benefit for a benefit month
in which the household was eligible for such a benefit also constitutes an
underpayment.
Eligibility for Correction of Underpayment
The agency representative corrects the underpayment as soon as possible, but not
later than thirty (30) days after discovery of the underpayment, to a current
recipient or one who would be a current recipient had the error causing the
underpayment not occurred.
In cases involving an underpayment and an overpayment in the same month, the
agency representative must factor in both in determining what the correct
payment should have been. If an underpayment still exists, it is promptly
corrected.
For purposes of determining eligibility and the amount of assistance, a
retroactive corrective payment is not considered income, nor is it considered a
resource in the month received or in the following month.
0850.03 CHILD CARE CENTRAL PROVIDER DIRECTORY
REV:08/2004
The Department of Human Services shall only make payment only for CCAP
authorized child care services when rendered by DHS CCAP approved child care
providers. To obtain approval, child care providers shall meet the minimum
requirements set forth in this section, including entering into an agreement
with DHS that fulfills the requirements set forth in this subrule. Providers
that have obtained DHS approved status are listed in the CCAP Central Provider
Directory (CPD) maintained by the Office of Child Care (OCC). The OCC
established the CPD to serve as the single point of entry for all providers
seeking approval to participate in the CCAP, receive payment for authorized
child care, and gain access to DHS subsidized health insurance coverage and
other programs administered by DHS.
A provider may begin to provide authorized services to CCAP eligible children
during the week that an application for the CCAP approval has been submitted to
the OCC. However, DHS shall only make payment for such services when, and on
the condition that, the provider is granted CCAP approved status, completes the
introductory training, and enrollment and reporting activities specified in this
rule.
0850.03.01 Definitions
REV:09/2007
For the purposes of this section, the terms below have the following meaning:
"Approved Non-certified Child Care Provider" means any relative, friend or
neighbor of a family eligible for CCAP rendering child care in the home of the
child or the provider, who has been successfully screened by the department in
accordance with the requirements set forth in Section 0850.03.03 of this subrule
and determined eligible to participate in the CCAP, listed in the CPD, and
receive payment for allowable child care expenses.
Non-certified providers are not required under applicable State laws
(R.I.G.L.42-72.1 et.seq.) to obtain licensure or a certificate of registration
from the Rhode Island Department of Children, Youth and Families, but must meet
the capacity requirements as specified in Section 0850.02.08(3). Non- certified
providers are only approved in CCAP as long as they have CCAP pending or an
eligible child in their care.
"Approved Nursery School" means a program for preschool age children approved by
the Rhode Island Department of Education.
"Allowable child care expense" means the total cost of CCAP authorized child
care services paid by DHS to an approved provider after deducting the amount the
family is required to pay the provider as its share of the cost (or family
share) for authorized services.
"CCAP Approved Provider Agreement (APA)" means the agreement that all CCAP
approved providers must sign with DHSS that establishes the respective
responsibilities and obligations of both the Department and the provider.
"CCAP Approved Provider Introductory Training" means the introductory training
session(s) about the CCAP, conducted by the Office of Child Care (OCC) and that
approved providers must complete in order to receive DHS reimbursement of
allowable child care expenses.
"CCAP Approved Provider Rate Report (APRR)" means the report that providers must
complete and submit to the OCC to gain or maintain approved provider status.
The APRR requires providers to specify the actual rate they charge for child
care services rendered to non-CCAP subsidized families. As part of this report,
providers are also required to submit their published rate schedule for all
payers other than DHS/CCAP. The APA shall include the Approved Provider Rate
Report (APRR) and this report will be incorporated into the agreement.
"Center-based Child Care Program" means a facility operated on a regular basis
which receives children, not of common parentage, and provides non-residential
care in a location separate from the children's parents during the day.
"Child Care Facility" means any facility that provides child care, including a
center-based program or family child care home, that is licensed or certified by
the Rhode Island Department of Children, Youth and Families (DCYF). The term
includes facilities that have programs such as: nursery school, preschool, pre-
kindergarten, child play school, before or after school care, or child
development center and applies to the total child care operation, including the
physical setting, administration, staff, equipment, program, and care of
children.
"DHS Authorized Payment Rate for Providers" means the rate that DHS CCAP pays
approved providers for CCAP authorized child care services. The DHS authorized
payment rate for each provider is either the actual rate the provider charges
for child care services as reported in the APRR or the DHS CCAP Established
Payment Rate for each rate category, whichever is lower
"DHS CCAP Established Payment Rate" means the maximum rate that DHS CCAP will
pay approved providers for authorized child care services in each rate category.
This maximum rate is established based on the results of a biennial Market Rate
Survey as defined in Rhode Island law (R.I.G.L. 40-6.2-1.1).
"Department of Children, Youth and Families or DCYF" means the Rhode Island
State agency with statutory responsibility for regulating child care providers.
DCYF licenses child care centers and group family child care homes and certifies
family child care homes.
"Family Child Care Home" means a child care program located in the provider's
home residence in which child care services may be offered at the same time to
four (4) or more children unrelated to the child care provider. Family child
care home shall not mean a private residence used for an informal cooperative
arrangement among neighbors or relatives, or the occasional care of children
with or without compensation.
R.I.G.L.42-72.1-4 requires family child care home providers to obtain a
certification from DCYF.
"Group Family Child Care Home" means a child care program located in the
provider's home residence in which child care services may be offered at the
same time for (9), but no more than twelve (12) children unrelated to the child
care provider.
R.I.G.L.42-72.1 requires group family child care home providers to obtain
licensure from DCYF.
"Successfully Screened Provider" means that there is no disqualifying
information or evidence of criminal activity in the background clearances and
criminal record checks of the individual seeking CCAP approved non-certified
provider status or of any of the adults living in the provider's household.
Child care providers who possess a valid DCYF license or certificate to operate,
and who are seeking CCAP approved status, are presumed to have been successfully
screened in accordance with the R.I.G.L. 40-13.2-1 et. seq.
"Summer Camp" means a DHS approved program serving eligible school age children
during periods when school is out-of- session. Summer camps must meet
applicable State laws and regulations pertaining to child health and safety and
any other applicable DHS requirements, though employees are not subject to the
DCYF screening process.
0850.03.02 CDP Approved Providers
REV:09/2007
The CCAP Central Provider Directory (CPD) standardizes the process for approving
child care providers to participate in the CCAP and provide a central source of
information about, and for, CCAP approved providers. The process for gaining
entry to the CPD, and attaining CCAP approved status, varies depending on type
of child care provider.
1) Categories of CPD Approved Providers. In general, entry into the CPD shall be
limited to the following categories of child care providers:
a) DCYF Licensed and Certified Child Care Providers.
Child care providers regulated by, and operating in accordance with, the
standards established by the Rhode Island Department of Children, Youth and
Families (DCYF) appropriate to the child care setting. Providers in this
category include licensed center-based child care programs, group family child
care homes, and school-age programs, as well as certified family child care
homes. Also included are summer camp programs operated by licensed centers
where children spend at least part of their day at the regulated facility where
DCYF center standards are maintained during the entire day.
b) Non-certified Child Care Providers. Relatives, friends and/or neighbors of
families eligible for CCAP who are not required by law to obtain DCYF licensure
or certification, but are authorized to participate in the CCAP. Providers in
this category will only be approved as long as they have a CCAP pending or
eligible child in their care and have been successfully screened by DHS as
specified in section 0850.03.03 of this rule; and
c) Non-certified Centers (also referred to as Summer Camps).
This category is reserved for child care providers that are in compliance with
the child care health and safety standards and/or program requirements
established by the Department of Health (DOH) as well as any other pertinent and
appropriate State agencies, and approved by DHS as meeting the CCAP program
requirements. Summer camps, by definition, may not operate for more than twelve
(12) weeks per year; and
d) Nursery Schools. Programs certified by the Rhode Island Department of
Education (DOE) to operate half (1/2) day pre- school programs and approved by
DHS as meeting the CCAP program requirements.
2) Scope of CCAP Approval. For the purposes of the CCAP, "approved" means that
the child care provider has met the requirements to enroll eligible children
through the DHS CCAP automated enrollment system, receive payment for allowable
child care expenses, and participate in certain DHS programs. Although these
requirements reflect the minimum standards for safe and healthful child care,
CCAP approved status is not, and shall in no way be construed as, related to the
quality of services rendered by the child care provider. DHS will not pay
providers for services rendered prior to the week that the CPD receives their
application to be a CCAP approved provider.
0850.03.03 CPD Application for Approval Process
REV:09/2007
Child care providers who fall into the categories defined in Section 0850.03.01
of these rules, may apply for entry into the CPD. In the event that the family
of an eligible child selects a child care provider that is not listed as
approved in the CPD, the provider must contact the Office of Child Care, to
request the appropriate CPD application forms and related information about
obtaining CCAP approved provider status. The process for becoming approved in
CCAP and entered into the CPD includes both general and category specific
application requirements, as outlined below.
1) General Access Requirements. All child care providers seeking access to the
CPD and CCAP approved status shall meet the following general requirements:
a) Applications shall be made on forms approved by the department. The
application may vary in length and type, depending on the category of provider.
Completed and signed applications, along with any required documentation, shall
be submitted for review to the Office of Child Care.
b) All CCAP approved child care providers shall sign a CCAP Approved Provider
Agreement (APA) that establishes the respective responsibilities and obligations
of both the Department and the provider as well as the grounds for
discontinuation of approved status. No payment shall be made for allowable
child care expenses until the Department receives the original APA, signed and
dated by the child care provider and notarized or witnessed by a member of the
staff of the OCC.
Providers shall agree to the terms and conditions set by DHS for:
* Completing the APRR;
* Enrolling eligible children;
* Complying with maximum capacity limits;
* Transmitting documentation of authorized services
rendered;
* Establishing the DHS authorized payment rate for
services provided to CCAP eligible children enrolled in
care as well as the payment method and interval;
* Ensuring the safety and well-being of children in their
care; and
* Filing timely reports to DHS about changes in
enrollment, licensure, or certification status, capacity
or any other such matters as deemed necessary to
maintain the CPD and authorize payment for services.
c) Providers, and any substitute providers, shall be successfully screened
through a background clearance and criminal record check by the department
specified --DCYF or DHS- - category specific requirements established in subrule
(2) of this subsection;
d) Providers shall be U.S. citizens or submit documentation of a legal
immigration status that includes the appropriate authorization to work in the
child care field, or a related, industry. DHS is prohibited from making payment
to, and therefore will not approve, non- citizen providers who do not have proof
of such authorization; and
e) Meet any category specific requirements set forth in this subsection.
2) Category Specific Access Requirements. In addition to the general access
requirements, child care providers shall meet the following category specific
requirements in accordance with R.I.G.L 40-5.1-17(b):
a) DCYF Licensed and Certified Child Care Providers. To be eligible to be
CCAP approved, a child care provider operating under the jurisdiction of DCYF
shall:
i. Provide documentation of a valid State of Rhode Island license or
certificate to operate, deemed by DCYF to be in good- standing, and meet any
additional requirements specified by DHS.
Individuals operating, or employed by, child care centers and family homes
regulated by DCYF are subject to screening -- including both a background
clearance and criminal records checks -- as part of the process of obtaining and
maintaining licensure or certification. Accordingly, a valid license or
certificate in good standing is considered evidence of successful screening for
the purposes of this section. For continued eligibility, all licensed providers
are required to submit a schedule of their rates for non-assisted or non-
subsidized families. If a provider's license lapses, is revoked, or otherwise
becomes invalid, DHS shall initiate appropriate action to discontinue approved
provider status. A provider whose approved status is discontinued must submit a
new application to be considered for reinstatement as CCAP approved provider.
ii. For continued approved provider status, all licensed and certified
providers are required to complete and submit a CCAP Approved Provider Rate
Report (APRR) that includes their published rate schedule. The CCAP APRR
specifies the actual rate a provider charges for child care services rendered to
any non-CCAP subsidized families in all rate categories. The APRR is used to
determine the DHS Authorized Payment Rates for Providers. If a provider does
not have a published rate schedule, the provided shall make a statement
attesting to that fact, as indicated, in the appropriate section of the CCAP
APRR.
b) Non-certified Child Care Providers. To be eligible for CCAP approval, a
non-certified provider shall:
i. Be relatives, friends or neighbors of families eligible for CCAP who
have been requested to provide child care services to a CCAP pending or eligible
child.
ii. Submit a completed and signed CPD/CCAP application packet including a
signed Health and Safety Certification Form in which the provider attests to
being free of any physical, mental and/or emotional condition(s) with the
potential to endanger children or impede the ability to care for children.
If an applicant is receiving disability related income and/or supportive health
care services, or has been hospitalized for a chronic condition for one (1) day
or more in the last year, a treating physician must submit either medical
documentation on the appropriate DHS form, or a signed letter, indicating that
the applicant is capable of providing safe and appropriate care for children.
Additionally, the application shall contain the following:
(a) A W-9 Form (Request for Taxpayer Identification Number and
Certification) completed and signed by the provider;
(b) Proof that the applicant is at least twenty-one (21) years old as
verified by a birth certificate or other legal document that contains an
applicant's date of birth;
(c) A valid social security number or proof that the applicant is a
United States citizen or a non-citizen who is lawfully entitled to reside and
work in the United States;
(d) Proof of the applicant's Rhode Island residency and of a stable
address. A post office box is not an acceptable form of proof of Rhode Island
residency, though it may serve as an applicant's official mailing address.
(i) As used in this subrule, a stable address means that the applicant intends
to maintain one principal place of residence once approved for the CCAP. For
the purposes of CCAP, a stable address is necessary to ensure prompt enrollment
of eligible children, timely payment for authorized services and to protect the
safety and security of the child care environment.
(ii) A signed and dated mortgage, lease or rental agreement in which the
applicant, or the parent or spouse of the applicant, is a legally responsible
party shall be considered acceptable proof of a stable address. A person who
lives in a residence as a boarder is not considered to have a stable address
and, as such, does not meet the requirements of this section.
(iii) At least thirty (30) days prior to the actual date of a planned move, an
approved non-certified provider must submit to the Office of Child Care (OCC),
the information necessary to verify the address of, and the intent to maintain,
a new principal place of residence. The provider shall also report any changes
in household composition that occur in tandem with, or as a result of, the
change in residence.
(iv) An approved provider who makes multiple changes in the principal place of
residence during the two (2) year period of CPD status is not considered to have
a stable address.
Accordingly, CPD status of such providers is subject to review by the Office of
Child Care and possible discontinuation of certified provider status.
e) Proof that there is a working telephone accessible at all time at the
applicant's residence as verified through a current phone bill. A cell phone
number is acceptable, provided that documentation is provided showing that the
phone is attached to the provider's residence;
f) Information on the applicant, and all adult members of the applicant
household, including social security numbers and dates of birth; and
g) A CCAP Parent-Provider Enrollment Agreement for each CCAP assisted child
the provider intends to care for signed by a parent who has submitted an
application for child care assistance from DHS and is currently pending or
eligible for such assistance from the CCAP; and
h) A self-declaration specifying how many children (both CCAP assisted and
non-CCAP assisted) will be rendered services, including any related children.
Non- certified providers are limited to caring for three (3) unrelated children,
or six (6) children if an acceptable degree of relationship to the provider can
be proven. The provider's children under six (6) years of age shall be included
in the maximum number of six (6) related children.
In instances in which the eligible children are related to the provider, legal
documentation must be submitted to the CPD verifying that the provider has a
relationship of acceptable degree to the eligible child(ren). For the purposes
of the CCAP, a relationship of acceptable degree is an eligible child's aunt,
uncle, grandparent, great grandparent, great aunt, great uncle, or adult sibling
age twenty-one (21) or older. The Central Provider Directory (CPD) shall accept
as verification of the provider's relationship the legal documents specified in
Section 0806.15.05 of the RIW administrative rules. Information about the
required legal documentation shall be made available to the provider by the CPD
upon request.
iii. Be successfully screened, along with all members of the provider's
household, at the time approved status is initially requested, and at two year
intervals thereafter.
The screening process entails a background clearance performed through DCYF's
Rhode Island Children's Information System (RICHIST) Unit, and a criminal record
check (also referred to as a background criminal investigation or BCI) conducted
by the Rhode Island Attorney General's Office. To be successfully screened, the
following criteria shall be met:
(a) DCYF/RICHIST clearances. There shall be no disqualifying information,
and no record of substantiated involvement in an investigation that may result
in disqualification, as defined in the applicable DCYF policy, as amended, in
the RICHIST background clearances of the provider and members of the provider's
household. Any changes in the composition of the household must be reported
immediately.
Background checks on the entire household shall be conducted anytime there is a
change in the composition of the approved provider's household.
(b) BCI Record Check. There shall be no evidence of criminal activity in
the BCI record check of the provider and members of the provider's household.
For the purposes of this section, evidence of criminal activity is defined as a
conviction or plea of nolo contendere in any criminal matter or the fact that
the individual has outstanding or pending charges, related to any of the
following:
Types of Criminal Activity
Offenses Against the Person:
Murder
Voluntary manslaughter
Involuntary manslaughter
Kidnapping
Kidnapping with intent to extort
First-degree sexual assault
Second degree sexual assault
Third degree sexual assault
Assault by spouse
Assault with intent to commit specified felonies
Felony assault
Domestic assault
First-degree child abuse
Second-degree child abuse
Offenses Against the Family:
Incest
Child snatching
Exploitation for commercial or immoral purposes
Public Indecency:
Transportation for indecent purposes:
Harboring
Prostitution
Pandering
Deriving support or maintenance from prostitution
Circulation of obscene publications and shows
Sale or exhibition to minors of indecent publications,
pictures, or articles
Child nudity in publication
Drug offenses:
Any offense constituting a felony which is enumerated
in R. I. General Law 21-28-81.01 et seq., the Uniform
Controlled Substances Act.
(c) Office of Child Care Review. The Office of Child Care reserves the
discretion to deny approval of an application in circumstances when the evidence
in the criminal record of a member of the household indicates a pattern of
behavior that poses a risk to the safety and/or well-being of the eligible
children to receive care. Such a determination shall only be made subsequent to
a comprehensive review of the information provided through the clearances and
background checks required in this section, as well as any related official
documents pertaining to the criminal record of the applicant or household member
that may become available.
0850.03.04 Determination/Maintenance Of Provider Status
REV:09/2007
The Office of Child Care shall review a child care provider's application,
complete the screening process, where appropriate, and make a determination of
the CPD's provider status in no more than thirty (30) days from the date the
appropriate signed application form and any required documentation are date-
stamped as received by DHS.
1) CCAP Approved Status Granted. Upon determining that a child care provider
has met the general and category specific requirements, signed the CCAP Approved
Provider Agreement (APA), and completed the CCAP Approved Provider Rate Report
(APRR), DHS shall provide notification in writing of their approved status to
the provider. Upon completing the Approved Provider Introductory Training, the
provider gains access to the CCAP automated enrollment system.
2) Application Denied. Applicants who do not meet the general and category
specific requirements shall be denied CCAP approved status. The Department
shall send written notice to the child care provider indicating the reasons for
denial and providing information on how to request a hearing and appeal the
decision.
Any provider who has been denied on two occasions must wait a period of twelve
(12) months before re-applying to be a CCAP approved child care provider.
3) Application Pending. DHS shall not make payment for allowable child care
services rendered during the period while the application for approved status is
pending.
However, if approved status is granted, the provider will be reimbursed for such
services at the DHS Authorized Payment Rate, in accordance with section
0850.04.02, but only after an Approved Provider Agreement has been signed and
the Approved Provider Introductory Training has been completed.
4) Approved Status Discontinued. The Department shall reserve the right to
remove a child care provider from the CPD and discontinue approved status in
CCAP upon obtaining evidence that the provider has met any of the criteria
outlined in these rules. Notice of Discontinuation of CCAP approved status
shall be sent to the provider and include the reasons for the discontinuation
and information on how to appeal DHS's decision.
DHS shall also notify the families of any eligible children affected by
discontinuation of the provider's approved status.
The grounds for discontinuation of approved provider status and termination of
the provider agreement are specified in Section F of this subrule.
5) Renewal. All CCAP approved providers, are listed in the CPD.
Non-Certified Providers are listed in the CPD for two (2) years (as long as they
continue to provide child care for a CCAP pending or eligible child) and
Licensed/Certified Providers for a period of five (5) years. After this period
of time, a provider must be re-approved and present appropriate documentation to
the CPD to remain active. Notice shall be sent to approved providers indicating
the dates and requirements for renewal of CPD status at least thirty (30) days
prior to the end date of their period of approval.
0850.03.06 DHS-CCAP Approved Provider Agreement
REV:08/2008
All CPD approved child care providers shall sign an agreement with DHS that
establishes the respective responsibilities and obligations of both the
department and the provider and the grounds for discontinuation of approval as
specified in this subsection. The signature on the agreement with DHS shall be
notarized or witnessed by a member of the staff of the OCC. No payment shall be
made for allowable child care expenses until the department receives an original
copy of the DHS-CCAP Approved Provider Agreement, signed and dated by the child
care provider.
(1) Terms and Conditions for Payment.
Based on section 0850.04.02 of these rules, the department
shall determine the DHS Authorized Payment Rate for each
eligible child enrolled. The department shall also
determine the method that approved providers shall use to
request and receive payment for allowable child care
expenses.
(2) Termination of the Provider Agreement and Discontinuation
of Approved Status.
In certain circumstances, the department may determine
that an approved provider is no longer qualified to
provide authorized CCAP services and, as a result,
approved status shall be discontinued. In such case, the
department shall cease payment for any CCAP services
rendered by the provider, access to the DHS CCAP
automated enrollment system is denied, and any health care
assistance is terminated.
a. Grounds for Discontinuation. The department reserves
the right to discontinue DHS approved status for
providers for any of the following reasons:
i. Failing to meet the terms and conditions established
in the DHS-CCAP Approved Provider Agreement;
ii. Engaging in fraudulent or other unlawful acts:
in obtaining or seeking to obtain CCAP approved
status;
in providing or receiving payment for CCAP;
in utilizing the CCAP automated enrollment system;
iii. Knowingly providing false information
to obtain benefits from any DHS program or any other
federally funded program; in not reporting CCAP
income when applying for a federally funded
program; or in committing tax fraud;
iv. Failing to maintain DCYF licensure or certification
or otherwise failing to comply with DCYF regulations
or the standards and regulations established by
another federal or State government entity applicable
to the setting in which the child care is provided;
v. Failing to protect the confidentiality of
information related to CCAP
beneficiaries; or
vi. Endangering, or failing to ensure, the health or
safety of any child in the
provider's care;
vii. Failing to report criminal convictions or the
imposition of civil penalties.
An approved provider shall report to DHS any
criminal conviction or civil penalties imposed for
such acts on: the provider, an employee of the
provider engaged directly in the provision of child
care; or, if a non-certified provider, an adult
member of the provider's household. Failure to
make such reports within ten (10) days from the date
the conviction/penalty is imposed shall be grounds
for discontinuation of approved status;
viii. Failing to report any changes in their provider
status, living arrangements, addition of new
household members, or other vital information to the
OCC within ten (10) days of the change;
ix. Caring for more children than allowed under this
rule or applicable state laws and regulations;
x. Caring for a child who lives in the same household
as the provider;
xi. Failing to attend CCAP Approved Provider
Introductory Training;
xii. Failing to provide DHS with a completed CCAP APRR
when requested;
xiii. Providing inaccurate or misleading information in
the CCAP APRR for the purposes of altering the
amount of the DHS authorized payment rate; or
xiv. Refusing or failing to cooperate with DHS personnel
conducting audits, reviews, or evaluations related
to the proper and efficient operation of
the CCAP or compliance with the rules set forth
herein or terms and conditions of the provider
agreement; or
xv. For legal Non-certified providers- ceasing to
provide child care services to CCAP pending or
eligible children.
b. Corrective Action Option. The department reserves the
right to offer a CCAP approved provider subject to
discontinuation the opportunity to take corrective
action prior to the effective date of discontinuation
of approved provider status and termination of the
provider agreement.
In such cases, the OCC shall send a notice to the
approved provider that shall clearly state the type of
corrective action required, the date it is to be
completed, and the method for evaluating whether the
deficiency has been corrected.
Corrective actions shall be permitted in only those
cases in which the department determines that the
health, safety and welfare of eligible children
and the fundamental purposes of the CCAP will not be
jeopardized while the remedy is being implemented.
(3) CPD Confidentiality. Both the CPD and web enrollment
raise certain confidentiality issues that have been
addressed by the department as follows:
a. Confidentiality Statement. Approved providers and the
families of eligible children shall be notified at the
time of application that, as CPD providers and
CCAP beneficiaries, certain personal information may be
accessed on the DHS web site by department personnel,
approved providers and contracted agents of DHS.
A confidentiality statement shall be signed by both
providers and parents, prior to participating in the
CCAP, indicating that they are aware of, and
understand, the limits on confidentiality associated
with the methods DHS employs to gather and disseminate
information through the CCAP automated enrollment
system and the purposes for such information, as well
as how that information will be accessed and used.
b. Technological Protections. DHS shall utilize the most
advanced technological methods available to ensure the
confidentiality of information contained in the
CPD and through web enrollment pertaining to CCAP
beneficiaries and approved providers.
0850.04 CCAP PAYMENT TO APPROVED PROVIDERS
REV:08/2004
To ensure that payment for CCAP authorized child care expenses is made in the
most timely and efficient manner possible, the department has established
requirements related to attendance and the payment of allowable child care
expenses for CCAP authorized child care services.
0850.04.01 CCAP Attendance
REV:08/2004
Payment shall only be made for CCAP authorized child care services during
periods in which the approved provider is open or available to provide services.
To determine the allowable child care expense, certain information related to
attendance is required by DHS, as follows:
1) Attendance Reports. An approved provider shall:
a) Submit accurate attendance reports to DHS for each eligible child in the
manner, and for the time periods, prescribed by in the DHS-CCAP Approved
Provider Agreement; and
b) Maintain signed, daily attendance records for each eligible child, on-
site, for a minimum of three (3) years.
2) Allowed Absences. When a child is enrolled with a licensed or certified
provider, DHS shall make payment for up to two (2) weeks of CCAP authorized
child care services during which an eligible child is absent and the parent
authorizes payment. Documentation of the parent's authorization must be
attached to the attendance report for the period in which the absence occurred.
No payment shall be made for periods of CCAP authorized services when the
eligible child is not in attendance once the two (2) week limit has been
reached, without the approval of department.
3) Conditions of Care. Presence at the Care Site - During periods when eligible
children are receiving services, the provider or an approved substitute
caregiver must be present at all times. For legal non-certified providers, the
approved substitute caregiver must be listed on the provider's current
application for CCAP Approval. For licensed and certified providers, substitute
caregivers must be approved by DCYF. In no case should the approved provider
listed on the application be absent for more than three (3) hours in any one (1)
week period.
4) Other Employment. If a provider has other employment, the total hours the
provider is permitted to work and maintain CPD status, is sixteen (16) hours in
a twenty-four (24) hour period. The sixteen (16) hour work limit applies to all
forms of employment combined, including the hours spent providing CCAP services
as well as while working at any other job(s) or traveling to and from other
employment.
5) Minimum Attendance. For CCAP payment to be made, an eligible child enrolled
with an approved licensed or certified provider shall attend at least some
portion of their CCAP authorized enrollment each week --e.g., part of scheduled
day. Non-certified providers receive DHS payment only for services rendered.
No payment is made to non- certified providers when an eligible child is not
receiving care.
0850.04.02 CCAP Payments
REV:08/2004
When making payment for allowable child care expenses, the following shall
apply:
(1)DHS Authorized Payment Rate for Providers. The process for determining the
DHS authorized payment rate is as follows:
a. Licensed and Certified Approved Providers. The DHS authorized payment rate
shall be the actual rate the CCAP approved provider charges for child care
services as reported in the APRR, up to, but not to exceed the DHS established
payment rate as set forth in these rules. The rate reported by each provider on
their APRR shall be equivalent to the lowest actual rate charged for services
delivered to any family by that provider. If a provider offers non-CCAP
financial assistance of any type to non-CCAP assisted families, the provider
shall be required to substantiate that every child is supported by a combination
of funding that equals the same rate reported to DHS on the APRR. The provider
shall also identify the source of funds that support that assistance.
b. Non-certified Approved Providers. The DHS authorized payment rate shall be
the CCAP Established Payment Rate as set forth in the tables in Section 0850.05.
(2) Changes in Licensed and Certified Provider Rates. All licensed and
certified providers shall report any changes in the actual rates they charge to
non-CCAP assisted families as reported on the APRR. Reductions in rates must be
reported at least thirty (30) days before the change takes place. If a provider
reports a reduction in rates, the reduced rates shall be entered into the CPD
effective on the date that the change took place. Increases in rates shall be
reported at least sixty (60) days before the change takes place. If a provider
reports an increase in rates, the increased rates shall be entered into the CPD
with an effective date in either June, at the start of the summer camp season,
or in September at the start of the school year, whichever comes first after the
effective date of the reported change. The department will limit rate increases
for any provider in the CPD to no more than once in any twelve (12) month period
and all such changes shall take effect in CCAP in either June or September. In
absence of submission of a new APRR, the provider's actual rate charged shall be
considered that which is currently entered in the CPD. Every five (5) years,
when licensed and certified providers renew their approval status in the CCAP, a
new APRR shall be collected and entered into the CPD.
(3) Payment Payment of allowable child care expenses for CCAP authorized
services shall be made at the DHS Authorized Payment Rate. The terms and
conditions for payment of CCAP services are established in the DHS APA in
accordance with the requirements of this rule.
(4) Billing Periods. An approved provider shall request payment for allowable
child care expenses in the twelve (12) month period that begins on the date the
authorized services were rendered. In no case shall DHS make payment for any
child care services rendered more than one (1) year prior to the date the
approved provider requests payment.
(5) Restrictions and Limitations.
a. There shall be no more than one (1) CCAP approved provider eligible to
receive payment from DHS for allowable child care expenses rendered at a
specific site or location at any one time. In the case of non-certified child
care providers, no more than one (1) person living in the household where CCAP
child care services are provided shall be permitted to obtain or retain active
Approved status@ at any one time.
b. Approved providers shall not be paid for child care services rendered to
children who live in their households.
0850.04.03 Periodic Provider Audits
REV:08/2004
DHS reserves the right to conduct periodic audits of provider records and
investigations of provider operations relevant to provider approval, rate
reporting, attendance reporting, and accepting payments from CCAP. At the time
an audit or investigation is conducted, designated representatives of the
Department will review attendance and payment records of all children currently
enrolled and receiving child care services and all children enrolled and
receiving services during the two (2) years prior to the audit or visit.
0850.05 CCAP ELIGIBLITY AND COST-SHARING LEVELS
REV:03/2009
CCAP ELIGIBILITY AND COST-SHARING LEVELS
BY GROSS INCOME ADJUSTED FOR FAMILY SIZE
Level Standard % Gross Countable Family Family
Income Applied as Size Size
Co-payment 2 3
0 < 100% FPL 0 Up to Up to
$14,570 $18,310
1 >100% FPL - $14,571 $18,311 -
125% FPL 2% 18,213 22,888
2 >125% FPL - $18,214 $22,890 -
150% FPL 5% 21,855 27,465
3 >150% FPL - $21,856 $27,466 -
180% FPL 8% 26,226 32,958
CCAP ELIGIBILITY AND COST-SHARING LEVELS
BY GROSS INCOME ADJUSTED FOR FAMILY SIZE
Level Standard % Gross Countable Family Family
Income Applied as Size Size
Co-payment 4 5
0 < 100% FPL 0 Up to Up to
$22,050 $25,790
1 >100% FPL - $22,051 $25,791 -
125% FPL 2% 27,563 32,238
2 >125% FPL - $27,564 $32,239 -
150% FPL 5% 33,075 38,685
3 >150% FPL - $33,076 $38,686 -
180% FPL 8% 39,690 46,422
CCAP ELIGIBILITY AND COST-SHARING LEVELS
BY GROSS INCOME ADJUSTED FOR FAMILY SIZE
Level Standard % Gross Countable Family Family
Income Applied as Size Size
Co-payment 6 7
0 < 100% FPL 0 Up to Up to
$29,530 $33,270
1 >100% FPL - $29,531 $33,271 -
125% FPL 2% 36,913 41,588
2 >125% FPL - $36,914 $41,589 -
150% FPL 5% 44,295 49,905
3 >150% FPL - $44,296 $49,906 -
180% FPL 8% 53,154 59,886
CCAP ELIGIBILITY AND COST-SHARING LEVELS
BY GROSS INCOME ADJUSTED FOR FAMILY SIZE
Level Standard % Gross Countable Family Family
Income Applied as Size Size
Co-payment 8 9
0 < 100% FPL 0 Up to Up to
$37,010 $40,750
1 >100% FPL - $37,011 $40,751 -
125% FPL 2% 46,263 50,938
2 >125% FPL - $46,264 $50,004 -
150% FPL 5% 55,515 61,125
3 >150% FPL - $55,516 $59,256 -
180% FPL 8% 66,618 73,350
CCAP ELIGIBILITY AND COST-SHARING LEVELS
BY GROSS INCOME ADJUSTED FOR FAMILY SIZE
Level Standard % Gross Countable Family Family
Income Applied as Size Size
Co-payment 10 11
0 < 100% FPL 0 Up to Up to
$44,490 $48,230
1 >100% FPL - $44,491 $48,231 -
125% FPL 5% 55,613 60,288
2 >125% FPL - $53,744 $57,484 -
150% FPL 5% 66,735 72,345
3 >150% FPL - $62,996 $66,736 -
180% FPL 8% 80,082 86,814
CCAP ELIGIBILITY AND COST-SHARING LEVELS
BY GROSS INCOME ADJUSTED FOR FAMILY SIZE
Level Standard % Gross Countable Family Family
Income Applied as Size Size
Co-payment 12 13
0 <100% FPL 0 Up to Up to
$51,970 $55,710
1 >100% FPL - $51,971 $55,711 -
125% FPL 2% 64,963 69,638
2 >125% FPL - $61,224 $64,964 -
150% FPL 5% 77,955 83,565
3 >150% FPL - $70,476 $74,216 -
180% FPL 8% 93,546 100,278
CCAP ELIGIBILITY AND COST-SHARING LEVELS
BY GROSS INCOME ADJUSTED FOR FAMILY SIZE
Level Standard % Gross Countable Family Family
Income Applied as Size Size
Co-payment 14 15
0 < 100% FPL 0 Up to Up to
$59,450 $63,190
1 >100% FPL - $59,451 $63,191 -
125% FPL 2% 74,313 78,988
2 >125% FPL - $68,704 $72,444 -
150% FPL 5% 89,175 94,785
3 >150% FPL - $ 77,956 $ 81,696 -
180% FPL 8% 107,010 113,742
Note: The percent of income assigned at each level is applied against the gross
countable family income calculated in determining eligibility for each family.
The system divides that percent of income by fifty-two (52) weeks to assign the
family share the family is expected to pay each week. The family share is
assigned to the eligible child who receives authorized services paid at the
highest rate (generally the youngest child). DHS subtracts the assigned family
share from the full rate for that child when making payment to a provider.
If the family share exceeds the rate paid for one child, the remainder of the
family's share is assigned to the next oldest child enrolled.
If family income or family size changes, the family share is re- calculated.
The family is expected to make the same weekly family share payment to the
designated provider regardless of the number of children or the amount of time
the children are enrolled.
0850.10 CCAP APPROVED PROVIDER RATES
REV:07/2008
CCAP APPROVED PROVIDER RATES
R.I. DEPARTMENT OF CHILDREN. YOUTH AND FAMILIES (DCYF)
REGULATED PROVIDERS
INFANT/TODDLER Care
Children 1 Week up to 3 Years of Age
Time Authorized Full Time Three Half Time Quarter Time & Enrolled
(FT) Quarter (HT) (QT)
Time(3QT)
Provider Type: DCYF Licensed $188 $141 $94 $47 Centers
DCYF Certified $155 $116 $77 $38 Family Child Care
Homes
PRESCHOOL Care
Children 3 Years up to Entry into 1st Grade
Time Authorized Full Time Three Half Time Quarter Time & Enrolled
(FT) Quarter (HT) (QT)
Time(3QT) Provider Type:
DCYF Licensed $157 $118 $78 $39 Centers
DCYF Certified $150 $112 $75 $37 Family Child Care
Homes
SCHOOL AGE Care
Children 1st Grade up to 13 Years of Age
YOUTHCare
Time Authorized Full Time Three Half Time Quarter Time & Enrolled
(FT) Quarter (HT) (QT)
Time (3QT)
Provider Type: DCYF Licensed $142 $106 $71 $35 Centers
DCYF Certified $142 $106 $71 $35 Family Child Care Homes
LEGAL NON-CERTIFIED PROVIDERS
INFANT/TODDLER Care
Children 1 Week up to 3 Years of Age
Time Authorized Full Time Three Half Time Quarter Time & Enrolled
(FT) Quarter (HT) (QT)
Time(3QT)
Care Type:
Non-Certified (NC) in Provider's Home $81 $60 $40 $20
Non-Certified (NC) in Child's Home $74 $55 $37 $18
PRESCHOOL Care
Children 3 years up to entry into 1st Grade
Time Authorized Full Time Three Half Time Quarter Time & Enrolled
(FT) Quarter (HT) (QT)
Time (3QT)
Provider Type: Non-Certified (NC) $54 $40 $27 $13 In
Provider's Home
Non-Certified (NC) in Child's Home $50 $37 $25 $12
SCHOOL AGE Care
Children 1st grade up to 13 years of age
Authorized Full Time Three Half Time Quarter Time & Enrolled
(FT) Quarter (HT) (QT)
Time (3QT)
Provider Type:
Non-Certified (NC) In Provider's Home $53 $39 $26 $13
Non-Certified (NC) $49 $36 $24 $12 in Child's Home
Summer Camps (SC) $43 These programs approved ONLY for
FT care for School Age children
during ten weeks of summer
vacation. Other rate categories
do not apply.
0850.11 CHILD CARE IMPROPER PAYMENTS
REV:08/2008
A client improper payment occurs when the child care benefit paid exceeds the
benefit that would have been issued if the payment were calculated correctly
based on accurate information that was reported , verified, and acted on in a
timely manner. A provider based improper payment occurs when a provider receives
a duplicate benefit or receives payments for services not received.
The cause of each improper payment shall be classified as agency, client or
provider caused. Client and provider caused improper payments shall be further
classified as unintentional household errors or intentional fraud violations.
Agency child care improper payments:
An improper payment shall be classified as an agency
error if the error was caused solely by actions taken by
the department or department staff. Agency errors shall
include, but not be limited to the following types of
errors:
A. errors caused by delays in processing applications
or taking prompt action on changes that were
reported timely;
B. errors in determining eligibility, the benefit
amount or the payment authorization period;
C. data entry errors;
D. errors caused by the incorrect application of state
regulations, policy or procedures; and
Improper payments caused by clients and providers:
Improper payments that are not due to agency error shall
be classified as client or provider caused. The error
shall be classified as both client and provider caused if
the client and the provider both had knowledge and
actively participated in the action that caused the
improper payment to occur.
A. Client error: Improper payments caused by the
client shall include, but not be limited to errors
caused by reporting false or inaccurate information,
and/or delays in reporting changes in household
income, resources, circumstances or provider
arrangements.
B. Provider error: Improper payments caused by the
provider shall include, but not be limited to the
following types of errors:
1. inaccurate reporting of information concerning
licensing status, age or other provider
eligibility requirements;
2. inaccurate reporting of the provider's
relationship to the child or the location at
which care is given;
3. inaccurate reporting of household circumstances;
4. committing an illegal act, such as cashing a
replacement check after falsely claiming that the
original check was lost, stolen or destroyed;
5. inaccurate reporting of actual charges, attendance
or dates of service; and
6. any other false claim for services provided.
Intentional and unintentional household errors:
The CCR/Fraud Unit shall make a preliminary determination of
whether the improper payment was intentional or an
unintentional household error pursuant to guidelines below.
Improper payments shall be classified as intentional if the
client or provider knowingly withheld or provided false
information on matters affecting eligibility, benefits or a
claim for services. An improper payment shall be considered
unintentional household error under the following
circumstances:
A. there was clearly no intent to commit fraud or to obtain
benefits or payments under false pretenses;
B. the client or provider did not purposefully withhold or
provide erroneous information;
C. illness, a family emergency, or any other good-cause
reason exists for not reporting information timely or
accurately; or
D. the error was due to a delay in taking action as the
result of an administrative hearing request.
If a question of Intentional Fraud Violation exists, the case
may be referred by the CCR/Fraud Unit to the DHS Office of
Legal Services and/or to the Office of the Attorney General of
Rhode Island for civil and/or criminal action, or for an
Intentional Fraud Violation hearing.
Recovery:
Below are the procedures for recovery:
* Enable a repayment in full settlement (a lump-sum
repayment);
* Enable a repayment agreement between the CCR/Fraud Unit and
the child care recipient, using the "Notice of Child Care
Overpayment";
* Enable a repayment agreement between the CCR/Fraud Unit and
the child care provider when there is no requirement for an
adjustment by the Department's Financial Office; and
* May be used to refer cases to the DHS Office of Legal
Services and/or Office of the Attorney General of Rhode
Island for civil and/or criminal action, or for an
Intentional Fraud Violation hearing.
When a child care improper payment is to be recovered from the
recipient, the recipient shall be given notice of that
determination using the "Notice of Child Care Overpayment."
The notice shall include an explanation of the improper
payment determination, including the following:
1. The amount and period of the improper payment;
2. The reasons for the improper payment;
3. The regulations supporting the improper payment
determination;
4. An explanation of the available methods of repayment;
5. The recipient's right to appeal; and
6. A telephone number to call for information about free
legal services.
Consequences for failure to repay:
Failure of the child care provider to repay a child care
improper payment made by the DHS CCAP and not subject to
adjustment by the Department's Financial Office because of
provider error, provider fraud, or agency error, shall result
in the termination/revocation of the "DHS-CCAP Approved
Provider Agreement" and disenrollment from the CPD. Denial
for certification shall continue until further notification.
An appeal may be taken from the denial in accordance with
policy Section 0110.
When a licensed child care facility has pled guilty to, has been determined to
have committed fraud, or has been convicted of fraud, the Department shall
notify the DCYF Child Care licensing section in writing of any findings of
fraud. Notification is to be made by the Hearing Officer if fraud is found in a
hearing, or to be made by the FRED/FRAUD Supervisor, if found by that unit.
The DHS shall retain any improper payment it recovers and shall use the funds
for the provision of child care services.
Improper payments that are recovered shall be reported to the Agency Director
and the Program Administrator.