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There are approximately 3,000 child care providers (license-exempt, in-home, and license) who accept CCDF/Subsidy. Approximately half of these providers are licensed with the State of Nebraska.

The 2019 MRS identified provider reported CCDF/Subsidy barriers categorized by communication, payments, and rates. Billing is completed via an electronic portal, and once claims are entered payment is dispersed to the provider within a few days. Providers also receive authorizations and changes made to authorizations electronically, within in 24 hours. Barriers identified around the payment and rates include: authorizations not updated timely when the child switches providers, parents not paying family-fees to the child care provider, rates lower than private rates, and no reimbursement for food.

b) Describe how payment rates are adequate and have been established based on the most recent MRS or alternative methodology . Note: Per the preamble (81 FR 67512), in instances where a MRS or alternative methodology indicates that prices or costs have increased, Lead Agencies must raise their rates as a result. The most recent MRS are based on the following factors: 1.) Geographic area (urban and rural counties); 2.) Provider type (Family Child Care Home I/II and Child Care Centers); and Age of child (infant, toddler, preschool, and school age). Rates were set at no less than the 60th percentile. 2019 rates went into effect 7/1/19.

c) Describe how base payment rates enable providers to meet health, safety, quality, and staffing requirements under CCDF. Health, safety, quality, and staffing requirements per the recent reauthorization of CCDBG were not fully implemented when the 2019 MRS was being conducted and are not reflected in the current rate. Title 391 of Nebraska Administrative Code - Children's Services Licensing, have established staff/child ratios and pre-service and annual training requirements for all licensed child care providers for years. Current CCDF/Subsidy rates reflect the existing requirements.

d) Describe how the Lead Agency took the cost of higher quality into account, including how payment rates for higher-quality care, as defined by the Lead Agency using a QRIS or other system of quality indicators, relate to the estimated cost of care at each level of quality. Note: For States without a QRIS, the States may use other quality indicators (e.g. Nebraska Page 120 of 314