TITLE 8 SOCIAL
SERVICES
CHAPTER 15 CHILD
CARE ASSISTANCE
PART 2 REQUIREMENTS
FOR CHILD CARE ASSISTANCE PROGRAMS FOR CLIENTS AND
CHILD
CARE PROVIDERS
8.15.2.1 ISSUING
AGENCY: Children, Youth and Families Department.
[8.15.2.1 NMAC - Rp, 8.15.2.1 NMAC, 02/14/05]
8.15.2.2 SCOPE: This policy
applies to all clients seeking child care assistance benefits, all child care
providers who provide services to clients qualifying for assistance benefits,
and employees of the department who determine eligibility for child care
assistance benefits. (See 8.15.2.8 NMAC for detailed list.)
[8.15.2.2 NMAC - Rp, 8.15.2.2 NMAC, 02/14/05]
8.15.2.3 STATUTORY
AUTHORITY: NMSA section 9-2A-7
(1991).
[8.15.2.3 NMAC - Rp, 8.15.2.3 NMAC, 02/14/05]
8.15.2.4 DURATION: Permanent
[8.15.2.4 NMAC - Rp, 8.15.2.4 NMAC, 02/14/05]
8.15.2.5 EFFECTIVE
DATE:
February 14, 2005, unless a later date is cited at the end of section.
[8.15.2.5 NMAC - Rp, 8.15.2.5 NMAC, 02/14/05]
8.15.2.6 OBJECTIVE:
A. To
establish standards and procedures for the provision of child care assistance
benefits to eligible clients and to establish the rights and responsibilities
of child care providers who receive payment for providing child care services
to clients receiving benefits. To establish minimum requirements for
eligibility for program participation and for the provision of child care
services to children whose families are receiving benefits and to allow
children receiving these benefits access to quality child care settings that
promote their physical, mental, emotional, and social development in a safe
environment.
B. Permissive
language such as "may or may be" when referring to actions taken by
the department, address situations where it is not always prudent or practical
to apply these actions. It is not meant
to reduce the weight of these actions nor should the intent of the policies be
circumvented due to this wording. This
language is intended to be construed in a fiscally responsible and/or equitable
manner, keeping in mind that consistency in application is the ultimate goal.
[8.15.2.6 NMAC - Rp, 8.15.2.6 NMAC, 02/14/05]
8.15.2.7 DEFINITIONS:
A. “Attending
a job training or educational program” means being physically present and
actively participating in a job training or educational program.
B. “Child
with special needs” means a child with a medically documented condition, which
results in physical or mental incapacity requiring care and supervision by an
adult.
C. “Closure”
means the child care case is closed due to the client no longer having a need
for child care assistance in accordance with program policy, being determined
ineligible due to receipt of income in excess of the income guideline, moving
out of state, failing to recertify in accordance with program procedures, completing
or withdrawing from an educational or training program or being disqualified
from participation in the program.
D. “Co-payment”
means the portion of the approved and agreed upon monthly child care cost for
clients receiving child care assistance that the client is required to pay to
the child care provider. The
department’s payment to the provider is reduced by the co-payment amount.
E. “Department”
means the New Mexico children, youth and families department.
F. “Earned
income” means income received as wages from employment or as profit from
self-employment.
G. “Star
level” means a license indicating the level of quality of an early childhood
program. A greater number of stars indicates a higher
level of quality. The AIM HIGH essential
elements, as approved by the child development board, are the criteria that
will be used for determining the number of stars.
H. “Incidental
money” means earnings of a minor child for occasional work performed such as
baby-sitting, cutting lawns, and other similar activities.
I. “Infant,
toddler, preschool, school age” means the age categories used for assigning
child care provider reimbursement rates, defined as follows:
(1) infant: 0-23
months;
(2) toddler: 24 -35
months;
(3) preschool: 3 to 5
year olds; and
(4) school age: 6 year olds and older.
J. “Job
training and educational program” means participation in a short or long term
educational or training program which provides specific job skills which allow
the participant to enter the workforce and/or directly relate to enhancing job
skills, including but not limited to the acquisition of a general equivalency
diploma (GED), English as a second language, literacy
training, vocational education training, secondary education including adult
basic education and accredited high school programs, and post secondary
institutions.
K. “National
accreditation status” means the achievement and maintenance of accreditation
status by an accrediting body that has been approved by CYFD. Approval of an applicant accrediting body by
CYFD is pursuant to procedures established by CYFD and requires, at a minimum,
that the applicant accrediting body meets the following criteria: 1) is
national in scope and practice; 2) has a process to ensure that interim quality
is maintained by the accredited entity; 3) meets or exceeds the standards of
one of the following national accrediting bodies: the national association for
the education of young children (NAEYC); the national
early childhood program accreditation (NECPA); the
American Montessori society (AMS); the Montessori
school accreditation commission (MSAC); the national
association of family child care (NAFCC); the council
of accreditation (COA); the national after school association (NAA); or the
association of Christian schools international (ACSI); and 4) promotes indicators of quality which
address, at a minimum, the following: staff training, director and staff qualifications,
curriculum and environment, program administration, and staff/child ratios.
L. “Non-traditional
hours of care” means care provided between the after hours of 7 p.m. and 7 a.m.
Monday through Friday and/or care provided during weekend hours between 12:00
a.m. Saturday morning and 12:00 a.m. Monday morning.
M. “Open
case” means a case that has not been closed as a result of a failure to
recertify, or that has not been closed due to becoming otherwise ineligible for
child care assistance benefits.
N. “Overpayment”
means a payment of child care assistance benefits received by a client or
provider for which they are ineligible based on incomplete or inaccurate
information provided by either the client or the provider, or agency error.
O. “Protective
services child care” means child care services for children placed in the
custody of the protective services of the department.
P. “Provider
types” means the characteristics of child care providers, which determine their
approved reimbursement rate, capacity, staffing levels etc. as follows:
(1) “In-home” care means care provided in the
child’s own home.
(2) “Registered home” means child care
provided in the home of a provider who is registered with the department’s
child and adult care food program to care for up to four (4) children. All
registered homes receiving child care assistance subsidies must be enrolled and
participate in the child and adult care food program (CACFP),
unless they are ineligible.
(3) “Licensed family child care home” means
child care provided in the home of a provider who is licensed by the department
to care for up to six (6) children.
(4) “Licensed group child care home” means
child care provided in the home of a provider who is licensed by the department
to care for up to twelve (12) children.
(5) “Licensed center” means child care
provided in a non-residential setting, which is licensed by the department to provide
such care.
(6) “Out of school time care” means child care
provided to a school age child up to age thirteen immediately before and/or
immediately after a regularly scheduled school day and/or when regular school
is not in session.
Q. “Recertification”
means the process by which a client’s eligibility to continue to receive child
care assistance benefits are determined.
R. “Registration/educational
fee” means a fee charged to private pay and families receiving child care assistance
for materials and supplies.
S. “Residing
with” means living in a household which provides shelter and care to a child
during the non-working hours of the child’s parent or guardian.
T. “Suspension”
means that the child care case is kept open, but benefits are not paid.
U. “TANF” means the temporary assistance to needy families
program administered by the U.S. department of health and human services. TANF is the
successor to the aid to families with dependent children (AFDC) program and
provides cash assistance to qualified low-income families with dependent
children.
V. “Teen
parent” means a biological parent under the age of 20 who is attending high
school or working towards a general equivalency diploma (GED).
W. “Termination”
means the child care case is terminated due to cause.
X. “Underpayment”
means a payment made by the department for services provided which did not
fully reimburse the client or provider.
Y. “Unearned
income” means income in the form of benefits such as TANF,
workmen’s compensation, social security, supplemental security income; child
support, pensions, contributions, gifts, loans, and grants which does not meet
the definition of earned income.
Z. “Waiting
list” means a list of families who have applied for child care services during
a period of lack of funding.
AA. “Working” means employment of any type, including
self-employment. For TANF
recipients, this includes work experience and/or community service or any other
activity that meets the TANF work activity requirements.
BB. “CACFP” means the child and adult
care food program, administered by the children, youth and families department.
[8.15.2.7 NMAC - Rp, 8.15.2.7 NMAC, 02/14/05; A, 09/15/05; A, 08/31/06]
8.15.2.8 TYPES
OF CHILD CARE: These policies apply to child care assistance
benefits provided to eligible children for the following types of child care to
ensure that parents have a variety of child care services from which to choose:
A. child
care programs administered by public schools and post-secondary institutions
that provide on-site care for the children of students;
B. child
care programs administered by tribal entities;
C. child
care programs administered by church or religious organizations;
D. in-home
care;
E. child
care in licensed centers;
F. child
care in registered family childcare homes;
G. child
care in licensed family and group childcare homes;
H. out
of school time programs; and
I. programs
operated by employers for their employees.
[8.15.2.8 NMAC - Rp, 8.15.2.8 NMAC, 02/14/05; A, 08/31/06]
8.15.2.9 PRIORITIES
FOR ASSISTANCE: Any funds received by the department under
the child care development fund and other sources are expended for child care
assistance pursuant to the following priorities:
A. Priority
one and priority one A: Clients receiving temporary assistance to
needy families (TANF) benefits are considered
priority one clients. Clients participating in the food stamp employment and
training (E&T) program as determined and
administered by the human services department (HSD) are considered priority one
A clients.
(1) Participation exemption: The human
services department grants participation exemptions to TANF
clients who cannot locate child care. The children, youth and families
department is responsible for the verification of the TANF
participant’s inability to locate child care. Reasons for a participation
exemption due to lack of child care are as follows:
(a) the
unavailability of appropriate child care within a reasonable distance from the
individual’s home or work site, or;
(b) the
unavailability or unsuitability of informal child care by a relative or under
other arrangements, or;
(c)
the unavailability of appropriate and
affordable formal child care by a relative or under other arrangements.
(2) A person who applies for participation
exemption for any and/or all of the above reasons is referred to the children,
youth & families department training and technical assistance (T&TA) contractor for that area. The T&TA
assists the client with location of child care. The final
validation/verification of a client’s inability to locate child care is determined
by the child care services bureau supervisor in conjunction with his/her
supervisor. A client who receives a participation exemption due to lack of
child care is required to re-apply for the exemption every six months. If a person disagrees with the determination
of their eligibility for a participation exemption, they may apply for a fair
hearing with the human services department (HSD). HSD is responsible for
providing notice of the approval and/or denial of a participation exemption.
B. Priority
one B: Child care assistance for income eligible families whose income is at or
below 100% of the federal poverty level. If the number of eligible clients in
this priority exceeds budget availability, the department may maintain a
waiting list. The department prioritizes child care services within priority
one B for children with special needs and for teen parents. If budget availability permits, the
department reserves the right to transfer priority one B families whose income
exceeds 100% of the federal poverty level but is at or below 200% of the
federal poverty level to the priority four category.
C. Priority
two: Child care assistance for a consecutive 12-month period for families
transitioning off TANF. Clients must have received TANF for at least one (1) month in the past twelve (12)
months in order to qualify for priority two. Only clients whose TANF cases are closed at least in part due to increased
earnings or loss of earned income deductions or disregards are eligible for
priority two. Priority two clients do not have to meet income eligibility
requirements during their twelve (12) consecutive month period of
eligibility for priority two child care.
D. Priority
three: No new families will be enrolled
in priority three. This category will be
eliminated through attrition as priority three families become ineligible for
any reason including but not limited to: income exceeding 200% of the federal
poverty level; failure to re-certify in a timely manner; and/or loss of
employment which results in loss of benefits.
E. Priority
four: Child care assistance for families whose income is above 100% of the
federal poverty level but at or below 200% of the federal poverty level,
adjusted annually in accordance with federal guidelines. These families are certified for a six month
block of time subject to the availability of funds and renewable subject to the
availability of funds. The department
reserves the right to expand the eligibility requirement up to 200% of the
federal poverty level based on budget availability. Families in any priority
may be transferred to priority four if budget availability permits. If the number of eligible clients in this
priority exceeds budget availability, the department may maintain a waiting
list. The department prioritizes child care services within priority four for
children with special needs and for teen parents.
F. CPS
child care: In addition to these priorities, the department pays for protective
services child care (CPS) as determined by the protective services of the
department.
[8.15.2.9 NMAC - Rp, 8.15.2.9 NMAC, 02/14/05; A, 09/15/05]
8.15.2.10 APPLICATION
PROCESS: Clients apply for child care assistance
benefits by presenting the following documents to establish eligibility in
person, or by mail, at the local child care office:
A. a
completed signed application form;
B. proof
of earned income or participation in the temporary assistance to needy families
(TANF) program or the food stamp employment and/or
training (E&T) program; social security numbers
may be used to establish TANF participation or
receipt of child care support;
C. school
schedule, if applicable;
D. birth
certificates for all applicant children;
E. proof
of unearned income;
F. proof
of residency; and
G. the
name, address, phone number, and social security number of the provider
selected to care for the children;
H. assistance
is provided effective the first day of the month of application if all of the
following apply:
(1) the client is
utilizing child care services;
(2) the client is
employed, attending school or a training program; and
(3) the provider to
be paid was providing care from the first day of the month forward.
[8.15.2.10 NMAC - Rp, 8.15.2.10 NMAC, 02/14/05; A, 08/31/06]
8.15.2.11 ELIGIBILITY
REQUIREMENTS: Clients are eligible for child care
assistance benefits upon meeting the requirements for eligibility as determined
by the department and federal regulation.
A. The
household: The household includes biological parents, stepparents, and legal
guardians living in the household, thereby constituting an economic unit, and
any dependents of the aforementioned who are under 18 years of age.
Grandparents will be considered household members only if they are legal
guardians of the children, are providing for the physical and emotional needs
of the children, and/or are applying for child care benefits on behalf of the
children.
B. Allowed
exclusions from the household: Excluded from the household for co-pay
calculation purposes are grandparents or legal guardians who have taken
custody/guardianship of children due to circumstances such as death of
biological parents or other documented circumstances such as mental or physical
incapacity of biological parents to care for the child or children.
Grandparents and/or legal guardians in this situation are required to qualify
for child care assistance as per Subsection D below and, upon qualification,
have the required co-pay waived.
C. Adult
dependent children: Eighteen (18) year old dependent children must be attending
school to be counted in the household. Incidental money earned by dependent
children is not to be counted as household income.
D. Household
income: Income eligibility for benefits is determined by the number of members
in the household and the total countable earned and unearned income.
E. Countable
earned and unearned income: The
following sources of income are counted when computing a family’s eligibility
for assistance and for determining the co-payment (if applicable). These
include, but are not limited to: income from employment by working for others
or from self-employment; child support payments; alimony payments; veterans
administration (VA) payments except VA payments for educational purposes; union
payments; unemployment or workman’s compensation; social security benefits for
dependent children; railroad retirement benefits; pensions; work study income; TANF benefits, including diversionary payments; royalties;
cash gifts, and income from rental property.
F. Exempt
income: The types of income not counted when computing eligibility or
co-payments include but are not limited to: earnings of a dependent child who
is under 18 and in school; food stamps, military food and housing allowances;
an increase in military salary or allowances due to “temporary national
emergency status beginning September 11, 2001;” third party payments; energy
assistance benefits; foster care payments; supplemental security income (SSI); loans; child or adult nutrition programs; income tax
refunds; payments for educational purposes; compensation under the Domestic
Volunteer Services Act and the volunteers in service to America (VISTA)
program; Work Investment Act (WIA) payments made to dependent
children; relocation payments; department of vocational rehabilitation (DVR)
training payments; in-kind gifts; payments from special funds such as the agent
orange settlement fund or radiation exposure compensation settlement fund; lump
sum payments such as those resulting from insurance settlements and court
judgments; or other resources such as savings, individual retirement accounts
(IRAs), vehicles, certificates of deposits (CDs) or checking accounts.
G. Verification
of income: Clients applying for child care assistance benefits are required to
verify income by providing proof of income for all members of the household who
receive income. Self-employed clients must show proof of business expenses in
order for the countable self-employment income to be determined.
H. Residency
requirement: A recipient of child care assistance or a child care provider must
be a resident of the state of New Mexico. Proof of residency is required.
I. Citizenship:
A recipient of child care assistance must be a citizen of the United States; or
a qualified alien as determined by applicable federal laws. If a child is
determined to be a citizen of the United States or a qualified alien, as
approved by the New Mexico human services department, the child will be eligible provided all other eligibility
requirements are met regardless of the citizenship and/or alien status of the
child’s parent or parents.
J. Age
requirement: Child care benefits are paid for children between the ages of six
(6) weeks up to the month in which the child turns 13 years old.
K. Teen
parent: A teen parent who is attending a high school or a GED
program or attending any other job skills training and/or educational programs
directly related to enhancing employment opportunities is prioritized relative
to budget availability.
L. Failure
to use authorized child care: If authorized child care has not been used for 10
consecutive scheduled days without a reason such as illness, sudden death, or
family medical emergency, child care assistance services may be
terminated. The department notifies the
client and requests contact within fourteen (14) calendar days of the mailing
date of the notification. If there is no contact by the final day of the
expiration of the fourteen (14) calendar day notice, the case will be closed.
The provider will be issued a fourteen (14) calendar day notice of the date of
the closure and payment will be made through the final day of the expiration of
the provider’s fourteen (14) calendar day notice, if the provider has reported
the non-attendance in a timely manner.
Clients in cyclical employment are exempted.
M. Work/education
requirement: Child care benefits are paid only for families who are working,
attending school or participating in a job training or educational program and
who demonstrate a need for care during one or more of these activities. Clients who are receiving TANF
are required to participate in a TANF-approved
activity. Work, educational or community
service activities must be approved by HSD for food stamp E&T
clients. Child care will not be paid
during the hours in which a parent or guardian is attending graduate or
post-graduate courses.
N. Special
supervision: Child care benefits may be provided to children between the ages
of thirteen and eighteen who are under the supervision of a court of law, or
who are determined by a medical professional to require supervision because of
a diagnosis of a physical, emotional, or neurobiological impairment, or who are
physically or mentally incapable of caring for themselves. Children with
special needs are prioritized relative to budget availability.
O. Children
enrolled in head start, kindergarten, school or other programs: Child care
benefits are not paid during the hours that children are attending head start,
kindergarten, school or other programs.
[8.15.2.11 NMAC - Rp, 8.15.2.11 NMAC, 02/14/05]
8.15.2.12 RECERTIFICATION: Clients must
recertify for services at least once every six (6) months and must provide
continued proof of eligibility. If recertification
is not completed in a timely manner, the case may be closed on the last day of
the month for which assistance is provided under the previous placement
agreement. At time of recertification,
clients must provide proof of income, and/or proof of school enrollment.
Changes in income, household size, employment, training or educational status
are noted in the client’s record.
Co-payment, if applicable, is re-determined at the time of
recertification.
[8.15.2.12 NMAC - Rp, 8.15.2.12 NMAC, 02/14/05]
8.15.2.13 CLIENT
RESPONSIBILITIES: Clients must abide by the regulations set
forth by the department and utilize child care assistance benefits only while
they are working, attending school or participating in a training program.
Using child care for recreational or other purposes is considered fraud and
sanctions may be imposed, including recoupment.
A. Co-payments: Co-payments are paid by all clients receiving
child care assistance benefits, except for child protective services
(CPS). Co-payments are based upon the
size and income of the household.
B. Co-payments
for each additional child are determined at one half of the co-payment for the
previous child.
C. Co-payments
for children in part-time care are determined based upon the block of time that
the child is in care.
D. Clients
pay co-payments directly to their child care provider and must remain current
in their payments. A client who does not
pay co-payments may be subject to sanctions.
E. In-home
providers: Parents who choose to use an in-home provider become the employer of
the child care provider and must comply with all federal and state requirements
related to employers, such as the payment of all federal and state employment
taxes and the provision of wage information. Any parent who chooses to employ
an in-home provider releases and holds the department harmless from any and all
actions resulting from their status as an employer. Payments for in-home
provider care are made directly to the parent.
F. Notification
of changes: Clients must notify the department of changes in income or other
factors affecting the receipt of child care benefits, and report any change(s)
in circumstances that affect benefits within 14 calendar days of the change,
including increase in earnings, losing or changing employment, increase or
decrease in work hours, change in school or training status, change in address
or residency status, or household composition. Priority one clients whose TANF cases are closed by the human services department at
the time of their TANF recertification, must contact
the department immediately. Clients who do not comply with this requirement may
be sanctioned, and may be subject to the recoupment
process.
[8.15.2.13 NMAC - Rp, 8.15.2.13 NMAC, 02/14/05]
8.15.2.14 CASE
SUSPENSIONS: Clients who are engaged in cyclical
educational programs or cyclical employment, such as students, public school
employees, and school bus drivers may request temporary suspension, not to
exceed three months per occurrence, of the use of child care assistance
benefits without losing eligibility for benefits. Pregnant women in the third trimester of their pregnancy or whose
doctor determines that continued employment before birth jeopardizes the mother
or the unborn child’s health may request suspension of their case. A client may
request suspension of a case for maternity leave after the birth or adoption of
a child for up to three months. The case may be suspended for longer than three
months if there are documented medical complications for either the mother or
the child. In addition, a case may be suspended for up to three months for a
medically documented condition. A case may also be suspended with child care
benefits being paid for up to 30 calendar days in a situation of lost
employment, providing the client is making a bona fide effort to secure new
employment, and the client reports the change in a timely manner. Case suspensions due to lost employment are
not to exceed two occurrences per calendar year.
[8.15.2.14 NMAC - Rp, 8.15.2.14 NMAC, 02/14/05]
8.15.2.15 PROVIDER
REQUIREMENTS: Child care providers must abide by all department regulations and provide child care paid
for by the department to clients only while such clients are working, attending
school or participating in a training program or participating in a TANF or food stamp E&T
program approved activity/component.
Child care provided for recreational or other purposes, or at times
other than those outlined in the child care agreement, are
paid for by the client. Knowingly
accepting payment from the department for child care provided for recreational
and other purposes is considered fraud and sanctions may be imposed.
A. All
child care providers who receive child care assistance reimbursements are
required to be licensed or registered by the department and meet and maintain
compliance with the appropriate licensing and registration regulations in order
to receive payment for child care services. All registered homes receiving
child care assistance subsidies must be enrolled and participate in a CACFP, unless they are ineligible. All registered homes
receiving child care assistance subsidies who register after July 1, 2006 must
complete, within six months of registration, an 18-hour course or an equivalent
approved by the department. The 18-hour course will count toward the 6-hour
annual training requirement during the year in which the course was completed
and the following year, exclusive of training required by CACFP.
Beginning July 1, 2006, all licensed providers receiving child care assistance
subsidies must have a 2-Star level at the time of their renewal. The department
honors properly issued military child care licenses to providers located on
military bases and tribal child care licenses properly issued to providers
located on tribal lands. First time
registered home providers have up to a 45 consecutive calendar day grace period
in which to comply with the registration requirement. A 45 calendar day
grace period is issued one time only. A
child protective services screen will be conducted on all new registered
providers and at their annual registration renewal. Evidence of a substantiated referral for
child abuse and/or neglect for a provider, a second caregiver, or any persons
age 18 or over residing in the provider’s home and/or working in a licensed
child care center/home will result in the ineligibility of that provider to
receive payments under the child care assistance program. The only exception is when a custodial parent
has a substantiated referral but resides with the child care provider who does
not have a substantiated referral.
B. Child
care providers collect required co-payments from clients and provide child care
according to the terms outlined in the child care agreement.
C. New
child care providers must participate in at least one orientation session
within the first six months of becoming a child care vendor for the department.
Providers are notified of this requirement. Providers who do not comply with
this requirement are not paid past this six month grace period and are provided
notice that payment may be suspended until this requirement is met.
D. Child
care providers must notify the department if the child is disenrolled
or is absent for 10 consecutive scheduled days.
Absences totaling ten or more consecutive scheduled days must be
approved by the client’s caseworker.
Providers who do not comply with this requirement are sanctioned and may
be subject to recoupment or disallowance of payments.
E. Child
care providers accept the rate the department pays for child care and are not
allowed to charge families receiving child care assistance above the department
rate.
(1) In situations where an incidental cost
may occur such as field trips, special lunches or other similar situations, the
child care provider is allowed to charge the child care assistance family the
additional cost, provided the cost does not exceed that charged to private pay
families.
(2) Providers may charge a
registration/educational fee to a child care assistance family comparable to
but not to exceed that charged to private pay families.
(3) Child care providers are allowed to charge
child care assistance families the applicable gross receipts tax for the sum of
the child care assistance benefit and co-payment.
F. Under
emergency circumstances, when CYFD has reason to believe that the health,
safety or welfare of a child is at risk, the department may immediately suspend
and/or terminate assistance payments to a licensed or registered provider.
[8.15.2.15 NMAC - Rp, 8.15.2.15 NMAC, 02/14/05; A, 09/15/05]
8.15.2.16 DEPARTMENT
RESPONSIBILITIES:
A. The
department pays child care providers who provide child care services to
department clients in a timely manner.
B. Child
care assistance workers perform all casework functions in a timely manner,
including the processing of payments and notifications of case actions.
C. Child
care assistance workers notify clients and providers in writing of all actions,
which affect services, benefits, or provider payments or status, citing the
applicable policy.
D. Child
care assistance workers determine eligibility for all child care assistance
programs except for TANF and E&T. Eligibility for TANF
and food stamp E&T program is determined by the
New Mexico human services department.
E. Child
care assistance workers must inform parents of their right to choose their
child care providers and provide information on how to look for quality child
care in a provider.
F. The
department and other organizations approved by the department provide
information and orientation programs regarding child care assistance benefits,
quality child care issues, and the impact of child care on the child’s
physical, mental, social and emotional development to parents and providers.
G. The
department and other organizations approved by the department offers provider
education programs consisting of training on program participation
requirements, parent and provider responsibilities, licensing and registration
requirements, payment issuance and background check processing, the competency
areas for child care providers as outlined by the office of child development,
or the department, the importance of providing quality child care, and other
topics of interest to parents and providers. These education programs count
toward the continuing education hours required of providers by registration and
licensing regulations.
[8.15.2.16 NMAC - Rp, 8.15.2.16 NMAC, 02/14/05; A, 08/31/06]
8.15.2.17 PAYMENT
FOR SERVICES: The department pays child care providers on a
monthly basis, according to standard practice for the child care industry. Payment is based upon the child’s enrollment
with the provider as reflected in the child care placement agreement, rather
than daily attendance. As a result, most
placements reflect a month of service provision and are paid on this basis.
However, placements may be closed at any time during the month. The following
describes circumstances when placements may be closed and payment discontinued
at a time other than the end of the month:
A. When
the eligibility period as indicated by the child care placement agreement
expires during the month, including the end of a school semester; or when the
provider requests that the client change providers or the provider discontinues
services; payment will be made through the last day that care is provided.
B. When
the client requests a change of provider, regardless of the reason, payment
will be made through the final day of the expiration of the fourteen (14)
calendar day notice issued to the provider. Payment to the new provider begins
on the day care begins.
C. The
amount of the payment is based upon the average number of hours per week needed
per child during the certification period. The number of hours of care needed
is determined with the parent at the time of certification and is reflected in
the provider agreement. Providers are paid according to the units of service
needed which are reflected in the child care agreement covering the certification
period.
D. The
department pays for care based upon the following units of service:
|
Full time |
Part time 1 |
Part time 2 |
Part time 3 |
|
Care provided for an
average of 30 or more hours per week per month |
Care provided for an average
of 20-29 hours per week per month |
Care provided for an
average of 6 -19 hours per week per month |
Care provider for an
average of 5 or less hours per week per month |
|
Pay at 100% of full time
rate |
Pay at 75 % of full time
rate |
Pay at 50 % of full time
rate |
Pay at 25% of full time
rate |
E. Out
of school time care provided by licensed child care providers who provide care
for 6-19 hours per week are paid at the 75% rate (part time 1).
F. Out
of school time care provided by licensed child care providers who provide care
for 20 or more hours per week are paid at the 100% rate (full time).
G. Out
of school time care provided for 5 hours or less per week are
paid at the 25% rate (part time 3) regardless of provider type.
H. Monthly
reimbursement rates
|
|
Licensed child care centers |
||||||||||
|
|
Full time |
Part time 1 |
Part time 2 |
Part time 3 |
|||||||
|
|
Metro |
Rural |
Metro |
Rural |
Metro |
Rural |
Metro |
Rural |
|||
|
Infant |
$476.37 |
$418.75 |
$357.28 |
$314.06 |
$238.19 |
$209.38 |
$119.09 |
$104.69 |
|||
|
Toddler |
$425.72 |
$389.63 |
$319.29 |
$292.22 |
$212.86 |
$194.81 |
$106.43 |
$97.41 |
|||
|
Pre-school |
$395.01 |
$363.02 |
$296.26 |
$272.27 |
$197.51 |
$181.51 |
$98.75 |
$90.76 |
|||
|
School age |
$345.64 |
$332.96 |
$259.23 |
$249.72 |
$172.82 |
$166.48 |
$86.41 |
$83.24 |
|||
|
|
Licensed group homes
(capacity: 7-12) |
||||||||||
|
|
Full time |
Part time 1 |
Part time 2 |
Part time 3 |
|||||||
|
|
Metro |
Rural |
Metro |
Rural |
Metro |
Rural |
Metro |
Rural |
|||
|
Infant |
$379.01 |
$355.96 |
$284.26 |
$266.97 |
$189.51 |
$177.98 |
$94.75 |
$88.99 |
|||
|
Toddler |
$343.93 |
$336.23 |
$257.95 |
$252.17 |
$171.97 |
$168.12 |
$85.98 |
$84.06 |
|||
|
Pre-school |
$338.08 |
$330.81 |
$253.56 |
$248.10 |
$169.04 |
$165.40 |
$84.52 |
$82.70 |
|||
|
School age |
$333.53 |
$323.53 |
$250.15 |
$242.65 |
$166.77 |
$161.77 |
$83.38 |
$80.88 |
|||
|
|
Licensed family homes
(capacity: 6 or less) |
||||||||||
|
|
Full time |
Part time 1 |
Part time 2 |
Part time 3 |
|||||||
|
|
Metro |
Rural |
Metro |
Rural |
Metro |
Rural |
Metro |
Rural |
|||
|
Infant |
$365.20 |
$342.60 |
$273.90 |
$256.95 |
$182.60 |
$171.30 |
$91.30 |
$85.65 |
|||
|
Toddler |
$325.08 |
$320.04 |
$243.81 |
$240.03 |
$162.54 |
$160.02 |
$81.27 |
$80.01 |
|||
|
Pre-school |
$324.17 |
$317.09 |
$243.13 |
$237.81 |
$162.09 |
$158.54 |
$81.04 |
$79.27 |
|||
|
School age |
$319.28 |
$309.64 |
$239.46 |
$232.23 |
$159.64 |
$154.82 |
$79.82 |
$77.41 |
|||
|
|
Registered homes and
in-home child care |
||||||||||
|
|
Full time |
Part time 1 |
Part time 2 |
Part time 3 |
|||||||
|
|
Metro |
Rural |
Metro |
Rural |
Metro |
Rural |
Metro |
Rural |
|||
|
Infant |
$278.74 |
$258.00 |
$209.06 |
$193.50 |
$139.37 |
$129.00 |
$69.69 |
$64.50 |
|||
|
Toddler |
$264.00 |
$217.69 |
$198.00 |
$163.27 |
$132.00 |
$108.85 |
$66.00 |
$54.42 |
|||
|
Pre-school |
$242.00 |
$220.00 |
$181.50 |
$165.00 |
$121.00 |
$110.00 |
$60.50 |
$55.00 |
|||
|
School age |
$242.00 |
$198.00 |
$181.50 |
$148.50 |
$121.00 |
$99.00 |
$60.50 |
$49.50 |
|||
I. The
department pays a differential rate according to the location of the provider, license
or registration status of the provider, national accreditation status of the
provider if applicable, Star level status of the provider if applicable, and in
accordance with the rate established for metro or rural location of the
provider. Providers located in the
metropolitan statistical areas of the state as determined by the U.S. census
bureau receive the metropolitan rate. These include Bernalillo, Sandoval,
Valencia, Santa Fe, Los Alamos, Dona Ana, and San Juan counties. All
other providers receive the rural rate.
J. Providers
holding national accreditation status receive an additional $120.00 per child
per month for full time care above the metro rate for type of child care
(licensed center, group home or family home) and age of child. All licensed nationally accredited providers
will be paid at the metro rates for the appropriate age group and type of
care. In order to continue at this
accredited reimbursement rate, a provider holding national accreditation status
must meet and maintain licensing standards and maintain national accreditation
status without a lapse. If a provider holding national accreditation status
fails to maintain these requirements, this will result in the provider reimbursement reverting to a lower level of
reimbursement. The provider is required to notify the department immediately
when a change in accreditation status occurs.
K. The
department pays a differential rate to providers achieving higher Star levels
as follows: 2-Star at $45.00 per month
per child for full time care above the base reimbursement rate; 3-Star at
$70.00 per month per child for full time care above the base reimbursement
rate; 4-Star at $104.50 per month per child for full time care above the base
reimbursement rate, and 5-Star at $132.00 per child per month for full time
care above the base reimbursement rate.
In order to continue at these reimbursement rates, a provider must
maintain and meet most recent star criteria and basic licensing requirements.
If the provider fails to meet the requirements, this will result in the
provider reimbursement reverting to the level demonstrated.
L. The
department pays a differential rate equivalent to 5, 10, or 15% of the
applicable full-time/part-time rate to providers who provide care during
non-traditional hours. Non-traditional care will be paid according to the
following charts:
|
|
1-10 hrs/wk |
11-20 hrs/wk |
21 or more hrs/wk |
|
After hours |
5% |
10% |
15% |
|
|
1-10 hrs/wk |
11-20 hrs/wk |
21 or more hrs/wk |
|
Weekend hours |
5% |
10% |
15% |
M. If
a significant change occurs in the client’s circumstances, (for example, an
increase or decrease in income, or a change in work schedule) the child care
placement agreement is modified and the rate of payment is adjusted. The department monitors attendance and
reviews the placement at the end of the certification period when the child is
re-certified.
N. The
department may conduct provider or parent audits to assess that the approved
service units are consistent with usage.
Providers found to be defrauding the department are sanctioned. Providers must provide all relevant
information requested by the department during an audit.
O. Payments
are made to the provider for the period covered in the placement agreement or
based on the availability of funds, which may be shorter than the usual six
month certification period. The client’s certification period may be
established for a period less than six months, if applicable to their need for
care.
[8.15.2.17 NMAC - Rp, 8.15.2.17 NMAC,
02/14/05; A, 08/31/06; A/E, 8/15/07]
8.15.2.18 UNDER
PAYMENTS: If a client or provider is underpaid for
child care services, the department may issue a one-time payment within 15
calendar days of the departments knowledge or receipt
of notification. Notification of the department by the client or provider must
occur within 90 calendar days of the occurrence of alleged underpayment.
[8.15.2.18 NMAC - Rp, 8.15.2.18 NMAC, 02/14/05]
8.15.2.19 OVER
PAYMENT AND RECOUPMENT: If a provider
receives payment for services for which he/she is not entitled, or a client
receives benefits on behalf of their child for which he/she is not entitled,
and this results in an overpayment, the child care
worker will initiate recoupment procedures unless the
family services director deems otherwise in exceptional circumstances. The
client or provider must repay the amount of the overpayment to the department
within 30 calendar days of notification, unless the department determines that
the amount is so large that it cannot be paid in one lump sum. In this case,
the department may allow the client or provider to repay the amount over a
payment period, usually not to exceed four months. The department arranges with
the client or provider to make regular payments over the agreed-upon payment
period or establishes a schedule of deductions from future payments issued over
the agreed-upon payment period. Failure to make regular payments may result in
sanctions including termination of benefits and/or referral of the account to a
collection agency and/or legal action.
[8.15.2.19 NMAC - Rp, 8.15.2.19 NMAC, 02/14/05]
8.15.2.20 FRAUD: The purposeful
misrepresentation of facts relating to eligibility for benefits, or knowingly
omitting information that affects eligibility is fraud and appropriate sanctions
are initiated by the department. Fraudulent cases are reported to the
department, which will take such action as is deemed necessary. The case
remains open at the same rate of benefits until the investigation is concluded
and disposition is determined.
[8.15.2.20 NMAC - Rp, 8.15.2.20 NMAC, 02/14/05]
8.15.2.21 SANCTIONS: Sanctions may
be imposed on clients/providers for failing to meet programmatic requirements
which affect benefits and result in an overpayment. Sanctions are imposed according to the
severity of the infraction as determined by the department and as detailed
below.
A. Providers
or clients who fail to make timely payments in the case of recoupment
of overpayments are disqualified from the program until payment is brought
current.
B. Providers
or clients who fail to report in a timely manner that a child is not in
attendance for ten consecutive, scheduled days will have the payment recoupment process initiated.
C. Providers
who allow their registration or license to lapse without renewal will not be
paid during the periods for which the license or registration is not current. Providers who lose national accreditation status or lose
eligibility for payment at any level of reimbursement for failure to maintain
the standards required to be paid at that level of reimbursement, will not be
paid at that level of reimbursement beginning with the first day of the month
during which the loss of accreditation or eligibility occurred. Payment recoupment will be sought for any period for which excessive
benefits have been paid.
D. Clients
who fail to pay co-payments may be disqualified until the co-payment is paid
and/or until an agreement is made between the client and the provider to bring
the co-payment current. The department assists the provider in collecting the
co-pay only if the co-pay has been in arrears 30 calendar days or less.
E. Clients
who fail to timely report changes that affect their eligibility resulting in an
overpayment will be sanctioned and payment recoupment
will be sought for the entire amount accruing from the end of the 14 calendar
days allowed for notification through the date the client provides notice of
the change to the department. A first
offense results in a written warning and recoupment;
a second offense results in a 3-month suspension and recoupment;
and a subsequent offense results in permanent disqualification.
[8.15.2.21 NMAC - Rp, 8.15.2.21 NMAC, 02/14/05; A, 08/31/06]
8.15.2.22 FAIR
HEARINGS: Clients who have been denied benefits, whose
benefits have been reduced, suspended, or terminated, or who have been
sanctioned or disqualified from the program, or providers who have been
sanctioned, disqualified from the program, had assistance payments suspended or
terminated, or from whom a payment recoupment is being
sought may request a fair hearing. The
request for a fair hearing must be made in writing within 30 calendar days from
the date the department took the adverse action affecting the claimant’s
benefits.
A. The
department reviews the request for hearing and determines if the matter can be
resolved without proceeding to a fair hearing. If the matter cannot be resolved
without a fair hearing, the department conducts the fair hearing within 60
calendar days of receipt of the letter requesting the hearing and notifies the
claimant of the date of the hearing no less than 14 calendar days prior to the
hearing. The location of the hearing must be easily accessible to the claimant.
Conducting the fair hearing by telephone is permitted. The claimant may request
a change of date, provided that the 60 calendar day time limit is not exceeded.
B. The
department appoints a hearing officer. The department is not responsible or
liable for a claimant’s travel costs, legal costs, or any other costs
associated with the claimant’s request for a fair hearing.
C. The
hearing officer reviews all of the relevant information and makes a final
decision within 30 calendar days of the hearing. The final decision is binding upon the
department and claimant and implemented within 14 calendar days of the hearing
decision. The claimant is notified in writing of the hearing officer’s decision
within 14 calendar days of the hearing decision.
D. At
the claimant’s option the case may remain open at the same benefit level until
disposition. If the decision is in favor
of the department, the claimant is responsible for repayment of all monies
received to which the claimant was not entitled, unless the hearing decision
provides otherwise or the family services director authorizes otherwise in
exceptional circumstances. The fair
hearing process is not intended as a means to extend the time for receipt of
child care assistance payments to which the recipient is not otherwise
entitled, and therefore exceptional circumstances must be explicitly stated.
E. Child
care assistance workers determine eligibility for all child care assistance
programs except for TANF and E&T. Eligibility for TANF
and food stamp E&T program is determined by the
New Mexico human services department. If TANF and E&T benefits are modified or terminated by HSD, then
the client applies for a fair hearing to HSD.
[8.15.2.22 NMAC - Rp, 8.15.2.22 NMAC, 02/14/05]
8.15.2.23 COMPLAINTS: Clients or
providers who are dissatisfied with the services provided by the department may
express their complaints orally or in writing to the local field office, the
central office, the director’s office or the office of the department
secretary. The department’s toll free
number is posted in each office and made available to clients and providers
upon request. The local supervisor,
bureau chief, director or secretary responds to complaints by clients or
providers orally or in writing as is deemed appropriate in each case.
[8.15.2.23 NMAC - Rp, 8.15.2.23 NMAC, 02/14/05]
8.15.2.24 CO-PAYMENT
SCHEDULE: The department will develop and publish an
annual co-payment schedule based on the federal poverty guidelines.
[8.15.2.24 NMAC - Rp, 8.15.2.24 NMAC, 02/14/05]
8.15.2.25 CONFIDENTIALITY: Client files are
established and maintained solely for use in the administration of the child
care assistance program. Information
contained in the records is confidential and is released only in the following
limited circumstances:
A. to
the client upon request;
B. to
an individual who has written authorization from the client;
C. to
department employees and agents who need it in connection with program
administration, including program auditors;
D. to
other agencies or individuals including law enforcement officers who satisfy
the following conditions:
(1) agency or
individual is involved in the administration of a federal or a
federally-assisted program, which provides assistance in cash, in kind or in
services directly to individuals on the basis of need;
(2) information is to
be used for the purpose of establishing eligibility, determining amount of
assistance or for providing services for applicants or recipients;
(3) agency or
individual is subject to standards of confidentiality comparable to those
contained herein; and;
(4) agency or individual has actual or implied
consent of the applicant or recipient to release the information; in an
emergency, information may be released without permission, but the client must
be informed of its release immediately thereafter; consent may be considered as
implied if the client has made application to the inquiring agency for a
benefit of service;
E. as
requested in a subpoena or subpoena duces tecum.
[8.15.2.25 NMAC - Rp, 8.15.2.25 NMAC, 02/14/05]
HISTORY OF 8.15.2 NMAC:
Pre-NMAC History: The material in this part was derived from
that previously filed with the Commission of Public Records B State Records
Center and Archives:
ISD
CCAP 200, Child Care Assistance Programs, 11/4/91.
ISD CCAP 300, Hours Of Child Care, 11/4/91.
ISD CCAP 700, Working Family
Child Care Assistance Eligibility, 11/4/91.
ISD CCAP 800, Income Eligible
Child Care Assistance, 2/10/92.
History
of Repealed Material:
8 NMAC 15.2
Requirements for Child Care Assistance Programs for Clients and Child Care
Providers, - repealed, 8/1/99.
8 NMAC 15.2
Requirements for Child Care Assistance Programs for Clients and Child Care
Providers, - repealed, 8/1/00.
8 NMAC 15.2
Requirements for Child Care Assistance Programs for Clients and Child Care
Providers, - repealed, 8/1/01.
8.15.2 NMAC
Requirements for Child Care Assistance Programs for Clients and Child Care
Providers, - repealed, 11/01/02.
8 15.2 NMAC
Requirements for Child Care Assistance Programs for Clients and Child Care
Providers, - repealed, 2/14/05.