4.4 Payment Practices to Providers

Lead Agencies must use subsidy payment practices that reflect practices that are generally accepted in the private pay child care market. The Lead Agency must ensure timeliness of payment to child care providers by paying in advance or at the beginning of delivery of child care services. Lead Agencies must also support the fixed cost of child care services based on paying by the child’s authorized enrollment, or if impracticable, an alternative approach that will not undermine the stability of child care programs as justified and approved through this Plan. Lead Agencies must also (1) pay providers based on established part-time or full-time rates rather than paying for hours of service or smaller increments of time, and (2) pay for reasonable, mandatory registration fees that the provider charges to private-paying parents. These policies apply to all provider types unless the Lead Agency can demonstrate that in limited circumstances the policies would not be considered generally-accepted payment practices. In addition, Lead Agencies must ensure that child care providers receive payment for any services in accordance with a payment agreement or an authorization for services, ensure that child care providers receive prompt notice of changes to a family’s eligibility status that could impact payment, and have timely appeal and resolution processes for any payment inaccuracies and disputes. 4.4.1 Prospective and enrollment-based payment practices Lead Agencies must use payment practices for all CCDF child care providers that reflect generally- accepted payment practices of providers serving private-pay families, including paying providers in advance or at the beginning of the delivery of child care services and paying based on a child’s authorized enrollment or an alternative approach for which the Lead Agency must demonstrate paying for a child’s authorized enrollment is not practicable and it will not undermine the stability of child care programs. Lead Agencies may only use alternate approaches for subsets of provider types if they can demonstrate that prospective payments and authorized enrollment-based payment are not generally-accepted for a type of child care setting. Describe the Lead Agency payment practices for all CCDF child care providers: a. Does the Lead Agency pay all provider types prospectively (i.e., in advance of or at the beginning of the delivery of child care services)? [ ] Yes. If yes, describe: [x] No, it is not a generally-accepted payment practice for each provider type. If no, describe the provider type not paid prospectively and the data demonstrating it is not a generally-accepted payment practice for that provider type, and describe the Lead Agency’s payment practice that ensures timely payment for that provider type: The Lead Agency cannot currently pay prospectively and has submitted a waiver per Office of Child Care guidance. The Lead Agency has requested a waiver through August 1, 2026, and intends to use the time allowed to develop and implement the necessary policies and procedures to be compliant. b. Does the Lead Agency pay based on authorized enrollment for all provider types? [ ] Yes. The Lead Agency pays all providers by authorized enrollment and payment is not altered based on a child’s attendance or the number of absences a child has. [ ] No, it is not a generally-accepted practice for each provider type. If no, describe the provider types not paid by authorized enrollment, including the data showing it is not a generally-accepted payment practice for that provider type, and describe how the payment policy accounts for fixed costs: [x] It is impracticable. Describe provider type(s) for which it is impracticable, why it is impracticable, and the alternative approach the Lead Agency uses to delink provider payments from occasional absences, including evidence that the alternative approach will not undermine the stability of child care programs, and thereby accounts for fixed costs: The Lead Agency cannot currently pay based on authorized enrollment and has submitted a waiver per Office of Child Care guidance. The Lead Agency has requested a waiver through August 1, 2026, and intends to use the time allowed to develop and implement the necessary policies and procedures to be compliant. 4.4.2 Other payment practices Lead Agencies must (1) pay providers based on established part-time or full-time rates rather than paying for hours of service or smaller increments of time, and (2) pay for reasonable, mandatory registration fees that the provider charges to private-paying parents, unless the Lead Agency provides evidence that such practices are not generally-accepted for providers caring for children not participating in CCDF in its State or Territory. a. Does the Lead Agency pay all providers on a part-time or full-time basis (rather than paying for hours of service or smaller increments of time)? [x] Yes. [ ] No. If no, describe the policies or procedures that are different than paying on a part- time or full-time basis and the Lead Agency’s rationale for not paying on a part-time or full-time basis: b. Does the Lead Agency pay for reasonable mandatory registration fees that the provider charges to private-paying parents? [x] Yes. If yes, identify the fees the Lead Agency pays for: The Lead Agency allows each provider to claim and be paid a registration fee up to $65 once a year for each child with a CAPS scholarship issued to the provider. [ ] No. If no, identify the data and how data were collected to show that paying for fees is not a generally-accepted payment practice: c. Describe how the Lead Agency ensures that providers are paid in accordance with a written payment agreement or an authorization for services that includes, at a minimum, information regarding provider payment policies, including rates, schedules, any fees charged to providers, and the dispute-resolution process: Child care providers serving children participating in the CAPS program are required to sign a Child Care Provider Agreement (CPA) at initial enrollment and on an annual basis thereafter. The CPA defines provider rights and responsibilities, including CAPS payment policies, payment calculations, and the payment dispute resolution process. CAPS payment policies are posted on the CAPS website. Child care providers may also call or email the Lead Agency for questions related to payment policies. d. Describe how the Lead Agency provides prompt notice to providers regarding any changes to the family’s eligibility status that could impact payments, and such a notice is sent no later than the day that the Lead Agency becomes aware that such a change will occur: On the day that the Lead Agency is aware of eligibility status changes, notices are sent to providers through Georgia Gateway to inform providers of any potential impact to payments being issued by the lead agency. Georgia Gateway is the system used to determine eligibility, create cases, and issue scholarships for care at eligible provider locations. e. Describe the Lead Agency’s timely appeal and resolution process for payment inaccuracies and disputes: Payment disputes and concerns regarding payment inaccuracies are addressed through the Lead Agency’s Provider Relations Quality Assurance and Payments team. A provider can request payment adjustments in the payment system, Georgia’s Child Care and Administrative Payment System, GACAPS, for various reasons that resulted in an under or overpayment to the provider. These payment requests are reviewed by the team, and payments are netted against previous payments, when applicable. CAPS Policy 12.3.3.2 provides appeal rights for providers receiving subsidies through the CAPS program. The policy states that providers have the right to appeal finance related matters and can request a hearing. CAPS Policy 18.4.2 describes providers’ right to an administrative hearing and providers’ right to request a reconsideration related to reclaiming funds. When funds are recouped from a provider through payment reviews conducted by the Quality Assurance and Payments team, they will receive a request for reconsideration and review the prior decision. If the decision is affirmed, the provider has the right to appeal. Appeals are handled by the Lead Agency’s Legal Division. A reconsideration and appeal process is also afforded to providers for reviews conducted by the Lead Agency’s Audits and Compliance team. f. Other. Describe any other payment practices established by the Lead Agency: 4.4.3 Payment practices and parent choice How do the Lead Agency’s payment practices facilitate provider participation in all categories of care? The Lead Agency uses a web-based billing portal to process provider claims. Once eligible providers sign up to be a program provider for child care subsidy, they are automatically enrolled to use the web-based portal. All providers are paid via an ACH transfer to the account provided. The web-based portal allows providers to view eligible children assigned to their program, track attendance, and quickly submit an invoice for care weekly. In addition, as noted in 4.4.1, the Lead Agency has taken steps to support equal access to a range of providers by: delinking provider payments from a child’s occasional absence and paying providers for a full week of care if the child is present at least one day that week; paying providers up to two weeks a year even if the child is absent the entire week; paying for full-time or part-time care (rather than hours or other smaller increments); and paying for registration fees