Transcript Policy & Regulatory Training

Policy &
Regulatory
Training
LOW INCOME
Table of Contents
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Goals (p. 9)
Important Terms (p. 10)
Handbook (p. 11)
Provision of Subsidy (p. 12)
 Examples (p. 13)
 Foster Children (p. 14)
 Option 1 (p. 15)
 Option 2 (p. 18)
Subsidy Benefits (p. 20)
 24-hour Care (p. 21)
Subsidy Limitations (p. 22)
Eligibility Determination
 Initial Determination (p. 23)
 PELICAN: Child Care Program (p. 24)
 PELICAN: Leave End Dates (p. 25)
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Table of Contents
Effective Dates (p. 26)
 Waiting List (p. 27)
 Example 1: No Waiting List (p. 28)
 Example 2: Waiting List (p. 29)
 Initial Application (p. 30)
 Prospective Work (p. 31)
 Redetermination: Low-Income (p. 32)
 Period of Eligibility (p. 33)
Signatures
 Application (p. 34)
 Release of Information (p. 35)
 Option 1 (p. 36)
 Option 2 (p. 37)
 HIPPA form (p. 38)
Family Definitions
 Family (p. 39)
 Caretaker (p. 40)
 Parent (p. 41)
Income (p. 42)
Family Size (p. 43)
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Table of Contents
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Work Requirement
 Definitions(p. 44)
 Requirements (p. 45)
 Temporary Exemptions (p. 46)
 Loss of Work/Training (p. 47)
Education/Training
 Education Definition (p. 48)
 Teen Parent Loss of Education (p. 49)
 Training Definition (p. 50)
 U.S. Dep’t of Education (p. 51)
 Accreditation Determination Steps (p. 52)
Prospective Work/Education/Training
 Definition (p. 53)
Determining Hours of Care
 Employment (p. 54)
 Self-employment (p. 55)
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Table of Contents
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Disability
 Definition (p. 56)
 Eligibility Criteria (p. 57)
 Eligibility Determination (p. 58)
 Partial Disability
 Single p/c (p. 59)
 2 p/c family (p. 60)
Child Support (p. 61)
Domestic and other Violence
 Definition (p. 62)
Verification/Self-Certification/Self-Declaration
 Definitions (p. 63)
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Table of Contents
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Co-payment Stabilization (p. 64)
 Adjusting Co-payment
 Maternity Leave (p. 65)
 Disability Leave (p. 66)
 Involuntary Loss of Work (p. 67)
 Prospective Work at Application (p. 68)
 Examples (p. 69)
 Prospective Work for Recipient (p. 71)
 Examples (p. 73)
Delinquent Co-payment (p. 75)
 Examples
 Co-payment Resolved (p. 76)
 Co-payment Unresolved (p. 77)
 Disqualification (p. 78)
Co-payment Exceeds Cost of Care (p. 79)
Face-to-Face (p. 80)
 Extension (p. 82)
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Table of Contents
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Report of Change (p. 83)
 Partial Redetermination (p. 84)
 CCIS Responsibilities (p. 85)
Redetermination (p. 86)
 Low-Income (p. 87)
 Waiting List (p. 88)
 Maternity/Disability Leave (p. 89)
Payment of Provider Charges (p. 90)
 Examples (p. 91)
 Nonstandard, Non-repeating Schedule
(p. 93)
 10- Day Notice (p. 94)
 10 Days of Absence (p. 95)
 Examples of 10-Day Notice versus 10 Days of
Absence (p. 96)
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Table of Contents
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Absence (p. 100)
Subsidy Continuation (p. 101)
Subsidy Suspension (p. 102)
 Continuation versus Suspension (p. 103)
 Examples
 Maternity Leave (p. 104)
 Regularly Scheduled Breaks (p. 105)
Case Notes within PELICAN (p. 106)
Record Retention (p. 107)
Child Abuse Reporting (p. 108)
Head Start
 Provisions (p. 109)
 Co-payment (p. 111)
 P/C Responsibilities (p. 112)
 Program Ending within PELICAN (p. 113)
Prekindergarten (p. 114)
 Eligibility Criteria (p. 115)
 Provisions (p. 116)
 CCIS Responsibilities (p. 117)
 P/C Responsibilities (p. 118)
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Goals
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Helping families obtain affordable,
accessible and quality child care.
Developing a “user-friendly” child
care system.
Reducing barriers to child care.
Promoting healthy child
development.
Promoting family self-sufficiency.
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Important Terms
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Notice period
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PELICAN
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Refers to the 10-day period that applies to
ALL notices (not just the AA).
Previously referred to as the “AA period”.
Within PELICAN, the period is really 13
days. PELICAN allows 3 additional days for
central mailing.
Pennsylvania’s Enterprise to Link
Information for Children Across Networks
Override
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A process within PELICAN to change
results as mandated by policy or regulation.
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Handbook
§ 3041.106(f)
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Provided by the Department.
The eligibility agency will give each
p/c who applies for subsidized
child care, a handbook of
rights/responsibilities in the
subsidized child care program.
Includes an explanation of the
relationship between the FPIG and
income eligibility.
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Provision of Subsidy
§3041.12
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Subsidy is available to an
otherwise eligible child who is
under 13.
Subsidy is available to an
otherwise eligible child who is 13
or older but under 19 and has an
injury or other impairment.
Incapability of caring for self
includes:
 Physical disability.
 Developmental delay/age.
 Behavioral disability.
See the following examples.
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Examples
1.
A family applies for subsidy. The
family consists of:
Mother

15 year old daughter with a cerebral
palsy
This family is eligible.
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2. A family is receiving subsidy. The
family consists of:
Mother
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12 year old daughter with a
developmental delay turning 13
This family continues to be eligible.
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Foster Children
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Foster children should receive continued care
as long as the new foster parents meet the
nonfinancial eligibility requirements (ex: both
foster parents work at least 20 hours per week,
etc.).
Offering continued child care to a foster child
provides support to a child who is experiencing
many changes; removing the child from a
known, stable child care setting could cause
further emotional trauma to the child. Even if
the child cannot continue at the same
provider, the structured environment of a child
care setting may be beneficial to the child.
Requests for continuation of subsidy
in other custody transfer situations
must be directed to the subsidy
coordinator.
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Moving a foster child with
active enrollments to
a new case: OPTION 1
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When other children in the family
continue to receive subsidized
child care, or when the transfer to
a new caretaker requires a change
in the CCIS that is serving the
child, the CCIS must create a
new case.
See the following slide for
directions regarding this option.
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PELICAN Actions required
to complete OPTION 1
Create the new case, if necessary and
add the child to the Case on the
Individual Information Detail page
and click Save.
2. Verify MCI results & click Save.
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Note: Since the child is already in
PELICAN, select the radio button
next to the correct name.
3. Update the Relationships Detail page
and click Save.
4. Update the Care Request page and
click Save.
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Note: You must select the Joint
Custody checkbox and add the date
the child moved into the new foster
home while the child is still active in
the original foster home case.
1.
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PELICAN Actions required to
complete OPTION 1 (cont’d)
Assess and Confirm Eligibility.
Enter Enrollments for the child.
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Note: If the child is still active in another
case, the child will appear on the waiting
list with their Eligibility Date from the
original case. When necessary, contact
Headquarters to authorize the child from
the waiting list.
7. Delete the child and discontinue their
enrollment (s) from the original case.
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Note: If the case is owned by another
office, contact that office to discontinue
enrollments and delete the child.
8. Go to the Care Request page in the new case
and clear the Joint Custody checkbox and
reset the date the child Moved Into Joint
Custody by changing it to select.
5.
6.
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Moving a foster child with
active enrollments to
a new case: OPTION 2
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When one foster child is
receiving subsidy in the foster
family and that child transfers
to another family, the CCIS
must keep the case open
and change the primary
caretaker.
See the following slide for
directions regarding this
option.
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PELICAN Actions required
to complete OPTION 2
1.
2.
3.
4.
5.
6.
7.
Add the new Parent Caretaker on the
Individual Information Detail page and click
Save.
Verify MCI results & click Save.
Move the Primary Caretaker radio button on
the Individual Information Detail page to the
new individual and click Save.
Update the Relationships Detail page and
click Save.
Go to the Individual Information Detail page
again and delete the parent and click Save.
Add any Eligibility Information for the new
Parent/Caretaker (i.e. Employment).
Assess and Confirm Eligibility.

Note: Also update the address, contact
information, enrollments, etc. as
necessary.
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Subsidy Benefits
§3041.14

A subsidy-eligible family may receive
child care during the hours the p/c
needs care including:
 Hours p/c attends work, education or
training.
 Travel between the p/c’s work,
education or training and the
child care facility.
 Uninterrupted sleep time when the
work shift ends between the hours of
12 a.m. and 9 a.m.
 THIS BENEFIT APPLIES TO
Low Income, TANF and
Former TANF families.
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Care for more than a
24-hour period
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IN CERTAIN CIRCUMSTANCES,
CHILD CARE MAY BE PROVIDED
FOR MORE THAN A 24-HOUR
PERIOD.
 48-hour shifts, including but not
limited to:
 Nursing Homes
 Hospitals
 Group Homes
When continuous care is needed for
more than 48 hours, the CCIS must
contact the Subsidy Coordinator.
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Subsidy Limitations
§3041.16
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A p/c must select an eligible provider and
enroll the child within 30 calendar days
following the date the CCIS notifies the p/c
that funding is available or that the family’s
current provider is ineligible to participate in
the subsidized child care program.
If a p/c does not select an eligible provider and
enroll the child within 30 days, the child is
ineligible for subsidized child care.
On day 17, the CCIS will receive an alert that
the p/c has not yet chosen a provider. Upon
receipt of the alert, the CCIS must contact the
p/c to determine if the p/c needs help finding
an eligible provider and remind the p/c of the
date the child must be enrolled in order to
maintain eligibility.
On day 31, the CCIS must send the Adverse
Action Notice if the child is not enrolled with
an eligible provider.
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Initial determination
of eligibility
§3041.122
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When the CCIS has received all
information/verification necessary
to complete the application, the
CCIS must determine a family
eligible retroactive to the date
the CCIS received/date
stamped the application.
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PELICAN:
Child Care Program
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Defined as the eligibility
rules the family must
follow.
Types of Child Care
Programs:
Former TANF
 Low-Income
 Head Start/Prekindergarten
 TANF
 Food Stamp (SNAP)
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PELICAN:
Maternity & Disability
Leave End Dates
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The CCIS must enter end dates
whenever a p/c’s disability or
maternity leave ends.
PELICAN will not recognize
employment information if the
end date is not populated in
these circumstances.
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Effective date of coverage
(Low-income) §3041.123
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When the CCIS determines the
family eligible and if funding is
available, payment of child care costs
is retroactive to the date the CCIS
received/date-stamped the
application.
If the CCIS places the child on the
waiting list following the
determination of eligibility, payment
of child care costs begins on the date
funding is available.
See the following examples.
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Waiting List
§3041.133
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If funds are not available to enroll a child
following the determination of the family’s
eligibility for subsidy, the CCIS must place an
eligible child on a waiting list on a first-come,
first-served basis. Placement on the waiting list
must be determined by the date and time
eligibility for the child was determined.
If a p/c requests subsidy for an additional child
following the date the family was initially
determined eligible for subsidy, the additional
child must be placed on the waiting list
according to the date and time that the p/c
requests care for the additional child.
A p/c must select an eligible provider and enroll
the child no later than 30 calendar days
following the date the CCIS notifies the p/c that
funding is available.
When a p/c does not select an eligible provider
and enroll the child within 30 days, the child is
ineligible for subsidized child care. On day 31,
the CCIS must send an Adverse Action Notice
and must remove the child from the waiting list.
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Effective Date of
Coverage/Waiting List:
EXAMPLE 1
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Application Date-Stamp = 3/1
Date last piece of
verification/documentation received/datestamped = 3/15
Date processed/eligibility determined =
3/30
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Eligibility Date = 3/1 NOT 3/15
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Waiting List Date = 3/1 NOT 3/15
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Date Funds are Available = 6/18
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Earliest Effective Date of Child Care
Payment = 6/18 NOT 3/1
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Effective Date of
Coverage/NO Waiting List:
EXAMPLE 2
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Application Date-Stamp = 3/1
Date last piece of
verification/documentation
received/date-stamped = 3/15
Date processed/eligibility
determined = 3/30
Eligibility Date = 3/1 NOT 3/15
Earliest Effective Date of Child
Care Payment = 3/1 NOT 3/15
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Effective Dates:
Initial Application

The CCIS must assess eligibility when
the CCIS receives the required
verification through written
documentation, collateral contact or
written self-declaration. Effective dates
are determined as follows:
 Eligibility Date = Date application is
received/date stamped.
 Waiting List Date = Eligibility date.
 Enrollment Date = Eligibility date or
Date Funds become Available.
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Effective Dates:
Initial Application/
Prospective Work

The CCIS must assess eligibility when
the CCIS receives the required
verification through written
documentation, collateral contact or
written self-declaration. Effective
dates are determined as follows:
 Eligibility Date = Date application
is received/date stamped.
 Waiting List Date = Eligibility
date.
 Enrollment Date = Date p/c begins
work or Date Funds become
Available.
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Effective Dates:
Redetermination/
Low-Income
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The CCIS must assess
eligibility when the CCIS
receives the required
verification through written
documentation, collateral
contact or written
self-declaration.
PELICAN will set the next
redetermination date 183 days
from the date eligibility is
assessed.
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Period of eligibility
§3041.125
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A family receiving subsidy
remains eligible until
determined ineligible.
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Signatures:
Application
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The application does not need to be
signed in order for the CCIS to begin the
process of determining eligibility.
If the p/c submits an application with no
signature, the CCIS must do one of the
following:
1. Interview SCHEDULED within the
30-day application period
 Have the p/c sign the application at
the face-to-face interview.
2. Interview NOT SCHEDULED within
the 30-day application period
 Mail or fax the application to the p/c
for signature along with a Missing
Verification Letter.
If the CCIS is unable to obtain the
signature within 30 days, the CCIS should
determine the family ineligible.
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Signatures:
Release of Information
§3041.61(e)&(f)
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The p/c must sign the Release of
Information form during the
application process.
The Release of Information form will
remain in effect for as long as the
family receives uninterrupted subsidy.
The CCIS must retain the signed
consent in the family’s file.
If the CCIS is unable to obtain the
signature within 30 days, the CCIS
should determine the family ineligible.
See the following options for obtaining
a missing signature on the Release of
Information form.
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Signatures:
Release of Information
Option #1
 Interview SCHEDULED w/in
30 days
 The p/c must sign the
Release of Information form
at the face-to-face interview if
the interview is scheduled to
occur within the 30-day
application period.
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Signatures:
Release of Information
Option #2
 Interview NOT SCHEDULED
w/in 30 days
 If the p/c is not scheduled for
a face-to-face interview, the
CCIS must mail or fax the
Release of Information form
to the p/c for signature. The
CCIS can send a copy of the
Release of Information form
to the p/c along with a
Missing Information Letter.
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Signatures:
HIPPA form
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A signed HIPPA form is not an
eligibility requirement.
The CCIS must request the p/c
to sign a HIPPA form.
If the p/c refuses to sign the
HIPPA form, the CCIS must
make note on the form and
place it in the family file.
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Family: Definition §3041.3
The child for whom subsidy is requested and
the following individuals who live with that
child in the same household:
 Parent of the child.
 Caretaker and caretaker’s spouse.
 Biological, adoptive, foster child or stepchild
of the p/c who is under 18 and not
emancipated by marriage or by the court.
 Unrelated child under the care and control
of p/c who is under 18 and not emancipated
by marriage or by the court.
 Child 18 or older but under 22 who is
enrolled in high school, a GED program or a
post-secondary program leading to a degree,
diploma or certificate and who is wholly or
partially dependent upon income of p/c or
spouse of p/c.
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Caretaker: Definition
§3041.3
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Aunts, uncles, grandparents, older
siblings or great-grandparents who
certify the relationship
Foster parents
Other individuals with legal
custody (i.e., a friend or neighbor)
THIS DOES NOT INCLUDE A
LIVE-IN COMPANION
UNLESS THE LIVE-IN
COMPANION IS THE
BIOLOGICAL PARENT OF A
CHILD FOR WHOM SUBSIDY
IS REQUESTED
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Parent: Definition
§3041.3
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
Biological or adoptive mother or
father, stepmother or stepfather
who exercises care and control of
the child for whom subsidy is
requested.
Refer to family composition
examples (R3 Policy Examples)
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Income: Definition
§3041.3
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
Earned Income
 Gross wages from work or cash or inkind payments received by an
individual in exchange for services,
including income from
self-employment.
Unearned Income
 Cash or contributions received by an
individual for which the individual
does not provide a service.
 Unearned benefits received
periodically by an individual, such as
unemployment compensation,
worker’s compensation or retirement
benefits.
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Family Size
§3041.31
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
An individual applying as a parent and a
caretaker may only be counted once when
determining family size.
EXAMPLES:
1. Mary Smith applies for subsidy for her
child and her nephew. Mary submits
verification that she has care and control
of her nephew. This is 1 case (NOT 2)
with a family size of 3.
2. John Doe is receiving subsidy for his
child. The neighbor is arrested and leaves
her child with John. John obtains legal
custody of the neighbor’s child and
requests subsidy for that child. This case
continues and the child is added to the
family size. This is NOT 2 cases. The
family size is now 3.
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Work, Employment &
Self-employment:
Definitions
§ 3041.3

Work


Employment
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
Working for another individual or
entity for income.
Self-employment


Employment or self-employment.
Operating one’s own business, trade
or profession for profit.
THERE IS NO MINIMUM
WAGE REQUIREMENT.
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Work Requirement
§3041.43

The p/c must work 20 hours/week
with the following exemptions
from the 20 hours/week work
requirement:
 A teen parent must participate in
education on a full-time basis.
 When a p/c works at least 10
hours/week; p/c may attend
training 10 hours/week. The
time spent in training is counted
toward the 20-hours/week.
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Work Requirement:
Temporary Exemptions
§3041.43(c)

A p/c shall remain eligible if currently
meeting the work-hour requirement
and one of the following applies:
 Illness or injury of the p/c.
 A medical appointment cannot be
scheduled at a time that does not
conflict with work hours.
 Employer closing (holiday/other
reason).
 Domestic violence.
 An emergency, such as illness, injury,
impairment, hospitalization or
disability of the child or another
family member.
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Loss of Work/Training


If a p/c voluntarily quits a job, the
p/c receives an AA and must meet
the work requirement on or before
the date the notice period expires.
If a p/c involuntarily loses a job, the
p/c receives a Confirmation Notice
and must meet the work
requirement no later than 60
calendar days following the loss of
work/training. The CCIS must
generate an AA on the 61st day
following the loss of work/training.
 A p/c can involuntarily loose
self-employment (i.e., flood, fire
or other natural disaster, etc.)
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Education: Definition
§3041.3


An elementary school, middle school,
junior high or high school program
including a general educational
development program.
A teen parent may receive care
during the hours the teen
participates in Cyber School if
the teen’s school district verifies
that Cyber School is part of the
teen’s full-time education
program.
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Teen Parent
Loss of Education

Voluntary Loss


When a teen parent quits an
education program, the teen parent
receives an AA and must enroll in an
education program on or before the
date the notice period expires.
Graduation

When a teen parent graduates from
an education program, the teen
parent receives a Confirmation
Notice and must meet the work
requirement within 60 calendar days
following the date of graduation.
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Training: Definition
§3041.3


Includes:
 Adult basic education.
 English as a second language.
 2-year or 4-year post-secondary degree
program.
 An internship, clinical placement,
apprenticeship, lab work and field work
required by the training institution.
The definition does NOT include
graduate school or cyber School.
 The CCIS MAY NOT pay for care
during the hours a p/c attends
graduate school or participates in
cyber school with the exception of
a teen parent (See definition of
education).
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U.S. Dep’t of Education

Must be accredited by a
nationally recognized
accrediting organization:

CCISs can check on
accreditations by visiting the
U.S Department of Education
website. See PELICAN R3
Training for link.
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Accreditation
Determination Steps
1. Type the name of the
institution/program to see if the
institution/program is accredited
by a nationally recognized
accrediting agency recognized by
the U.S. Department of Education.
2. Select Pennsylvania and enter a
city.
3. Click “Search”.
4. If the institution/program is
returned in the search results, the
institution/program IS accredited.
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Prospective Work,
Education & Training:
Definition
§ 3041.3

Employment, education or training
verified by the employer, school
official or training official to begin
no later than 30 calendar days
following the date the CCIS
received/date-stamped the
application for subsidy or no later
than 60 calendar days following
the involuntary loss of work.
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Determining Hours of Care:
Employment


The CCIS will pay for care when care is
needed based on the p/c’s selfcertification unless evidence contradicts
the p/c’s self-certification of the need
for care.
Examples of when care is permitted:
 Teen parent attending education and
working in the p.m. Care is needed
during work hours only.
 P/C is working and training. Care is
needed during training hours only.
 In a 2-p/c family dad works M-F, 9-5;
mom works 15 hours/week while dad
is home and attends training M-F,
9-5. Care is needed during mom’s
training hours only.
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Determining Hours of Care:
Self-Employment

The CCIS will pay for care
when care is needed based on
the p/c’s self-certification
unless evidence contradicts
the p/c’s self-certification of
the need for care.
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Disability: Definition
§3041.3

A physical or mental
impairment that precludes
a p/c from participating in
work, education or training.
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Eligibility for a p/c
with a disability §3041.48




At application, a single p/c is ineligible for
subsidy when the p/c has a disability.
Following determination of eligibility, a single
p/c who reports a disability is eligible for a
maximum of 183 calendar days from the onset
of the disability.
At application, a 2-p/c family may be eligible
when one p/c is meeting the work requirement
and the other p/c has a disability.
Following enrollment, a 2-p/c family is eligible
as long as the family meets the verification
requirements.
 If the working p/c leaves, treat the p/c with
the disability as a single p/c with a
disability and grant 183 days of eligibility
from the date the working p/c left the
household.
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Disability:
Eligibility Determination




The p/c may be unable to care for the child
due to a need to attend treatment for the
disability. §3041.48(b)
THERE IS NO REQUIREMENT TO
APPLY FOR PERMANENT DISABILITY
BENEFITS OR A 2-YEAR LIMIT.
TEMPORARY Disability
 In a 2-p/c family, the p/c with a disability
who is not receiving disability payment
must provide verification of the disability at
each redetermination in order to remain
eligible. §3041.70(1)
PERMANENT Disability
 Verification of disability payment in a 2-p/c
family is considered permanent verification
of the disability and must be submitted only
once. The family remains eligible until
subsidy is no longer needed as long as all
other eligibility requirements continue to be
met. §3041.70(2)
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Partial disability:
Single P/C Family


Applicant
 A single p/c family is ineligible when
the p/c reports a partial disability
(works some hours but not enough
hours to meet the work
requirement).
Recipient of Subsidy
 In a single p/c family receiving care,
the family may be eligible when the
p/c reports a partial disability (works
some hours but not enough hours to
meet the work requirement).
 Example:
1. P/C reports a partial disability and
verifies 5 hours/week of work.
The p/c is eligible for 183 days
from the date the p/c became
partially disabled.
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Partial disability
2-P/C Family

In a 2-p/c family applying for or
receiving care, the family may be
eligible when a p/c reports a
partial disability (works some
hours but not enough hours to
meet the work requirement).
 Example:
1. The p/c verifies a partial
disability and verifies 5
hours/week of work. The
family is eligible as long as the
p/c meets the verification
requirements regarding
disability.
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Child Support




ALTHOUGH THERE IS NO LONGER A
REQUIREMENT TO PURSUE COURTORDERED CHILD SUPPORT, THE
OFFICE OF CHILD DEVELOPMENT
DOES ENCOURAGE THE PURSUIT OF
SUPPORT.
A p/c must report the receipt or payment of
child support. §3041, Appendix A, Income
Inclusions
When a p/c reports the receipt or payment of
child support, the CCIS must include it in the
income calculation.
 Child support income must be entered at
the p/c level in PELICAN.
The CCIS MAY NOT contact the DRO as a
general practice; however, in certain
circumstances the CCIS may use a collateral
contact (phone/email) with DRO as follows:
 Upon the p/c’s request.
 If the CCIS has reason to suspect the p/c is
withholding information when the p/c had
been receiving child support and reports he
is no longer receiving it.
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Domestic and other violence:
Definition §3041.3







A physical act that results in, or threatens to
result in, physical injury to the individual.
Mental abuse, including but not limited to
stalking, threats to kidnap, kill or otherwise
harm people or property, threats to commit
suicide, repeated use of degrading or
coercive language, controlling access to food
or sleep and controlling or withholding
access to economic and social resources.
Sexual abuse.
Sexual activity involving a dependent child.
Being forced as the caretaker or relative of a
dependent child to engage in nonconsensual
sexual acts or activities.
A threat of, or attempt at, physical or sexual
abuse.
Neglect or deprivation of medical care.
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Verification,
Self-certification &
Self-declaration:
Definitions
§ 3041.3



Verification is the process of confirming
information needed to determine eligibility for
subsidy. The term includes documentary
evidence or information obtained through
collateral contacts, self-certification and selfdeclaration.
Self-certification is a written statement
provided by the p/c for the purpose of
establishing selected factors of nonfinancial
eligibility.
Self-declaration is a written statement
provided by the p/c for the purpose of
establishing financial or nonfinancial eligibility
for a period of time NOT TO EXCEED 30
calendar days.
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Co-payment Stabilization



PELICAN will stabilize copayments between full
redeterminations which occur
every 6 months.
Co-payment stabilization allows a
decrease, but not increase, in the
co-payment between
redeterminations.
PELICAN will decrease a copayment to reflect a change in
income when the p/c reports and
the CCIS enters a decrease in work
hours or income.
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Adjusting Co-payment
in Ongoing Mode:
Maternity Leave


The CCIS must override the co-payment
to the minimum amount when a single
p/c reports maternity leave with no
income from work.
The CCIS must assess and confirm
eligibility, and manually generate a
Confirmation Notice 13 days prior to the
date the p/c is expected to return to
work. The p/c begins to pay the
originally assessed co-payment (or less)
on the Monday following the date the
notice period expires.
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Adjusting Co-payment
in Ongoing Mode :
Disability Leave


The CCIS must override the
co-payment to the minimum amount
when a single p/c reports a disability
with no income from work.
The CCIS must assess and confirm
eligibility, and manually generate a
Confirmation Notice upon the p/c’s
return to work. The p/c begins to pay
the originally assessed co-payment (or
less) on the Monday following the date
the notice period expires.
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Adjusting Co-payment
in Ongoing Mode :
Involuntary Loss of Work



PELICAN will adjust the co-payment to the
minimum amount or an amount based on
the income entered when a worker inputs
information that a single p/c reported the
involuntary loss of work.
The CCIS must override the co-payment to
the original amount based on the previous
employment income and any other income
entered in PELICAN.
The CCIS must assess and confirm
eligibility, and manually generate a
Confirmation Notice upon the p/c’s return
to work. The p/c must report income from
work within 10 days of receipt. The p/c
begins to pay the originally assessed
co-payment (or less) on the Monday
following the date the notice period
expires.
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Adjusting Co-payment, Ongoing Mode
Prospective Work at Application






A single p/c who applies for subsidy and who
reports prospective work is not required to pay
a co-payment until he receives income from
work.
The CCIS must override the co-payment to $0
when a single p/c verifies prospective work with
no income at application.
The CCIS must assess and confirm eligibility,
and manually generate a Confirmation Notice
using the date the 1st pay is expected for work as
the 1st date field (PELICAN date p/c reported not
the date p/c submitted income verification) and
the Monday following the date 1st pay is expected
as the 2nd date field.
 EXAMPLE: “…co-payment will be waived until
(1st date field). Effective, (2nd date field), you
must begin paying…”
The CCIS must select the appropriate reason
code in PELICAN when generating the
Confirmation Notice.
The p/c begins to pay the originally assessed
co-payment (or less) on the Monday following
the date the 1st pay is expected.
See the following examples.
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Adjusting Co-payment
in Ongoing Mode:
Prospective Work at Application:
EXAMPLE 1

A single p/c applies on 4/1/05 with
prospective employment starting on
4/25/05.
 1st paycheck = 4/29/05:
 Send Confirmation Notice
increasing co-payment effective
the Monday following the date 1st
pay is expected (4/29/05) =
5/2/05
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Adjusting Co-payment
in Ongoing Mode:
Prospective Work at Application:
EXAMPLE 2

A single p/c applies on 4/1/05 with
prospective employment starting on
4/25/05.
 1st paycheck = 5/6/05:
 Send Confirmation Notice
increasing co-payment effective
the Monday following the date 1st
pay is expected (5/6/05) = 5/9/05
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Adjusting Co-payment
in Ongoing Mode:
Prospective Work for a Recipient


A single p/c who receives subsidy, has
involuntarily lost work and reports
prospective work, is assessed the
minimum co-payment based on family
size and income until he receives
income from work.
The CCIS must override the co-payment
to the minimum amount when a single
p/c verifies prospective work with no
income between redeterminations (in
ONGOING mode).
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Adjusting Co-payment
in Ongoing Mode:
Prospective Work for a Recipient
(cont’d)





The CCIS must assess and confirm eligibility,
and manually generate a Confirmation Notice
using the date the 1st pay is expected for work
as the 1st date field (PELICAN date p/c
reported not the date p/c submitted income
verification) and the Monday following the
date 1st pay is expected as the 2nd date field.
 EXAMPLE: “…co-payment will be reduced
until (1st date field). Effective, (2nd date
field), you must begin paying…”
The CCIS must select the appropriate reason
code in PELICAN when generating the
Confirmation Notice.
The p/c begins to pay the originally assessed
co-payment (or less) on the Monday following
the date the 1st pay is expected.
If a p/c receives other income, the co-payment
will be based on that income and the waiver
would not apply.
See the following examples.
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Adjusting Co-payment
in Ongoing Mode:
Prospective Work for a Recipient:
EXAMPLE 1

Prospective work to begin on 4/25/05.
 No other income.
 Co-payment = $5 until 1st paycheck is
received on 4/29/05
 Upon determination of eligibility based
on prospective work, send a
Confirmation Notice acknowledging the
report of prospective work, explaining
the waiver of co-payment and notifying
the p/c of the date the increased copayment is effective. The increased
co-payment is effective 5/2/05.
 Increase co-payment to the original
amount or less based upon income
entered in PELICAN
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Adjusting Co-payment
in Ongoing Mode:
Prospective Work for a Recipient:
EXAMPLE 2

Prospective work to begin on 4/25/05.
 SSI $550/month.
 Co-payment is based on SSI income
until 1st paycheck is received on 5/6/05.
 Upon determination of eligibility based
on prospective work, send a
Confirmation Notice acknowledging the
report of prospective work, explaining
the waiver of co-payment and notifying
the p/c of the date the increased
co-payment is effective. The increased
co-payment is effective 5/9/05.
 Increase co-payment to original amount
or less based upon income entered in
PELICAN.
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Delinquent Co-payment
§3041.105(c)




The CCIS must generate an AA each time a
family co-payment becomes delinquent.
The CCIS agency will not transfer the child to
a new provider if there is an outstanding
delinquent co-payment. The requested
transfer will take place when all co-payments
owed to the original provider are paid.
Payment is applied first to current copayment. Any additional payment is then
applied to the delinquent co-payment.
Provider must first apply p/c’s payment to
current and delinquent co-payments. Any
remaining funds may be used to cover
additional fees (ex: transportation, snack)
charged by the provider.
 See the following examples.
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Delinquent Co-payment:
Co-payment Resolved
EXAMPLES

On 5/2/05 provider reports p/c
did not pay $10 co-payment due
4/29/05. CCIS sends AA to p/c
citing delinquent co-payment.
1. On 5/5/05 p/c pays provider
$20 = delinquent
co-payment is resolved
2. On 5/10/05 p/c pays provider
$30 = delinquent
co-payment resolved
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Delinquent Co-payment:
Co-payment Unresolved
EXAMPLES

On 5/2/05 provider reports p/c did
not pay $10 co-payment due
4/29/05. CCIS sends AA to p/c
citing delinquent co-payment.
1. On 5/5/05 p/c pays provider $10
= delinquent co-payment not
resolved ($10 must be applied to
current co-payment,
delinquency remains)
2. On 5/10 p/c pays provider $10 =
co-payment not resolved (new
week; p/c is still behind $10)
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Delinquent Co-payment &
Disqualification
§3041.106(d)


A family whose subsidy is terminated
for failure to pay the co-payment may
not be reauthorized for enrollment until
all outstanding co-payments have been
paid in full.
The family may reapply at any time, but
may not be enrolled until all delinquent
co-payments are resolved.
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Co-payment exceeds
cost of care
§3041.108(d)


If the co-payments for 1 month are
equal to or exceed the monthly
payment for care, the family is
ineligible for subsidized child care
with that provider.
 This does not apply to a
month in which there are 5
Mondays.
The p/c has the option of choosing
another provider.
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Face-to-face:
Low-Income Families
§3041.126


If the CCIS determines a family
eligible for subsidy and if funding
is available, the p/c must attend a
face-to-face no later than 30
calendar days following the date
the CCIS notifies the family of
eligibility.
If the CCIS determines a family
eligible for subsidy and funding is
not available, the p/c must attend
a face-to-face within 30 calendar
days following enrollment of the
first child.
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Face-to-face:
Low-Income Families
(cont’d)




The CCIS may still waive the
face-to-face requirement for a
family who has left subsidy and
returns again within one year.
The face-to-face requirement is
an application requirement
only.
In a 2-p/c family only one p/c
is required to attend the
face-to-face.
When a single p/c is receiving
subsidy and marries, the
spouse is not required to
attend a face-to-face.
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Face-to-face:
Extension for Low-Income
§3041.126(d)


The CCIS may extend the 30-day
timeframe for the face-to-face if,
on or before the 30th calendar day,
the p/c claims hardship due to
conflicts with the p/c’s work hours,
transportation problems or illness
of the p/c or another family
member.
At the time the p/c claims
hardship, the CCIS may grant an
additional 30 days to complete
from the date the hardship is
claimed.
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Report of change:
What must a p/c report
within 10 calendar days?
§3041.127








Loss of work, including layoffs or strikes.
Decrease work/education/training hours
below an average of 20 hours/week.
A change in the number of days/hours for
which subsidy is needed.
Onset of maternity, paternity or adoption
(family) leave and return to work following
leave.
Onset of a disability and return to work
following disability.
Change of address.
Change in family composition.
THERE IS NO REQUIREMENT TO
REPORT A CHANGE IN INCOME.
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Report of change:
Partial Redetermination

The following changes would be entered in
PELICAN in ONGOING mode:
 A change that may result in a decrease in
the family co-payment.
 Loss of work, including layoffs or strikes.
 Decrease work/education/training hours
below an average of 20 hours/week.
 A change in the number of days/hours for
which subsidy is needed.
 Onset of maternity, paternity or adoption
(family) leave and return to work
following leave.
 Onset of a disability and return to work
following disability.
 Change of address.
 Change in family composition.
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Partial Redetermination:
CCIS Responsibilities


When conducting a partial
redetermination, the CCIS must
enter/update all information in
ONGOING mode only.
Complete a partial
redetermination within 10
calendar days following the date
a p/c reports and verifies a
change. §3041.129(b)
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Redetermination
§3041.130




A redetermination is completed in
FULL REDETERMINATION
mode every 6 months.
A p/c is required to verify earned
income only.
In a 2 p/c family where one p/c is
working and the other p/c has a
disability but does not receive
disability benefits, the p/c with a
disability must verify the disability.
A p/c is required to verify any
information that has changed from
the last full redetermination.
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Redetermination:
Low-Income

The CCIS MUST process the
redetermination upon receipt
of the Redetermination
Summary Form and all
verifications.
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Redetermination Process:
Waiting List §3041.133(d)

The CCIS must complete a
redetermination for
families who are on the
waiting list for more than 6
months.
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Redetermination Procedure:
Maternity/Disability Leave

The CCIS MUST complete a redetermination
for families who are on maternity or disability
leave as follows :
 Print the Redetermination Letter and
Summary Form and send them to the p/c.
 Leave/re-enter the old income information.
 Override the co-payment to an amount
based on the income the p/c is actually
receiving during the leave.
 Request pay verification from the p/c and
end date leave in PELICAN upon the p/c’s
return to work.
 Assess and confirm eligibility upon the p/c’s
return or failure to return to work.
PELICAN will assess the original copayment or a
co-payment based on
the amount of income entered in PELICAN
at that time.
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Payment of Provider
Charges §3041.15



A change in the p/c’s need for child
care and the resulting adjustment in
the amount of payment to the
provider shall begin on the date the
p/c reports the change or on the date
the change begins, whichever is later.
Per policy, use the first Monday
following the date of the p/c’s report
of change in child care need or the
date the change begins, whichever is
later to generate the Enrollment
Summary.
See the following examples.
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Payment of Provider
Charges: EXAMPLE 1

Increase in number of days
 P/C reports a change in child care
need from 2 days/week (Tu. & Th.) to
5 days/week (M-F) on Tuesday,
4/5/05. Additional care is needed
beginning Wednesday, 4/6/05.
 Add the additional days (Wednesday,
4/6/05 and Friday, 4/8/05) to the
child’s schedule.
 Generate the Enrollment Summary
as of Monday, 4/11/05 to indicate the
change.
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Payment of Provider Charges:
EXAMPLE 2

Decrease in number of days
 P/C reports a change in child care
need from 5 days/week (M-F) to 3
days/week (Tu., W & Th.) on
Tuesday, 4/5/05.
 Pay the remainder of the week based
on the child’s previous schedule
(CCIS would pay W, Th. & F).
 Generate the Enrollment Summary
as of Monday, 4/11/05 to indicate the
change.
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Payment of Provider Charges:
Nonstandard,
Nonrepeating Schedules



P/C reports she works at Wal-Mart and
cannot provide a stable schedule from
one week to the next.
Verification of work hours confirms this
statement.
The CCIS must immediately consider
this to be the p/c’s report of change and
average the child’s schedule going
forward.
 AVERAGING PRINCIPLES
MUST BE CONSISTENT
WITHIN EACH CCIS.
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Payment of Provider
Charges: 10-day Notice


Some CCIS agencies have established the
practice of continuing to pay the provider
after the p/c withdraws the child from the
provider’s care. In these cases, the CCIS is
attempting to fulfill the p/c’s contract with
the provider to give a 10-day notice prior to
withdrawing the child from care.
The 10-day notice of withdrawal is an
agreement between the p/c and the
provider. It is up to the p/c to fulfill the
contract. The CCIS is not required to pay
when the p/c fails to give notice to the
provider. Providers may go though their
local magistrates to collect unpaid child
care bills. Holding parents responsible to
uphold their end of the p/c-provider
contract may help to alleviate some of the
prior notice problems.
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Payment of Provider Charges:
10 days of Absence


The difference between the provider’s 10-day
withdrawal notice and DPW’s 10-day absence
regulation has to do with the p/c’s notification to
the CCIS and the provider. We pay for ten-days
of absence when the child is ill or temporarily
unable to attend the child care facility. The term
“absence” implies that the child intends to return
to the provider. We also pay for ten days of
absence when the child does not attend the
facility and neither the CCIS nor the provider has
heard from the p/c. In these cases, the CCIS
agency sends an AA to the p/c on after the 10th
day of absence.
When a p/c informs either the CCIS or the
provider that the child will no longer be
attending a particular facility, the CCIS should
stop payment to the provider on the last day the
child attends, or the day the p/c informs the
CCIS, whichever is later. If the p/c requests a
new provider, the CCIS should begin to make
payments to the new provider immediately. The
CCIS should not continue to pay the original
provider for additional days in order to fulfill the
p/c’s obligation to give notice to the provider.
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10-day Notice versus 10
days of Absence: Example 1

The child receives care Monday through
Friday. On Friday 8/26 the parent
informs the CCIS that the child will be
attending a new facility on Monday
8/29. The provider has a ten-day notice
policy that parent has not fulfilled.
 CCIS action: The last paid day for the
original provider is 8/26. The CCIS
enrolls the child at the new provider
and begins payment to new provider
on 8/29, the date the parent reports
the change to the CCIS.
 Provider action: The provider
discusses payment of agreed upon
10-day notice with parent. If parent
refuses to honor the agreement,
provider files a complaint with the
local magistrate.
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10-day Notice versus 10
days of Absence: Example 2

The child receives care Monday through
Friday. Child has been absent from
Monday 8/15 through Friday 8/26 (10
days); neither the provider nor the CCIS
have heard from the parent.
 Provider action: Provider contacts
the CCIS to report the absence at the
end of the day on 8/26 or beginning
of the day on 8/29 (11th day of
absence)
 CCIS action: CCIS sends the parent a
Notice of Adverse Action. CCIS pays
the provider through 8/26.
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10-day Notice versus 10
days of Absence: Example 3

The child receives care Monday through
Friday. Same as #2. The parent calls the
CCIS upon receipt of the Notice of Adverse
Action and reports that she began to use a
new provider on 8/15.
 CCIS action: The parent did not inform
the provider or the CCIS of the change
in providers. The CCIS pays the old
provider for 10 days of absence through
8/26. The CCIS enrolls the child with
the new provider starting Monday 8/29.
 Provider action: The new provider
should not have expected payment from
the CCIS without receipt of an
Enrollment Summary or a call from the
CCIS. The new provider will need to
discuss payment arrangements with the
parent for care given 8/15 through 8/26.
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10-day Notice versus 10
days of Absence: Example 4

The child receives care Monday through
Friday. The child has been absent from
8/15. On Monday 8/22 the parent calls the
CCIS and informs the worker that she
began to use a new provider on 8/15.
 CCIS action: The CCIS pays forward
based on the parent’s report. The CCIS
ends enrollment at original provider,
paying through 8/19. The CCIS then
creates an enrollment at the new
provider and begins paying on 8/22, the
date the parent reported the change.
 Provider action: The original provider
received payment for five days of
absence. If the provider’s agreement
with the parent is to have 10 days prior
notice, the provider will need to make
arrangements with the parent for
payment for the additional five days.
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Absence §3041.19




Termination due to absence does not
include days of a child’s illness, injury
or other impairment or other reason
specified under subsidy suspension.
The p/c must report the date the child
returns to care.
Following the issuance of an AA,
payment will resume on the day the
child returns to care within the AA
period.
If the child does not return within the
AA period and there are no grounds for
subsidy suspension, the child’s subsidy
will be terminated the day following the
expiration of the AA period.
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Subsidy Continuation
§3041.20



The timeframe following the involuntary
loss of work, the date a strike begins or the
date the p/c graduates from or completes
an education or training program is
extended from 30 to 60 calendar days.
Maternity leave is extended from 56 to 84
calendar days.
 PELICAN ISSUE:
Maternity leave must be handled
as a disability for a p/c who is
self-employed.
Subsidy continues during regularly
scheduled breaks in work, education or
training, if the break is less than 31
calendar days.
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Subsidy Suspension
§3041.21


Subsidy may be suspended if a
p/c has a break in work,
education or training that
exceeds 30 calendar days but
does not continue beyond 90
calendar days.
Subsidy may be suspended if
the p/c needs to locate another
provider because the current
provider cannot meet the p/c’s
or child’s child care needs.
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Subsidy Continuation
versus Subsidy Suspension



Maternity leave – P/C may choose:
 Care to continue for up to 84 days; or
 Care to be suspended for up to 90 days.
Regularly scheduled breaks in work, education
or training – P/C may choose, if the break is
less than 31 days:
 P/C must verify length of break.
 Care to continue for up to 30 days; or
 Care to be suspended for up to 30 days.
Regularly scheduled breaks in work, education
or training greater than 31 days:
 P/C must verify length of break.
 Care is suspended for up to 90 days
UNLESS the p/c finds alternate
employment/training during the break.
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Continuation versus Suspension:
Maternity Leave Examples
P/C chooses to have care continue for up to
84 days and then on day 70 calls the CCIS
requesting that care be suspended. How
long do you suspend care?

Care to be suspended for up to 90 days so
in this case care would be suspended
beginning on day 70 through day 90.
2. P/C chooses to have care suspended for 90
days and then on day 70 calls the CCIS
requesting that care resume although the p/c
has NOT returned to work. How do you
handle this?

Care may resume beginning on day 70
through day 84. On day 84, the CCIS
must ensure the p/c has returned to work.

If the p/c has returned to work, care
continues.

If the p/c has not returned to work,
AA.
1.
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Continuation versus Suspension:
Examples of Regularly
Scheduled Breaks
P/C chooses to have care suspended and
then on day 30 requests that care continue to
be suspended because the break does not
end until day 36. How do you handle this?

Suspension may not continue.

If p/c returns to work/education/training,
care continues.

If p/c does not return to
work/education/training, AA.
2. Regularly scheduled breaks in work,
education or training greater than 31 days –
P/C wants care to continue although break is
95 days long. How do you handle this?

If p/c finds alternate work/training
during the break care may continue.

If the p/c does not find alternate
work/training during the break care is
suspended for up to 90 days.
1.
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Case Notes within PELICAN



PELICAN is the formal record keeping
system.
The CCIS must enter case notes within
PELICAN unless the family’s circumstances
include one of the following:
 Domestic Violence
 Teen Parent under 12 years of age
 CCIS worker receiving subsidy
Cases involving the circumstance listed
above must be treated as follows:
 Case notes are kept outside of PELICAN
 Minimal access to the family file
 Kept in locked files in a separate
location from other family files
 Director, supervisor and primary
worker only are permitted access
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Record Retention
§ 3041.85


The CCIS must retain family files,
completed application forms, written
notices, books, records and other fiscal
and administrative documents
pertaining to subsidized child care.
Records must be maintained for at least
6 years from the end of the fiscal year in
which subsidized child care has been
provided or until an audit or litigation is
resolved.
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Child Abuse Reporting
§ 3041.86

CCIS staff are mandated
reporters and must
immediately report suspected
child abuse.
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