Child Care Provider Guide

Transcription

1 DEPARTMENT OF HUMAN SERVICES: children, adults and families division Child Care Provider Guide DHS Child Care Program Independent. Healthy. Safe.

2 Frequently used phone numbers: Name and Address Local Phone Number Toll-free Number Direct Pay Unit (DPU) PO Box Salem, OR (Salem) Automated information system to check on payments Background Check Unit (BCU) PO Box Salem, OR Child Care Division (CCD) PO Box Salem, OR (Salem) (Salem) (Salem) Oregon Center for Career Development Portland State University Oregon Registry PO Box 751 Portland, OR (Portland) Ext for Spanish Child Care Resource and Referral Network Child Care Resource and Referral US Department of Agriculture Sponsors (USDA Food Program) AFSCME Council 75 Local Tandem Ave NE Salem, OR SEIU Local Commercial St. SE Salem, OR (Salem) See pages for Directory See page 70 for Directory (Salem) The Oregon Department of Human Services (DHS) will not discriminate against anyone. This means DHS will help all who qualify. DHS will not deny help to anyone based on age, race, color, national origin, gender, sexual orientation, religion, political beliefs or disability. You can file a complaint if you think DHS singled you out because of any of these things.

3 Table of contents General information...1 Why should you read this booklet?... 1 How does the DHS Child Care Program work?... 1 DHS and the IRS... 2 Unions... 2 Registering with the Child Care Division... 3 Who will DHS pay?... 4 What can DHS tell you about families?... 4 What you should ask parents... 5 What providers and parents must do... 5 Sample Child Care Provider Letter (DHS 7494E)... 7 How to become a listed provider for the DHS Child Care Program...9 What does it mean to be listed?...9 How do I get listed?...9 What are the provider requirements?...10 Help with basic health and safety standards...11 Provider training...12 How to fill out the Child Care Provider Listing form (DHS 7494)...13 Sample Child Care Provider Listing form (DHS 7494)...16 Background checks...18 Who must be on the listing form to get a background check?...18 What happens when the background check is completed?...19 If I am denied, how do I request a hearing?...20 The billing process: how to bill for care...21 About the billing forms...21 Reading the child care billing form...22 More on definitions of provider type...22 More on child age categories...23 How do I report hours of care on the billing form?...24 Missing, lost or destroyed billing forms...25 Billing for absent days...26 Sample DHS Child Care Billing form...27 Copays...28 What is a copay?...28 What happens if the family does not pay the copay?...29 Continued on next page

4 Table of contents continued DHS payments...31 When will I get my payment?...31 Checking on your payment...31 How much will DHS pay?...32 How is the payment calculated?...33 About enhanced rates...35 How do I get a higher rate for children with special needs?...36 If a family needs extra hours of care...36 DHS child care maximum rates...39 Child age categories...39 Provider type definitions...39 DHS Child care maximum rates (effective 10/1/2007) Troubleshooting, overpayments and reporting changes...45 Troubleshooting What do I do when things go wrong?...45 Provider payment reviews and overpayments...45 Intentional Program Violations (IPVs)...46 What if I disagree with a DHS decision? (Hearing rights)...47 Reporting changes...48 Filling out the Provider Report form (DHS 7496)...48 Sample Provider Report form...50 Preventing Child Abuse: the provider s role...51 Providers are mandatory reporters...51 Importance of reporting abuse...51 Recognizing child abuse...52 How do I make a report?...55 Department of Human Services offices for child abuse reporting Preventing disease: the provider s role...61 Preventing the spread of infectious disease...61 Required immunizations for children in care...63 Recommended Childhood Immunization Schedule for Resources and other information...65 Child Care Resource and Referral offices Nutrition education and meal reimbursements U.S. Department of Agriculture (USDA) Sponsor List...70 Child care payment worksheet Sample Oregon Department of Revenue brochure ( ) Sample Attendance sheet...74 Web sites...75

5 General information General information What is the Department of Human Services (DHS) Child Care Program? The DHS Child Care Program helps parents or caretakers pay for child care so they can work, or so they can prepare for employment. Why should you read this booklet? If you provide care for families who get child care benefits from DHS, this booklet is for you. It explains what you need to know to become a listed provider and get payment from the DHS Child Care Assistance Program. We want to make these programs work for you and the families we serve. If this booklet does not answer your questions, look on page 45 (Troubleshooting What do I do when things go wrong?) to find where to call for help. You may also visit our Web site at: How does the DHS Child Care Program work? The parent applies for child care assistance, or subsidy, at a local DHS office in their area. DHS determines if they qualify, the number of hours of childcare needed, and the portion the family is expected to pay (the copay). The amount of the subsidy is based on the family s income, family size, the type of child care they receive, and how many hours of care they need. If the parent qualifies, they select a child care provider. Providers must be listed with the Direct Pay Unit (DPU) before a payment can be issued. (See What does it mean to be listed? on page 9.) Once the provider is approved, DHS pays them a portion of the cost of care, through the DPU in Salem. This amount is called the subsidy. Most parents are also required to pay a portion of the cost, called the copay, directly to the provider. 1

6 General information continued DHS and the IRS Child care providers are self-employed. Most child care providers are self-employed. That means you are responsible for the children in your care, keeping records, and paying taxes on your income. You must keep records of the children s attendance and all payments received from the family and from DHS. For your convenience, a tear-out sample attendance log is available on page 73. DHS makes child care subsidy payments on behalf of the family DHS is not your employer. What DHS tells the Internal Revenue Service (IRS) DHS keeps track of all payments made to child care providers. We report what we pay you to the IRS. We will send you a statement (IRS 1099-Misc) in January, showing how much we paid you during the previous year. You must report this income for tax purposes. Consult a tax advisor if you need information about how to include this income on your tax forms. Why DHS needs your Social Security number or Federal Tax ID number The Internal Revenue Service (IRS) requires DHS to obtain your Social Security Number (SSN) or Federal Tax ID Number to report what we pay you. The name you give DHS must match your name with the IRS. We check your name and number with the IRS. If your name and number are not valid, you may be subject to an IRS fine and you will not get checks from DHS. You may also have to pay back any money received from DHS. Unions There are two unions that represent child care providers: AFSCME Council 75, Child Care Providers Together represents family providers who are registered and certified with the Child Care Division (CCD) of the Oregon Department of Employment. SEIU Local 503 OPEU represents family providers who receive a DHS subsidy who are exempt (not CCD registered or certified). 2

7 For more information, you may contact the unions by telephone or visit their Web sites at: AFSCME Council SEIU Local x454 Registering with the Child Care Division Should I be registered? Many family child care providers are required by law to register with the Child Care Division (CCD) of the Oregon Employment Department. You may be required to register even if you don t provide child care for a DHS family. If you provide child care in your home, you are required by law to register with CCD, unless you: Provide care in the child s home; Are related to the children in care by blood, marriage or adoption; Care for children from only one family at a time; Care for three children or fewer; Care for children fewer than 70 days per year; Are younger than age 18. To register, providers must meet certain requirements and maintain minimum health and safety standards set by CCD. There is an application processing fee, but the fee may be reduced if the provider s income is below the federal poverty level. While many of the registration requirements are similar to DHS listing requirements (see page 10), registration is separate from listing and is not carried out by DHS. It is the provider s responsibility to comply with the law. If you have questions about CCD registration or need an application, you may contact your local Child Care Resource and Referral office (see local listings on pages 66-68), or call the Child Care Division at (Salem) or (outside of Salem). You may also access their Web site at: 3

8 General information continued Who will DHS pay? Families may use any child care provider they choose. However, DHS can only pay providers who meet the listing and provider requirements on pages Also, the provider cannot be: A parent or stepparent of the child being cared for; A parent of the child s brother or sister, if all are living in the same household; On the same Temporary Assistance for Needy Families (TANF) grant as the child; In the same DHS filing group as the child; Younger than age 18. Additionally, child care providers who have been previously denied by DHS and are now in approved status are not eligible to be paid for child care provided while they were in denied status. What can DHS tell you about families? The law allows DHS to give limited information about families we serve once we have verified with the parent or through the listing process that you are the provider for that family. We can tell you: Which program the family is on; The family s case number; The number of authorized hours for child care; The amount DHS will pay you; The amount the family must pay you; The reason for any delay in paying DHS share of a bill. If DHS can t verify that you are the provider, have the family call their caseworker. 4

9 What you should ask parents Before you provide care, you should have: A Child Care Provider Listing form (DHS sample on page 16); or A Child Care Provider Letter (DHS 7494E - sample on page 7); or A billing form (sample on page 27); or Direct approval from a DHS caseworker to be sure the family is eligible for help with their child care payment. If DHS does not give you one of the above, the family could be responsible to pay for the child care provided. You should also ask families for other information you need to know, such as: What days and hours will the children be in care? What is the family s address and telephone number? What is the work telephone number for reaching a family member? Who else can you call in an emergency? What is their phone number? Who is allowed to pick up the children? When will the family pay their share of the bill? What is the family s case number? What providers and parents must do Providers must: Fill out DHS forms completely and accurately and return them promptly; Meet the provider and listing requirements (see pages 9-11); Treat DHS families the same as other families for whom they provide care. (This means providing the same services, not charging higher rates for DHS families than other families, etc.); Provide healthy, safe and dependable child care; Register with the Child Care Division, if required to do so by law. 5

10 General information continued Parents must: Give providers any provider forms they receive from their worker; Send their income information to DHS on time; Pay their share of the child care bill; Give adequate notice before changing providers; Inform their provider when their eligibility for assistance changes. To learn more about the DHS Child Care Program, visit our Web site at: 6

11 Date: Family s Name: Case Number: Estimated Copay: Estimated Hours of Care: Provider s Name: Dear Child Care Provider: This letter verifies that the Department of Human Services (DHS) will help pay child care for the family named above, beginning X-X-XX. This replaces the Child Care Provider Listing form for providers already approved by DHS. You should receive a child care billing form within one week. If you don t, please call the Direct Pay Unit (DPU) at ( in Salem). DHS does not usually pay the total child care expense. Most families are required to pay a portion of the bill, known as the copay. The amount of the copay will be shown on the billing form. In addition, the family is responsible for any difference between the rate you charge and the maximum rate DHS will pay. To find out what the maximum rate is for your area, or to answer other questions you may have about DHS child care programs, please refer to the Child Care Provider Guide. If you don t have the Provider Guide, you can request one by calling DPU at the number given above. The Provider Guide and rate information is also available on-line at Thank you for providing this very important service. Sincerely, SAMPLE DHS 7494E 7

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13 How to become a listed provider for the DHS Child Care Program What does it mean to be listed? To be eligible for payment from DHS, the provider must be listed. To be listed with DHS, providers need to fill out a separate application, called a Child Care Provider Listing form (DHS 7494). DHS listing is separate from the process of becoming registered or certified with the Child Care Division (CCD). The listing form asks for information about you. It also contains an agreement you must sign to be eligible for payment. It includes a list that describes minimum standards for a safe facility. By signing this form, you agree to meet all the program requirements. You also authorize background checks for you and everyone who will have access to the children in care (see page 18). The background checks include both criminal and Child Protective Services records. How do I get listed? To be listed, the provider fills out a Child Care Provider Listing form (DHS 7494: see sample on page 16). You get this form from the family. The family gets this form from their DHS worker when they are eligible for child care assistance. This form tells you the family is eligible for help for the first month. It is important that you complete this form and send it in to the DHS Direct Pay Unit (DPU) within 10 days. DPU s address is on the form. The listing form must be received and processed before a billing form can be sent to you. You will need to receive a billing form so you can be paid. To make sure you meet the requirements, carefully read What are the provider requirements? on pages Also read the section on Background checks beginning on page 18 of this guide. We must have information about all persons subject to the records check and their signatures. If the listing form is not complete, it may be returned to you, and processing will be delayed. You may contact the Direct Pay Unit at if you have questions about completing the form. 9

14 How to become a listed provider for the DHS Child Care Program continued What are the provider requirements? A family chooses the provider they wish to care for their children. DHS pays the provider on behalf of the family. In order for DHS to make the payment directly to the provider, the provider agrees to meet certain requirements. This includes passing criminal history and Child Protective Service record checks. The provider also agrees to meet basic health and safety standards. The provider s signature on the Child Care Provider Listing form affirms that they agree to meet the requirements listed below. In the area of basic requirements the provider must: Be age 18 or older. Be in such physical and mental health as will not adversely affect a child in care. Be the person who provides the care. Notify DHS (and CCD if you are a licensed provider) before using a substitute caregiver. (Substitute caregivers must be listed on a Child Care Provider Listing form.) Not be the parent or stepparent of the child, or of the child s sibling (if all live in the same household), or on the same TANF grant as the child. Be registered or certified with CCD, if required by law. Pass a background check. (This includes the provider and all other persons required to be on the listing form.) Cooperate with any investigation and allow DHS to inspect the site of care during the hours child care is provided. In the area of health and safety the provider must: Meet the DHS health and safety minimum standards on the listing form and agree to continue to meet those standards. Supervise children in care at all times. Review immunization schedule with parents and keep immunization records up-to-date. Take steps to prevent the spread of infectious diseases. Report suspected child abuse to a DHS Child Protective Services office (Child Welfare) or a law enforcement agency. 10

15 Report to DPU within 10 days any arrests, convictions or involvement with Child Protective Services (Child Welfare) of themselves or people living with them. Prevent people who may harm children from gaining access to children in care. Allow custodial parents to have immediate access at all times to their children who are in care. In the area of billing and record keeping, the provider must: Give DHS their correct, valid SSN or IRS identification number. Charge the family the same rate (or less than) they normally charge other families. Bill for the amount of care they actually provided. Keep billing records and daily attendance records that show the in and out times each day for each child in care. The records must be kept for at least one year. Allow DHS to review attendance records upon request. A sample attendance log is provided on page 73. Report to DPU within 10 days any changes in the provider s names, phone number or address, or any changes in who is working in the facility or moving in or out of the home. Not bill a DHS family for the provider s obligations. For example, providers must not bill a DHS family for any amount DHS collects from the provider to recover an overpayment, or for any amount paid by DHS to a creditor of the provider due to a lien, garnishment or other legal process. Help with basic health and safety standards Limited assistance is available for meeting the basic health and safety standards for providers who care for DHS client families. For example, DHS can provide help with barriers for protecting children from wood stoves or electrical outlets. If you do not meet the standards, mark the appropriate box on the Child Care Provider Listing form (DHS 7494). You will receive information about who to contact for help. You can still qualify to provide care while you are working with us to meet the standards. 11

16 How to become a listed provider for the DHS Child Care Program continued Provider training Orientation training is encouraged for all providers. Beginning July 1, 2010, orientations will be mandatory for all license-exempt providers in order to receive payment from DHS. Orientation contains important information on: The payment process; Program rules; Child care provider rights and responsibilities; Enhanced rate training options; Food program resources through the U.S. Department of Agriculture; and other resources and reimbursements available through public and private sources. If you would like more information on this and other child care provider training opportunities, contact the Child Care Resource and Referral Network. To find the agency nearest you, see the directory of local agencies on page You may also contact the Resource and Referral Network office in Salem at You can get help to meet the basic health and safety standards to provide child care. 12

17 How to fill out the Child Care Provider Listing form (DHS 7494) Please also read Instructions to Provider on the first page of the Child Care Provider Listing form (sample on page 16). Pages Write your name or the name of your business as it appears on Internal Revenue Service (IRS) records. If the name does not match IRS records, you could receive a fine from the IRS and stop getting payments from DHS Write your Social Security number, or your IRS identification number, if you have one. (The IRS identification number can be a personal tax ID number or employer ID number.) You must give your correct, valid Social Security number or IRS identification number to receive payment. Write your name (or the name of your facility if it is a center or certified family home). This is what will be printed on the check. Write the address where child care is provided. This may be different from your mailing address or the address where you live. We need the address where care is provided to determine your DHS rate area. Write in your telephone number. Write the address where you actually live. Do not leave this area blank unless you are registered or certified by the Child Care Division (CCD). Write the name of your first language (for example, English, Spanish, etc.) Write your mailing address. We will send your checks and letters to this address. Note: You must be registered with the post office to receive mail at that address. The post office will not deliver checks in your name if your name is not registered with them at that address Write the name and birth date (if known) of each child you are caring for from this family. Mark yes or no to show if you are related to any of the children. If related, indicate how. For example, grandmother, uncle, etc. 13

18 How to become a listed provider for the DHS Child Care Program continued You are not eligible for payment from DHS if you are: The child s parent or stepparent; Younger than age 18; Not related to the child, but you live with the child s parent and have a child together, or you are expecting a child, with that parent. 10. Check this box if you provide care for the child in the child s own home. 11. Check this box if you are currently certified to provide foster care. If so, you must also attach a letter from your certifier approving you to do child care in addition to foster care or you will not be approved to provide child care. 12. If you are registered or certified by the Child Care Division, write your CCD provider number, and skip to number 15, the Provider Agreement. Otherwise, continue with number 13 through Review the health and safety standards information sheet. Check yes if you meet all the health and safety standards listed on that sheet. Check no if you do not meet all those standards yet, and we will contact you on how to get help meeting the standards. You must meet the standards within 30 days or your listing will not be approved. 14. You must provide information on all people who are required to have background checks, unless your facility has been registered or certified by the Child Care Division. You must answer all of the questions asked, for the provider and all people you list. One of the questions asks if the person has any criminal arrests, convictions or Child Protective Services involvement. If you or any of the people you listed on the form marked yes to that question, you will need to attach a separate sheet of letter-size paper explaining the history, including each incident, date and location. If you do not list everyone who is required, that will make you not eligible for payment, and you may have to repay payments you have already received. Each person listed must sign to authorize background records checks or the form will be returned. 14

19 Background checks are required for all of the following who are 16 years old or older: You, the provider; Employees or staff who work in the child care facility (in facilities with more than one caregiver); Substitute caregivers who will provide care when the primary caregivers are unavailable; All members of the household where the care is being provided (including the parent, if the parent and provider live together); All frequent visitors, or people who may have unsupervised access to the child in care, in the place in which care is provided. 15. Read the provider requirements carefully on pages of this guide. DHS will not pay providers who do not agree to meet them. Sign your name, date the form and print your name where indicated. Your signature on the listing form means that you agree to meet all of the requirements and the information given is true and complete. After you sign and date the form, send it to the DHS Direct Pay Unit (DPU) as soon as possible at the address on the form. All providers paid by DHS must meet the provider requirements. This includes criminal history and Child Protective Service records checks. 15

20 How to become a listed provider for the DHS Child Care Program continued DHS SAMPLE DHS

21 SAMPLE DHS

22 Background checks To be eligible for payment from DHS, providers and other people in the house or facility who will have access to the children in care must pass a background check. This check is conducted by the DHS Background Check Unit and includes a criminal history check and a Child Protective Services (CPS) history check. If DHS finds the provider or other person on the listing form do not meet the requirements, the provider is not eligible for payment. Providers must give complete information for all persons subject to a background check. Each of these individuals must sign the form to authorize their background check. A provider who gives misleading, false or incomplete information can be denied eligibility for payment by DHS and may have to repay any payments they received from DHS. They may also be subject to legal action. A provider with a current registration or certification by the Child Care Division (CCD) who has already passed a background check may be required to have another background check by DHS. Who must be on the listing form to get a background check? For license-exempt child care facilities, providers must provide on the Child Care Provider Listing form (DHS 7494) the names of the site director, and everyone who works in the facility who will have access to the children in care. This includes substitute caregivers. For child care homes, providers must provide on the Child Care Provider Listing form (DHS 7494) the names of everyone age 16 and older who lives in the house, is a substitute caregiver, or is a frequent visitor to the house during the hours care is provided, and who may have unsupervised access to the children in care. Note: The parents of the children in care must also be included on the listing form, if they live with the provider. The Department may find a child care provider ineligible for payment based upon the Child Protective Service (CPS) or criminal history of any of the people subject to a background check. This decision is based on prior conduct that indicates that one of those individuals is likely to engage in 18

23 conduct that may jeopardize the safety of, or have a detrimental effect on, a child in the care of the provider. To make its determination, the Department may use any available information including the CPS records of the Department, an investigation of a complaint, or information provided by another agency. A single incident may be sufficient history for denial of eligibility. This disqualification is determined by weighing the content and source of the reports, the time elapsed since the reports, the number of reports and referrals, the person s participation in rehabilitation, training or counseling, and the likelihood of the person s abuse of drugs or alcohol. After reviewing the circumstances, DHS may also determine the provider is still eligible for payment even though there is a founded or valid report. That decision would be based on a fitness determination that repeated behavior is unlikely and that the presence of the individual likely would not jeopardize the safety of a child in the provider s care. A copy of the rules containing the list of crimes and potential disqualification periods can be found on the Criminal History Check rules Web site at: Persons who have lived outside of Oregon in the last 18 months for 60 consecutive days or more, or who have convictions or arrests for crimes in other states, will be required to submit fingerprint cards for a national check in order to complete the background check process. What happens when the background check is completed? Once the background check is complete the provider will receive a Notice of Fitness Determination. The notice will indicate one of the following: Approved Based on the background check, you have been approved to receive payment to provide care to DHS clients. Once approved, any changes in your status must be reported to DPU, including changes to your name, address, people who must be included on your listing form, or if you or people on your listing form become subject of criminal charges, or an investigation of abuse or neglect. Failed Based on the information you provided, it is not possible to complete your background check at this time, due to missing or inaccurate 19

24 information about you or someone on your listing form. For example, you could be failed for not providing a Social Security Number, or not disclosing or providing explanation for an arrest or involvement with an abuse or neglect investigation. If you receive a notice you have failed, you will need to reapply, being very careful to provide all required information. Denied Based on the background check, you have been denied to receive payment for providing care for DHS clients, due to the nature of the criminal history or history of abuse and neglect of one or more of the individuals on the listing form. You may request a hearing if you disagree with this decision. If the problem is the history of someone in the household where care is provided, other than the provider, the denied provider can reapply only if they have changed the location where care is provided, or if the individual whose background check resulted in a denial is no longer living in or visiting that location. If the listing was denied, DHS will also send a notice to the family to let them know the listing was denied, and that they must find another provider if they want to continue to receive child care help through DHS. If I am denied, how do I request a hearing? To request a hearing, providers may submit a written request to: DHS Background Check Unit (BCU), PO Box 14870, Salem, OR You can get a hearing request form from your nearest DHS office, or on the Child Care Program Web site at For more information on hearing rights, see What if I disagree with a DHS decision?, on page

25 The billing process: how to bill for care About the billing forms Once you are a listed provider, your billing forms should arrive by mail around the beginning of each month. Each child care billing form has its own voucher number and can be used only once for the time period stated on the form. DHS will make only one payment per billing form. The form cannot be changed to bill for a different time period. A sample billing form is on page 27. Instructions for filling out the Child Care Billing form follows this section. The billing form tells you: The time period covered by the billing form; The copay amount (if any) that will be deducted; The names of the eligible children in the family and their age categories; The maximum authorized child care hours. At the end of the period authorized on the billing form, fill out the billing form and send it to the Direct Pay Unit (DPU) for processing and payment. Do not bill for future days you expect to provide care; only for care that has already been provided. Be sure to send the billing form in promptly each month. Billing forms expire 90 days after they are issued 21

26 The billing process: how to bill for care continued Reading the child care billing form See the sample billing form on page Section one of the child care billing form tells you: The voucher number and the date it was issued; The program the family is on, the local DHS branch number, the family s case number and the worker s identification; The family s case name; The provider s DHS provider number and the provider type (see definitions below). Program Branch Date issued VOUCHER # /01/2006 M AC SC Worker ID JONES, JOHN Q Case number ABCZ FAM Provider type Provider # More on definitions of provider type On your Child Care Billing form, your provider type tells you if you are coded to receive the standard, enhanced or licensed rate. The definitions below explain which rate you will receive for that billing based on your provider type: Provider type: You will receive: FAM...Standard Family Rate NQC...Standard Center Rate QFM...Enhanced Family Rate QEC...Enhanced Center Rate RFM...Licensed Registered Family Rate CFM...Licensed Certified Family Rate CNT...Licensed Certified Center Rate 2. If you have a new address or phone number, do not write it on the form. Please call DPU at (or in Salem) or send in the Provider Report (DHS 7496). A tear-out Provider Report form is on page

27 3. This is the time period the billing form covers. Do not change the dates. It will make your billing form invalid. If you need a billing form for a different time period, contact DPU at (or in Salem) to find out what to do. 4. This paragraph tells you what the family s copay is. You should collect this amount from the family. Check the box if you wish to report that the family has not yet paid their copay to you. This only applies to the copay amount. (See What happens if the family does not pay the copay? on page 29.) Do not check the box unless you want to report the copay has not been met. Do not check the box if the family has paid the copay, even if they still owe you for other charges, such as amounts over the DHS rate. 5. If any important information about your Child Care Billing needs to be added, it will be added here (for example, identifying that it is a re-issued billing rather than the original). 6. This section shows the eligible child s name, the age category of the child and the maximum authorized hours for each child. This is also where you bill for the child care you provided. (See How do I report hours of care on the Child Care Billing form? on page 24.) More on child age categories On your Child Care Billing form, the age category of each child tells you the age rate DHS will pay you. The definitions below explain the DHS age categories: Infant...Newborn to 1 year Toddler...1 year (12 months) to 3 years Preschool...3 years to 6 years School...6 years or older (Unless the child has a special circumstance, Employment Related Day Care (ERDC) pays child care for children through age 11. Temporary Assistance for Needy Families (TANF) pays child care through age 12.) Special needs...a child from newborn to 18 years old who needs more costly care due to a physical, behavioral or mental disability. 7. You should not send in your billing form before the end of the month, unless you no longer provide care for the family. Please mark the appropriate box and write in the last date you provided care. 23

28 The billing process: how to bill for care continued 8. This is where you, the child care provider, will sign. 9. This is where the family signs. You must have the signature of one of the parents on the case, unless you no longer provide care for that family. How do I report hours of care on the Child Care Billing form? Send in the billing form for payment at the end of the authorized period, after you have provided all of the care for the month. Even if you did not provide care for the month, you should still send in the billing form. Write zero (0) for the hours of care, and for the total charge. Mark the appropriate box on the billing form (section 7 of the sample billing form on page 27.) Check either hourly or monthly to show whether you are charging by the hour or by the month. (Select only one.) Fill in the number of hours of care you provided that you are billing for, rounding up to the nearest whole hour. (For example: 136½ hours = 137.) Fill in your total charge in dollars and cents. (For example: $400.00). Bill DHS at your normal rates, for the total actual amount of care you provided. (Note: This may not be the same as the authorized maximum for the child.) Example 1: The child is authorized for up to 140 hours a month, but you only provided care for 105 hours. Do not write 140: write 105. If the child receives less than the maximum authorized amount of care, DHS will pay only for the actual hours provided. Example 2: Perhaps the child is authorized for 120 hours of care, but you provided 150 hours. Write in 150 hours. DHS will not pay for more than the maximum hours authorized, but you should still record it. The family would then be responsible for the amount over the maximum hours authorized. Charge only for care that was provided. Do not bill for hours a child was in school. You may bill for up to five absent days per month under certain circumstances. (See What if the child is absent for the entire month? on page 26.) Do not deduct the family s copay amount from the amount you are billing. It will be deducted from your payment automatically. 24

29 Mark any of the appropriate boxes that apply to you. This includes reporting a copay not met. (See What happens if the family does not pay the copay? on page 29.) Have the parent sign and date the form. (If you no longer provide care for this family and are unable to contact them for a signature, check the box that says you do not provide child care for this family any more and write in the last day of care you provided. The family s signature will not be required.) You, the provider, must sign and date the form. Complete the billing form prior to having the family sign it. This allows the parent to understand what is being billed. Neither the parent nor the provider should sign a blank billing form. Be sure to keep a copy of your completed billing form for your records. Send the original to the Direct Pay Unit (DPU) for processing. Mail the billing form to DPU for processing and payment to the address at the top of the form. Notify DPU when you stop providing care for a family or you change your address or phone number. Missing, lost or destroyed billing forms What if I don t get a billing form? If you don t get a billing form, you can ask the family about it, call the Direct Pay Unit, or talk to the family s DHS worker to find out why. (See What can DHS tell you about families? on page 4.) If DHS does not send you a billing form or tell you that the child care will be paid by DHS, the family is responsible to pay for the cost of care provided. How do I replace a lost or destroyed billing form? A lost or destroyed billing form can be replaced by calling DPU at (or in Salem). 25

30 The billing process: how to bill for care continued Billing for absent days Providers who meet the following criteria may bill DHS for up to five absent days per month when: The care was authorized by DHS and scheduled by the parent, but the child was absent and the provider could not fill the time slot with another child; and It is the provider s policy to bill all of their families for absent days; and The scheduled hours are logged on the provider s attendance log as an absent day. DHS will not pay for more than five consecutive absent days of scheduled care even if it extends from one month to the next. What if the child is absent for the entire month? If you did not provide any care for the month, and you are not billing for absent days (see above), mark a zero (0) in the Total Charge box, mark the box that explains why you are sending in the billing form, sign the form and send it to DPU. As a provider, you must keep attendance records of the hours and days you care for children for at least one year. 26

31 SAMPLE

32 Copays What is a copay? Most working families receiving child care help from DHS must pay part of the cost of their child care each month. The family s required share of the cost is called their copay. The family s copay amount is based on their income and size of their family. The family pays their copay amount directly to their primary provider, plus any amount the provider charges above the DHS payment limits. The billing form shows the copay amount the family is responsible for paying, which will be deducted from the DHS allowed rate. DHS pays the provider the difference the allowed rate minus the family s copay amount. There is a Child Care Payment Worksheet (DHS 7492W) for your use on page 71. You can use this worksheet to determine how much the parent will need to pay you after DHS pays their portion of the child care. Both you and the family will know the copay amount in advance. If a family has more than one provider, usually only one will collect the copay from the family. The family pays the copay to the primary provider. This is usually the provider who does most of the child care. The family tells their worker who their primary provider is. It is the provider s responsibility to collect the copay or make other arrangements with the parent. If you are the primary provider, it is very important that you and the parent talk about their copay. It is up to you and the parent to decide how and when to collect the copay and other amounts DHS does not pay. In working out the family s payment schedule, it may help to find out when the family gets paid. Some providers and parents agree to barter instead of paying the copay. For example, the parent might provide care for the provider s children. If you decide to do this, make sure your agreement is in writing. Give the parent a receipt, whether you re paid in cash or in some other way. The parent may need the receipts if they apply for the Oregon Working Family Child Care Credit. Please see page for information from the Oregon Department of Revenue. 28

33 What happens if the family does not pay the copay? To stay eligible for child care benefits in the Employment Related Day Care (ERDC) program, the family must pay their copay to the provider, by the end of each month or make other arrangements with the provider. If they don t, you can check the box on the Child Care Billing form that says, Check here ( ) if the parent did not pay this amount or arrange with you to pay it. This reports to DPU that the copay has not been met. You may also write a letter or call DPU to report the copay hasn t been met. You must notify DPU within 60 days from the date we paid you to report a copay that has not been met. Otherwise, the copay will be considered met. If you notify DPU that the copay has not been met, DPU will send a notice to the family that their ERDC program benefits will end. Once the benefits end, DPU cannot continue the family s benefits until they are notified by you in writing or have other proof that the family has paid or made arrangements to pay you their copay. Any billing forms already sent to you will still be processed. (The parent may be eligible for child care benefits from other programs that do not have a copay.) DHS can end the family s benefit for not paying the copay amount stated on the Child Care Billing form. We can t end the family s benefit for failure to pay other costs the parent owes to the provider (for example, the amount the provider charges over the DHS payment limit). Any payments made to the provider by the family are applied to the copay first. If the provider notifies DPU that the family made satisfactory arrangements for the copay, it is up to the provider to collect it. We cannot close the family s benefit again for not honoring the arrangement between the provider and the family. 29

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35 DHS payments When will I get my payment? After you have mailed in your billing form to DPU at the end of the authorized period, your billing form will be processed and entered into the computer within four working days. Your billing form may be sent back to you unprocessed if it is: Incomplete or incorrect; Sent in before the end of the authorized period; Sent in before the care billed has actually been provided. This could delay the processing and payment of your billing. For providers who have requested direct deposit for their payments, DHS will deposit the payment directly to the provider s bank account on the next working day after processing. For providers who receive their payments by check, DHS will send the payment check on the next working day after the form is processed. When DHS sends a payment, we include a notice to the provider showing how much child care was paid for each child. Please keep this notice for your tax records. The family gets a similar notice telling them how much DHS paid. Checking on your payment DPU has an automated system you can call 24 hours a day, every day, for payment information. The system can tell you if your payment: Has already been processed and a check was mailed to you; Has been denied, either due to an issue with the voucher, or because the amount billed was less than the family s copay amount. If the system states that no information is available, that means your billing form has not yet been processed. 31

36 DHS Payments continued Here s how it works: Call in Salem, or statewide. You will hear a menu of options; select the number indicated for the information you want. Be ready with your Social Security Number or Federal Tax ID Number. Be ready with the voucher number for the billing you wish to check on. If the system states that no information is available, that means your billing form has not yet been processed. It may take 3-4 days. If you are a new provider or have not received payments in some time, you may get the message that the system does not recognize your Social Security Number. That means the process of linking you as the provider to the client family may not be complete yet. It takes a few days. Please always press # before you hang up. About rates: How much will DHS pay? DHS has maximum child care rates they can pay providers each month. The rates are based on a statewide market survey of child care providers and the amount most of them charge in their area. These are the maximum rates DHS is allowed to pay a provider. DHS will pay the amount the provider bills, or the maximum allowable DHS rate, whichever is less. The amount paid to a provider is determined by several factors: The ZIP code where the care is provided This determines which area the care is provided in: Group Area A, B or C. (See DHS Child Care Maximum Rates on pages ) The type of provider Family or child care center, and whether they receive the standard, enhanced or licensed rate. (See Reading the Child Care Billing form More on provider type definitions on page 22 and How do I qualify for the enhanced rate? on page 35.) The age category of the child See Reading the Child Care Billing form More on child age categories on page

37 The authorized hours on the billing form This is based on the family s expected work hours or approved activity hours, plus 25 percent for commuting and meal time. This is the maximum total number of child care hours the child can receive from all providers for the time period on the billing form. How the provider billed Whether the provider bills by the hour or by the month, and how many hours were billed. The total charge the provider billed If the provider bills for less than the DHS maximum rate, DHS cannot pay more than the provider bills. The DHS maximum rates Payments will not exceed the DHS maximum rates listed. If parents choose a provider who charges more than the maximum DHS can pay, the parents are responsible for paying anything over the DHS maximum. The family s copay amount This amount is deducted from the DHS allowed amount. There are multiple providers If the combined billings from multiple providers add up to more than the maximum allowable for care, providers may receive a percentage of the allowable amount. Example: if the first provider provided 85 percent of the total hours of care for a child, and the second provided 15 percent of the total hours, then the first provider will be paid 85 percent of the maximum allowable amount, and the second would receive 15 percent of that maximum. How is the payment calculated? DHS will pay: At your hourly or monthly rate, or up to the DHS maximum hourly or monthly rates for your provider type, whichever is less; The actual amount of care you provide, up to the total number of authorized hours, minus the family s copay amount (specified on the billing form). 33

38 DHS Payments continued DHS will not pay: More than you bill; More than the authorized hours; More than the DHS maximum rates. Even if you bill hourly, DHS cannot pay more than the maximum monthly rate; Amounts less than one dollar. Once the allowed amount is calculated for each child, the copay is deducted from the total of the allowed amounts. If you have additional questions about how your payment was calculated, contact the Direct Pay Unit at (or in the Salem area). The following is an example of how a payment is calculated: A family provider who gets the standard rate in Region C is authorized for and bills for 215 hours of care. The provider charges $ monthly rate for an infant in full time care. The parent s copay amount is $ The DHS maximum monthly rate is $ for an infant in Region C for a Standard Family provider (from page 42, DHS maximum rates). Provider billed $400; DHS allowed $374; parent s copay is $136. DHS allows... $374 Family s copay... -$136 DHS pays... $238 Provider billed... $400 DHS paid... -$238 Family owes... $162 The family is responsible for their copay ($136) plus any amount that DHS doesn t pay ($26). ($136 + $26= $162). ***Do not deduct the copay from the amount you are billing. DHS will automatically deduct the copay from the DHS allowed amount. 34