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 reimburses providers on a two-week billing cycle. The Department is working to complete an online child care management system that will support the implementation of prospective payments based on enrollment in the Child Care Affordability Program. The Department anticipates implementation of prospective enrollment-based payments in 2025. 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 is in the midst of building a new data management system with a estimated launch date in 2025. The Lead Agency is also building a fiscal plan to meet CCDF Rule. 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? [ ] Yes. If yes, identify the fees the Lead Agency pays for: [x] No. If no, identify the data and how data were collected to show that paying for fees is not a generally-accepted payment practice: The Lead Agency conducts a survey of all providers at the time of new provider agreement enrollment periods every three years. At that time, the majority of providers indicated that this was not practiced by the majority. 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: Along with the provider agreement all new interested child care providers are sent a packet with the agreement. The packet includes market rates, the CCAP bi-weekly billing schedule, and billing fact sheets. The Department will pay the Child Care Provider within twenty-one (21) calendar days of receipt of an invoice/bill. The Department will not pay a Child Care Provider who does not submit a bill within sixty (60) calendar days of the Department established submission deadline. The State of Maine observes 13 paid holidays. (No fees are charged to Providers) The Lead Agency notifies providers at the time of any changes to a family’s CCAP award. Billing cycle dates are posted and sent to providers ahead of schedule. If there is a repayment needed for an improper payment, the Lead Agency notifies the provider and agrees to a payment schedule that is followed. Here is the information providers receive for the dispute-resolution process. Providers have the right to ask for an Administrative Hearing. If you want an informal conference with the State Child Care Administrator or his/her agent, you must request within ten (10) days of the receipt of notification by submitting a written request to: State Child Care Administrator Office of Child and Family Services, DHHS 11 State House Station, 2 Anthony Ave Augusta, Me 04333-0011 Services shall be continued throughout the entire hearing process when the written requests for a state Administrative Hearing are received within ten (10) calendar days. The Hearings Department will render a decision within 30 days of the hearing. 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: The Lead Agency notifies providers at the time of any changes to a family’s CCAP award A two- week notice is sent via mail and when possible email at the same time. e. Describe the Lead Agency’s timely appeal and resolution process for payment inaccuracies and disputes: The Lead Agency's CCAP Rules provide providers the Lead Agency's information regarding provider payment policies and the dispute-resolution process. The CCAP Provider Agreement provides the written agreement on information regarding provider payment policies, including rates, and schedules. Here is the information providers receive for the dispute-resolution process: Providers have the right to ask for an Administrative Hearing. If you want an informal conference with the State Child Care Administrator or his/her agent, you must request within ten (10) days of the receipt of notification by submitting a written request to: State Child Care Administrator Office of Child and Family Services, DHHS 11 State House Station, 2 Anthony Ave Augusta, Me 04333-0011 Services shall be continued throughout the entire hearing process when the written requests for a state Administrative Hearing are received within ten (10) calendar days. The Hearings Department will render a decision within 30 days of the hearing. f. Other. Describe any other payment practices established by the Lead Agency: N/A 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’s payment practices are statewide and across all types of care. The reimbursement rates are differentiated by region and include reimbursements at a higher percentile for family child care to support participation of home-based providers. Additional reimbursements added above weekly reimbursement rates include a 35% bump for serving children with special needs and a 35% bump for serving children in need of off hour care between 6p.m. to 6 a.m on weekdays and on weekends available to all licensed child care programs.