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Title 13: Social Service Resources Page 86 Iowa Department of Health and Human Services Employees’ Manual Chapter G: Child Care Assistance Identifying the Provider Revised June 14, 2024 Provider Requirements

* Applicant will choose a provider. * CCCAU or PJ worker will check KT. Licensed/ Registered Non-registered or Non-licensed HHS sends a copy of the Provider Agreement to CCA or PJ worker upon request CCA or PJ worker completes NOD based upon the clients' need for service ELIGIBLE NOT ELIGIBLE CCCAU or PJ worker will issue NOD Provider Agreement on file with HHS? CCCAU or PJ worker sends the provider: * Payment Application for Nonregistered Providers, form 470-2890 or 470-2890(S) * Non-Law Enforcement Record Check, form 595-1489 or 595-1489(S) * Comm 95 * Child Care Assistance Provider Agreement, form 470-3871 Applicant must choose another provider Forward all forms to CCCAU staff at HHS central office HHS CCCAU staff: * Completes all required record checks * Completes form 470-3871 or 470-3871(S) YES YES Go to 1 NO Provider returns forms to CCA or PJ worker? NO YES 1 Checks done already? YES NO NO Let CCA or PJ worker know: * "yes" provider has been approved, or * "no" provider is not approvable CCA Provider Eligibility Determination Process and Form Flow Provider returns forms to CCA or PJ worker? CCA or PJ worker sends the provider Child Care Assistance Provider Agreement, form 470-3871 or 470-3871(S) Applicant must choose another provider NO No Provider Agreement on file with HHS? Yes Yes CCCAU or PJ worker determines need for CCA and eligibility for family