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______________________________________________________________________________ DIVISION OF WELFARE AND SUPPORTIVE SERVICES Child Care Policy Manual Example: Client reschedules an interview and at the interview additional verification is required which when allowing the 10 days would take the decision date past the 30-day calendar period. 141 Notice of Action to the Client At the end of the interview/evaluation, the case status is pending, denied, or approved. Any time benefits are approved, denied, increased, or reduced, a Notice of Action/Notice of Appeal, Form 2158-WC, must be provided to the household. The Notice of Action explains their eligibility status and the reason for the decision and the household is given the opportunity to appeal any negative decision made by the Child Care office. 142 Denied Application Benefits are denied immediately when: • Ineligibility is established; or • The client/representative fails to provide information essential to determine eligibility within the requested period; or • The client/representative voluntarily withdraws their request for assistance. If the household is denied, the client must receive a Notice of Action/Notice of Appeal explaining the reason for denial. 143 Approved Application Benefits are approved when all eligibility requirements are met. At the time the client is determined to be eligible for subsidy benefits, they must be issued a separate Certificate for each eligible child and a Notice of Action/Notice of Appeal. Refer to MS 160 for information on approved applications. The Certificate must include the following: The date subsidy benefits begin and end; • The approved daily rate for the child (based on care level, provider type and geographical location of the provider); The family co-payment contribution; The applied portion of the copayment contribution that will be payable for the child’s care monthly; The overage that may be charged by the provider if it exceeds the approved daily rate on the certificate; The name of the eligible child; The name and physical address of the provider who will care for the child; The authorized schedule and schedule type (i.e. pay by schedule or pay by actual attendance) for the child; The amount of time the child is authorized to attend daily (i.e. FT, PT); and • The signature of the approving case manager. 143.1 Certificate Distribution The original signed Certificate(s) must be kept in the eligibility case file. Copies must be provided to: • The client/representative, and • The provider. 100-Program Overview [16] MTL 01/24 July 1, 2024