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249 4110-3 B. STANDARD AND VARIABLE LANGUAGE ON A CHILD CARE ASSISTANCE AUTHORIZATION DOCUMENT The Child Care Assistance Authorization document includes standard language which prints at the bottom of the document, to advise parents and child care providers of the following: a registration fee of up to $50 may be paid to licensed providers; parents are responsible for any costs a provider charges over the authorized rate, in addition to their monthly co-pay; care authorized on an attendance basis will only be paid for the time the child is in care; and payment will not exceed a full month enrollment plus a part month enrollment. 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 $ 3689.00Caregiver (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 PASSI) Variable language will also be typed in, if necessary, to provide additional and/or specific unit of care or payment clarification(s) for a child or month included on the Child Care Assistance Authorization document. Variable language must not include any specific parent information including a parent’s: eligible activity; place of employment; income; hours engaged in their activity; or the name of a child’s school; or hours the child will be in attendance.