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REV. MARCH 10, 2009

NEBRASKA DEPARTMENT OF CCS PROGRAM MANUAL LETTER # 17-2009 HEALTH AND HUMAN SERVICES 392 NAC 4-003.07

The Department considers that the following are included in the child care rate: Cost of the facility (including utilities), indoor and outdoor space where care occurs; staff salaries, benefits, training and indirect costs; equipment; toys; materials needed to operate; food children are served unless the facility is unable to prepare food and parents have the option to bring food for their children. (If food is not included, the rate should reflect the lower cost.)

Parents cannot be asked to pay additional fees for these expenses. 4-003.08 Child Care Rate Exceptions 4-003.08A Special Needs Rate: The local office administrator or his/her designee may approve an exception for an increased rate for a child with special needs or a child with a childhood illness. For the definition of special needs, see 392 NAC 1-003. A special need must be documented by a physician, licensed or certified psychologist, or licensed mental health practitioner. Note: Special needs rate is not allowed for childhood diseases such as measles, chicken pox, flu, etc. 4-003.08A1 Factors To Be Considered: For a special needs child, the rate for service is not based on the diagnosis but rather on care and equipment needed beyond that for normal child care. Considerations in establishing the rate include: 1. Additional staffing required; 2. Skills of staff; 3. Special supplies; 4. Special equipment; and 5. Environmental modifications. 4-003.08B In-Home Sick Child Care Rate: The local office administrator or his/her designee may approve in-home care for a child with a temporary illness. This arrangement is for children who have illnesses such as measles, chicken pox, or the flu. The in-home provider must be paid minimum wage for one through three children and may reside with the child. If the provider is not approved, the worker would reimburse the client by voucher.

4-003.08C Sole Provider: The worker may request exception approval from the Central Office for increased rates if the only provider in a community exceeds the rate schedule. 4-003.08D Accredited Providers: Providers who have current accreditation with Department-approved accrediting organizations are eligible to receive the lower of: 1. Their private rate; or 2. The Department’s maximum for accredited providers. See 392-000-203 for accredited rates.