DPSS ePolicy

To convert existing policy to new writing style only – No concept changes

 

Child care payments are made by the Resource and Referral/Alternative Payment Program (R&R/APP) agencies using their own computer systems. Stage 1 Child Care (S1CC) payment data is updated to the California Statewide Automated System  (CalSAWS).

A properly completed Provider Payment Request (PPR) form must be received by the R&R/APP agency from the provider before a reimbursement can be processed. R&R/APP agencies shall reimburse providers in arrears and reimbursements must be made in accordance with the California Code of Regulations and the Regional Market Rate (RMR) regulations.

(See Child Care Payment Process under the "Procedures" Section below.)

Determination of Provider Rates

Child care services for CalWORKs S1CC families shall be reimbursed at rates that are within the RMR ceilings. The RMR ceilings are the maximum amount child care providers can be reimbursed from the State of California for subsidized child care.

Licensed providers are required to provide their updated rate information to the R&R/APP agency and may update the rates for subsidized child care services once a year. The rate information should include a copy of their rate sheets listing the amount charged for subsidized children, including discounts and scholarships policies along with a statement confirming that the rates charged for each subsidized child are equal to or less than the rates charged for each unsubsidized child.

Licensed Child Care Provider

1. Licensed providers shall be reimbursed for child care services provided to subsidized families at the same rate as unsubsidized families for the same services. 
2. If the licensed provider serves only subsidized families, the provider shall be reimbursed based on the rate the provider establishes for prospective unsubsidized families. However, in no case shall the reimbursement exceed the appropriate RMR ceiling.

License-Exempt Child Care Providers

(Include Child Care Centers that are exempt from licensure and Providers who provide child care either in or outside the child's home)

1. Child care centers that operate recreation programs and public and private schools operating before and after school programs/extended day care programs are treated as license-exempt, but reimbursed for child care at actual cost up to the maximum licensed child care center RMR ceiling, instead of the license-exempt RMR ceiling. 
2. License-exempt providers are to be reimbursed at a rate not to exceed 70 percent of the Family Child Care Home ceilings and do not qualify for evening/weekend adjustments.

TrustLine Registration Requirements

A license-exempt child care provider who is not the aunt, uncle, or grandparent by blood, marriage, or court decree of the child is subject to TrustLine registration requirements and must complete the TrustLine registration process before child care reimbursements may be issued.

A license-exempt provider who completed the TrustLine registration requirements and is TrustLine-registered may be eligible to receive a retroactive payment for up to 120 calendar days from the date the provider is TrustLine-registered.

When processing a participant’s request for child care with a license-exempt provider who is not exempt from TrustLine registration requirements, the R&R/APP agencies must ensure that procedures are followed.

Payment Limitations on Reimbursement

• Reimbursement for S1CC services shall not exceed the fee charged to other members of the public receiving the same service.
• Providers shall only be reimbursed using a single rate category, unless they are being reimbursed using both a daily rate and an hourly rate, when:
  • No single rate established by the provider corresponds to the family's child care needs;
  • The provider has established a rate in both daily and hourly rate categories; and
  • Using both rates consistent with the rates that the provider charges for unsubsidized families needing similar hours of care.
• In situations in which a participant chooses to bring his/her child approved for S1CC to a child care center where the participant is also employed, the provider will not be eligible for reimbursement for any time period when the participant/employee is providing child care for his/her child or is in the same area or classroom.

The provider and the participant are required to sign under penalty of perjury a written statement that declares the participant is not providing child care for his/her child nor working in the same area/classroom where his/her child is receiving care. (See Processing of a Participant’s Request for Child Care at Child Care Facility Where the Participant is an Employee under the “Procedures” Section below.)

• If a participant is employed at a child care facility that is not a child care center or license-exempt school/center and requests child care at the same facility during his/her work hours, the participant shall be asked to find another provider. (See Example on Payment Limits under the "Examples" Section below.)

Exception to Payment Limits

Child care providers may be reimbursed at a rate that exceeds the RMR ceilings, when there are no more than two child care providers in the region offering services which meet the needs of the subsidized family, and the provider has established a rate that exceeds the ceilings. However, this is not likely to occur in Los Angeles County.

Co-Payments and Family Fees

There is a distinction between a co-payment and a family fee. If a family chooses a child care provider who charges a higher rate than the allowable maximum subsidy amount (RMR ceiling), the family shall be responsible to pay the difference between the rate charged by the provider and the reimbursable, subsidized RMR ceiling. The difference is a co-payment made by the parent/participant and paid directly to the provider. (See example on Co-Payments under the "Examples" Section below.)

Assessment of Family Fees

A family fee in the S1CC Program is the amount a participant/parent is required to pay toward his/her child care costs based on the family’s hours of care certified for the month, income, and family size. 

Who to Assess for Family Fees

1. Families with incomes that exceed 40 percent of the State Median Income (SMI), adjusted for family size, and families that have not received an exemption are required to pay a family fee for subsidized child care services.
2. Former CalWORKs families who are not receiving CalWORKs cash aid, but continue to receive S1CC. 

R&R/APP staff must ensure that families who are exempt from family fees are not assessed or charged a family fee.

Who is Exempt from Family Fees

• Families receiving CalWORKs cash aid.
• Families who continue to receive a CalWORKs grant on behalf of the children, such as Safety Net or sanctioned families.
• Families with “at risk” children.

“At risk” children are children who are at risk of abuse, neglect, or exploitation as determined by a legally qualified professional in a legal, medical, or social services agency, or an emergency shelter.

Families with “at risk” children may be exempt from paying a family fee for up to three months. However, if a county welfare department certifies that the child is receiving Child Protective Services (CPS), the exemption from family fees may continue for up to 12 months. The cumulative period for the family fee exemption shall not exceed 12 months.

• Families with children receiving CPS services may be exempt from paying a fee for up to 12 months if child care services are determined to be necessary by the county welfare department. The cumulative period for the family fee exemption shall not exceed 12 months.
• Families with children receiving part-day California State Preschool Program services.

When to Assess Family Fees

• At initial enrollment;
• When updating the family's data file; and 
• At recertification.

How to Determine the Cost for Family Fees

• Family fees are assessed according to the current Family Fee Schedule. (Click on the link to see the Family Fee schedule https://www.cde.ca.gov/sp/cd/ci/documents/fy2425famfeeschedule.xlsx)
• Families are to be assessed either a full-time fee or part-time fee, based on hours of care certified for the month, income, and family size.
• Families with a certified need of less than 130 hours per month are to be assessed a part-time fee.
• Families with a certified need of 130 hours or more per month are to be assessed a full-time fee.
• Family fees cannot be calculated based on a child’s actual attendance.

At Initial Enrollment

• When assessing fees for families with predictable schedules, the fee is to be assessed using the total monthly certified hours of care. When the initial enrollment is not on the first day of the month, the family fee can be assessed based on the certified hours for the partial month and then based on the certified hours for the full month thereafter.

(See Example on Determining the Cost for Family Fees under the “Examples” Section below.)

• When assessing fees for families with unpredictable or variable schedules, the fee is to be assessed using the average hours of the parent’s verified work schedule for the four months immediately preceding the certification.
• If at the time of initial certification the parent does not have a work history, a flat monthly fee is to be assessed based on: the verified hours the employer expects the parent to work or the self-employment documentation provided by the parent.
• The family fee is to be calculated using the projected average number of hours the parent is expected to work per month over the next four months.
• The family fee for initial certification is due upon enrollment.

When Updating the Family’s Data File and at Recertification

• When updating a family’s file or during recertification, families with predictable schedules may require that the family fee be reassessed if there is a change in the family’s circumstances.
• Families with unpredictable or variable work schedules must update their need for services at least every four months until such time as the employment pattern becomes predictable.
• When updating the need for services, the R&R/APP staff can reassess the fee by averaging the actual hours of attendance in the preceding three to four months to determine the monthly average on which the family fee will be based.
• When the family’s work schedule becomes predictable, the fee will be reassessed based on the newly certified hours of need.
• A Notice of Action (NOA) must be issued to the participant at least ten calendar days prior to a change in the family fee.
• The fee must be collected monthly on the first of each month following the effective date of the NOA.
• Families who have income in excess of the monthly income ceiling based on family size are ineligible for the CalWORKs Child Care Program.

Income to be Considered for Family Fee Determination

With the exception of cash aided, safety net and sanctioned families, the family fee is determined by using the countable income of all adults and children related by blood, marriage, or adoption who live in the home. This includes step-parents, regardless of whether they are included in the assistance unit; and countable child income, such as foster care payments, inheritance, and death benefits. Income of the following individuals shall not be counted for the purposes of calculating a family fee:

• Beneficiaries of Supplemental Security Income/State Supplemental Program (SSI/SSP);
• Other adults who are neither the parents of the child nor the spouse of the parent, nor the children of those adults, if any; and
• Income of working dependent children under age 18.

Information to Provide to Families Who are Not Exempt from Family Fees

1. The R&R/APP agencies shall provide the former cash-aided participants and other families who are not exempt from family fees with a copy and explanation of their policies regarding assessment of family fees and the agency’s collection method.
2. The participant is responsible for paying the required family fees.  S1CC case cannot be terminated if the participant fails to pay.
3. Delinquent/uncollected family fee balances accrued in S1CC for participant’s cases  may not be transferred to other California Department of Education-administered CalWORKs Child Care Stages.

Fees that are Reimbursable through S1CC

1. Payment of fees for registration, materials, and insurance that are also charged to other private, unsubsidized clients may be paid through the S1CC Program as long as the fees (or prorated amount of the fee over a 12-month period), plus the child care reimbursement do not exceed the maximum subsidy amount.
2. The participant is responsible for payment of any portion of the fees not reimbursable through Stage1 because the fees plus the subsidized care together exceed the RMR ceiling.

How to Pay the Reimbursable Fees

1. In cases in which the regular child care payment is less than the RMR ceiling, the difference between the ceiling and the child care payment may be used to pay for registration, materials, or insurance fees, if the entire fees cannot be paid to minimize the participant’s out-of-pocket expenses.
2. Fees may be paid in a single payment or prorated over an extended period, up to 12 months.
3. If the prorated fees, when added to the regular child care payment amount are within the RMR ceiling, the prorated portion of the fees may be paid.
4. If the prorated amount when added to the regular child care payment amount exceeds the RMR ceilings, the registration fee, materials, or insurance fees may not be paid.
5. If the full amount of the fees would result in exceeding the RMR ceiling, then only payment for the amount of child care services plus the portion of the total fees that do not exceed the RMR ceiling may be issued to the provider.

(See Examples on Reimbursable Fees under the “Examples” Section below.)

Reimbursable Guidelines for Child's Excused Absences

1. Reimbursable hours for a child’s regular provider shall include time when the child is ill or at other such reasonable times, if the provider’s child care agreement/contract states that the provider requires payment for such absences.
2. When a child is ill and the family needs an alternate eligible child care provider, payment to an alternate eligible child care provider is limited to ten days per child, per fiscal year. Fiscal year is defined as July 1 of one calendar year through June 30 of the following calendar year.
3. Additional reimbursement may be made in excess of the ten-day limit based on the illness of the child, if the parent provides a physician’s verification.

Reimbursable Guidelines for Provider’s Day(s) of Non-Operation

1. Reimbursable hours for a child’s regular provider shall include time, if a family uses a provider whose child care agreement/contract with the family states that the provider requires paid non-operation days, and the provider has the same agreement with other unsubsidized families.
2. When a family has a provider who has a paid day of non-operation, the family may obtain an alternate eligible provider.  Payment to an alternate eligible provider is limited to ten days per fiscal year for each child.

Reimbursable Guidelines for School Hours

1. When a school-aged child is attending scheduled instruction at a public educational program or is enrolled and attending a private school, reimbursement for S1CC cannot be made for the same period of time.
2. If school is not available, such as when a child is suspended or expelled, child care payments may be made for the same time that school is in session. 

Reimbursable Guidelines for Multiple Providers

1. R&R/APP agencies shall reimburse only one provider of child care services per child when the hours of operation of the child care provider selected by the parent can accommodate the need for child care.
2. More than one provider per child may be reimbursed when the hours of operation of the first provider cannot accommodate the need for child care.
3. When a family’s first provider is not a licensed center and the parent chooses a licensed center for the specific purpose of providing the child with large group school readiness experiences, the services provided by the licensed center may also be reimbursed.
4. Multiple providers shall not be paid for the same portion of a child’s need for child care, except as otherwise specified in “Child’s Excused Absences” and  “Provider’s Day(s) of Non-Operation” Sections above.

(See Example on Multiple Providers under the “Examples” Section below.)

Reimbursable Guidelines for Breaks in Activities

1. R&R/APP agencies shall allow child care to cover breaks between activities, during the course of the day as long as there is no impact on the rate of pay.  Where there is an additional cost, allow up to four hours (excluding travel time) for licensed and license-exempt child care.
2. For breaks of 30 days or less between activities, the R&R/APP agencies shall allow participants who have been authorized for licensed child care to request and continue to receive licensed child care to allow continuity of care, and to hold the space for the child in the licensed child care facility.
3. The 30-day rule may be extended to no more than 60 days for a student’s semester break, but only if he/she is not changing schools.

Reimbursable Guidelines for Overpayments and Underpayments

1. The R&R/APP agencies shall take steps to promptly correct any overpayment or underpayment for child care services.
2. The R&R/APP agencies shall follow the Overpayment and Underpayment Procedures under the “Procedures” Section below.

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Provider Payment Request (PPR)

An invoice that the child care provider completes to be paid for services rendered.

Certified Hours of Care

The hours of child care that have been pre-approved or authorized by the contracted R&R/APP agencies.

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