2.5 Promoting Continuity of Care

Lead Agencies must consider children’s development and promote continuity of care when authorizing child care services and must establish a minimum 12-month period for each child, both at the initial eligibility determination and redetermination. 2.5.1 Children’s development Describe how the Lead Agency’s eligibility, enrollment, reporting, and redetermination policies promote continuity of care in order to support children’s development. The Lead Agency has the following policies, which promote continuity of care to support children’s development: establishing minimum eligibility periods greater than 12 months, using cross-enrollment to other public benefits programs, working with entities that provide other child support services, and providing more intensive case management for families with children with multiple risk factors. 2.5.2 Minimum 12-month eligibility Lead Agencies must establish a minimum 12-month eligibility period for each child, both at the initial eligibility determination and at redetermination to support continuity in child care assistance and reduce barriers to families retaining eligibility. This requirement is: • Regardless of changes in income, Lead Agencies may not terminate CCDF assistance during the minimum 12-month period if a family has an increase in income that exceeds the Lead Agency’s income eligibility threshold but not the federal threshold of 85 percent of SMI; and • Regardless of temporary changes in participation in work, training, or educational activities. a. Does the Lead Agency certify that their policies or procedures provide a minimum 12- month eligibility period for each child at initial eligibility determination? [ ] Yes. [x] No. If no, describe: The Lead Agency received the preliminary monitoring notice on April 20, 2024. The Lead Agency will be in compliance by October 1, 2024. the application is automatically backdated to the first day of the month, regardless of the date the application was received or approved. b. Does the Lead Agency certify that its definition of “temporary change” includes each of the minimum required elements? 1. Any time-limited absence from work for an employed parent due to such reasons as the need to care for a family member or an illness. 2. Any interruption in work for a seasonal worker who is not working between regular industry work seasons. 3. Any student holiday or break for a parent participating in a training or educational program. 4. Any reduction in work, training, or education hours, as long as the parent is still working or attending a training or educational program. 5. Any cessation of work or attendance at a training or educational program not listed above. In these cases only, Lead Agencies may establish a period of 3 months or longer. 6. Any change in age, including a child turning 13 years old during the minimum 12-month eligibility period. 7. Any changes in residency within the State or Territory. [x] Yes. [ ] No. If no, describe: c. Are the policies different for redetermination? [x] No. [ ] Yes. If yes, provide the additional/varying policies for redetermination: 2.5.3 Job search and continued assistance a. Does the Lead Agency consider seeking employment (engaging in a job search) as an eligible activity at initial eligibility determination and/or at the minimum 12-month eligibility redetermination? (Note: If yes, Lead Agencies must provide a minimum of 3 months of job search.) Check all that apply: i. [ ] Yes. The Lead Agency does consider seeking employment (engaging in a job search) as an eligible activity at initial eligibility determination. If yes, describe: ii. [ ] Yes. The Lead Agency does consider seeking employment (engaging in a job search) as an eligible activity at redetermination. If yes, describe: iii. [x] No. The Lead Agency does not consider seeking employment (engaging in a job search) as an eligible activity at initial eligibility determination or redetermination. b. Does the Lead Agency continue assistance during the minimum 12-month eligibility period when a parent has a non-temporary loss or cessation of eligible activity? [ ] Yes. The Lead Agency continues assistance. [x] No, the Lead Agency discontinues assistance. i. If no, describe the Lead Agency’s policies for discontinuing assistance due to a parent’s non-temporary change: The Lead Agency discontinues assistance if there is no need for service due to a parent's non-temporary change that exceeds 3 months following the minimum 3-month period of job search at the same level of care. ii. If no, describe what specific actions/changes trigger the job-search period after each such loss or cessation: The household is required to report any non- temporary changes in their need for service. Once the household reports the non- temporary change in their need for service, they then receive the 3 months of job search at the same level of care. If they begin engaging in another need for service during those 3 months, then they will continue to receive care through the end of the eligibility period. iii. If no, how long is the job-search period where a family can continue assistance (must be at least 3 months)? 3 months c. The Lead Agency may discontinue assistance prior to the next minimum 12-month redetermination in the limited circumstances listed below. Check and provide the policy for all circumstances in which the Lead Agency chooses to discontinue assistance prior to the next minimum 12-month redetermination: i. [ ] Not applicable. ii. [x] Excessive unexplained absences despite multiple attempts by the Lead Agency or designated entity to contact the family and provider, including the prior notification of a possible discontinuation of assistance. Provide the Lead Agency’s policy defining the number of unexplained absences identified as excessive: 392 Neb. Admin. Code (NAC) § 4-002 requires a child’s unexplained absence be reported to the Department if they have not attended care for more than three consecutive days without prior notice to the provider. iii. [x] A change in residency outside of the State or Territory. Provide the Lead Agency’s policy for a change in residency outside the State or Territory: The Lead Agency’s policy, 392 Neb. Admin. Code § 2- 005.01 "Recipient eligibility will be redetermined at least once every 18 months, but not more than once every 12 months." The Department policy is to provide continuity of care to reduce disruptions in care for the 12 to 18-month eligibility period. During the recipient’s eligibility period Child Care can only close if the household moves out of state. iv. [x] Substantiated fraud or intentional program violations that invalidate prior determinations of eligibility. Provide the Lead Agency’s definition of fraud/intentional program violations that lead to discontinued assistance: Fraud/Intentional program violations are addressed in 392 Neb. Admin Code (NAC) 1-001.17, which states ￿INTENTIONAL PROGRAM VIOLATION. Any action by an individual to intentionally: (A) Make a false statement, either verbally or in writing, to obtain benefits to which the individual is not entitled; (B) Conceal information to obtain benefits to which the individual is not entitled; or (C) Alter one or more documents to obtain benefits to which the individual is not entitled.￿ 392 NAC § 2-005.01 PERIODIC REDETERMINATION. Recipient eligibility will be redetermined at least once every 18 months, but not more than once every 12 months. Guidance: The Department will provide continuity of care to reduce disruptions in care for the 12￿18-month eligibility period. During the recipient's eligibility period Child Care can only close for the following reasons:… (3) The household commits fraud or receives an IPV; 2.5.4 Reporting changes during the minimum 12-month eligibility period Lead Agencies may only require families to report changes that impact a family’s eligibility, including only if the family’s income exceeds 85 percent of the SMI, taking into account irregular fluctuations in income, or there is a non-temporary change in the parent’s work, training, or education status, during the 12-month eligibility period. Lead Agencies may also require families to report that enable the lead agency to contact the family or pay providers, such as a new telephone number or address. Note: The response below should exclude reporting requirements for a graduated phase-out, which are described in question 2.5.5. Does the Lead Agency limit what families must report during the 12-month eligibility period to the changes described above? [x] Yes. [ ] No. If no, describe: 2.5.5 Policies and procedures for graduated phase-out of assistance at redetermination Lead Agencies that establish initial family income eligibility below 85 percent of SMI must provide a graduated phase-out of assistance for families whose income has increased above the Lead Agency’s initial income threshold at the time of redetermination but remains below the federal threshold of 85 percent of SMI. Lead Agencies that provide a graduated phase-out must implement a two-tiered eligibility threshold, with the second tier of eligibility (used at the time of eligibility redetermination) to be set at: (i) 85 percent of SMI for a family of the same size; or, (ii) An amount lower than 85 percent of SMI for a family of the same size but above the Lead Agency’s initial eligibility threshold that: (A) Takes into account the typical household budget of a family with a low income (B) Provides justification that the second eligibility threshold is: (1) Sufficient to accommodate increases in family income over time that are typical for workers with low incomes and that promote and support family economic stability (2) Reasonably allows a family to continue accessing child care services without unnecessary disruption At redetermination, a child must be considered eligible if their parents are participating in an eligible activity even if their income exceeds the Lead Agency’s initial eligibility income limit as long as their income does not exceed the second tier of eligibility. Note that once determined eligible, the child must be considered eligible for a full minimum 12-month eligibility period, even if the parents’ income exceeds the second tier of eligibility during the eligibility period, as long as it does not exceed 85 percent of SMI. A child eligible for services via the graduated phase-out of assistance is considered eligible under the same conditions as other eligible children with the exception of the co-payment restrictions, which do not apply to a graduated phase-out. To help families transition from child care assistance, Lead Agencies may gradually adjust co-payment amounts in proportion to a family’s income growth for families whose children are determined eligible under a graduated phase-out. Lead Agencies may require additional reporting on changes in family income but must still ensure that any additional reporting requirements do not constitute an undue burden on families. Check and describe the option that best identifies the Lead Agency’s policies and procedures regarding the graduated phase-out of assistance. a. [ ] Not applicable. The Lead Agency sets its initial eligibility threshold at 85 percent of SMI and therefore is not required to provide a graduated phase-out period. (If checked, skip to question 3.1.1.) b. [ ] The Lead Agency sets the second tier of eligibility at 85 percent of SMI. If checked, describe the policies and procedures: i. [ ] Lead Agency adjusts the family’s co-pay during the graduated phase-out period. If checked, describe how the Lead Agency gradually adjusts co-payment for families under a graduated phase-out period in proportion to a family’s income growth. Include information on the percentage or amount of change made in the co-payment during graduated phase-out: ii. [ ] Lead Agency requires additional reporting requirements during the graduated phase-out period. If checked, describe: c. [x] The Lead Agency sets the second tier of eligibility at an amount lower than 85 percent of SMI for a family of the same size but above the Lead Agency’s initial eligibility threshold. If checked, provide the following information: i. Provide the income level ($/month) and the percent of SMI for the second tier of eligibility for a family of three: The second tier of eligibility for a family of three is $4,144/month, which is 58% of the SMI or 200% FPL. ii. Describe how the second eligibility threshold takes into account the typical household budget of a low-income family: The family income connects to the Federal Poverty Levels (FPL) and is adjusted annually for the new FPL amounts. Ten percent of a household’s gross earned income shall be disregarded after the household has received Child Care Subsidy for 12 consecutive months and at each subsequent redetermination. The 10% disregard accounts for any fractional income raises from employment a family may be received during their eligibility period. iii. Describe how the second eligibility threshold is sufficient to accommodate increases in family income over time that are typical for low-income workers and that promote and support family economic stability: Once a family is determined eligible, child care is authorized for a 12-to-18-month eligibility period. During the eligibility period, the family will continue to remain eligible for child care as long as their income remains under 85% of the State Median Income (SMI). At re- determination, families are determined eligible if they still have a need for service and their income is under the second tier of 200% FPL. The second tier addresses the change in income that can occur between initial eligibility and re- determination as the initial eligibility income limit is 185% FPL so this allows for a second tier of income eligibility at the time of re-determination. iv. Describe how the second eligibility threshold reasonably allows a family to continue accessing child care services without unnecessary disruption: Once a family is determined eligible, child care is authorized for a 12-to-18-month eligibility period. During the eligibility period, the family will continue to remain eligible for child care as long as their income remains under 85% of the State Median Income (SMI). At re-determination, families are determined eligible if they still have a need for service and their income is under the second tier of 200% FPL. This allows family to continue care without disruption by having a higher income limit than the initial income eligibility limit of 185% FPL. The Lead Agency also does not require certain verifications again at the time of re-determination that were verified at initial eligibility such as citizenship, family relationships, and age. v. [x] Lead Agency adjusts the family’s co-pay during the graduated phase-out period. If checked, describe how the Lead Agency gradually adjusts co-payment for families under a graduated phase-out period in proportion to a family’s income growth. Include information on the percentage or amount of change made in the co-payment during graduated phase-out: Family co-pays are adjusted based on reported income changes. Family co-pays can decrease during the eligibility period, but they cannot increase during the eligibility period. Family co- pays are re-assessed at every redetermination (12-18 months) and may increase with increased income. vi. [ ] Lead Agency requires additional reporting requirements during the graduated phase-out period. If checked, describe: 3 Child Care Affordability CCDF subsidies make child care more affordable for eligible families, providing access to a greater range of child care options that allow parents to work, go to school, or enroll in training and they allow parents to access higher quality care options that better support children’s development. CCDF requires some families participating in CCDF to pay an affordable co-payment set by the Lead Agency to cover a part of their care. But co-payments can be a significant and destabilizing financial strain on family budgets and a barrier to parent employment, and the CCDBG Act requires that the co-payment amount not be a barrier to families participating in CCDF. Lead Agencies may not set parent co-payments above 7% of family income regardless of gradual phase- out policies and regardless of the number of children receiving assistance. Lead Agencies are encouraged to set co-payments much lower than 7% to make child care more affordable for more families and have broad flexibility to waive co-payments for to many participants. Lead Agencies must ensure that the total payment to a child care provider is not reduced because of family’s lowered or waived co-payment. In this section, Lead Agencies will identify how they determine an eligible family’s co-payment, the policies in place to waive or ensure co-payments are affordable for families, and how the Lead Agency improves access for children and families in economically and/or socially marginalized communities.