Page 126

99

category, and units of care; g. Anticipated eligible cost of care and for PASS II and III, the family’s contribution (co-pay) ; h. Maximum amount payable by the State of Alaska CCAP;and i. Variable language providing specific additional information pertaining to the unit of careauthorized.

2. Authorization Documents Include StandardLanguage Advising both the Family and Provider that: a. Attendance based care is paid only for the time the child is actually in care and the parent is in an eligibleactivity; b. Registration fee charged by a licensed provider may be paid annually up to $50.00 per child; c. The parent is responsible for any costs a provider charges over the authorized rate in addition to the monthlyco-pay; and d. Payment will be made for up to the authorized care not to exceed a full time monthly enrollment plus a part timemonthly enrollment. 3. PASS I Standard Variable Language The Child Care Assistance Authorization document includes the PASS I family’s caseworker and phone number. When a Manual Authorization Request Form – PASS I CC02 is submitted instead of a Request for PASS I Child Care, the family’s case manager and phone number must be entered into the variable section before “creating” the document.

The Child Care Assistance Authorization document also includes free form space for variable language to be entered, only as necessary, to provide additional information for providers about the care authorized and/or any payment parameters. Variable language is not used for every authorization.

The following variable language options are available in ICCIS and are to be used when applicable, when creating the Child Care Assistance Authorization document:

a. In-Home: Payment for authorized care with In-Home caregiver not to exceed the monthly maximum of $3689.00 Caregiver (name must be typed in); and

b. New Provider: **INITIAL AUTHORIZATION: No further authorizations will be issued to this provider until they complete the application process. (This can only be used for PASS I)