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: Ohio pays providers at the frequency they determine, up to 4 weeks after service. A child is authorized to a provider and attendance is tracked. Upon the provider submitting the attendance the payment will be issued. Ohio provides weekly payments if the business elects to submit attendance at that rate. Ohio tracks data on both authorization and utilization. Monthly, between 15 percent to 30 percent of the children authorized to attend a program never utilize a single day. To safeguard payment for no service Ohio utilizes attendance tracking prior to payment but allows for holidays and absent days to count toward the payment category. This applies to all provider types. The Department of Children and Youth (DCY) will be analyzing the fiscal impact for all of the federal child care payment rules that became effective in April 2024. DCY will plan to request a 2-year waiver while legislative and rule changes are identified and funding estimates are completed. The State's biennial budget process will begin in the fall of 2024, with the Governor preparing his proposed operating budget for the legislature by early 2025. The final statute and funding will not be known until July 1, 2025. Ohio will then begin implementing the policies that were modified and funded through the state budget process. 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: Ohio currently pays based on attendance with the exception that each child is eligible for up to 20 absent days every 6 months. Additionally, Ohio tracks data on both authorization and utilization. Monthly, between 15 percent to 30 percent of the children authorized to attend a program never utilize a single day. To safeguard payment for no service Ohio utilizes attendance tracking prior to payment but allows for holidays and absent days to count toward the payment category. This practice is currently under further review to ensure alignment with the new federal rules. The Department of Children and Youth (DCY) will be analyzing the fiscal impact for all of the federal child care payment rules that became effective in April 2024. DCY will plan to request a 2-year waiver while legislative and rule changes are identified and funding estimates are completed. The State's biennial budget process will begin in the fall of 2024, with the Governor preparing his proposed operating budget for the legislature by early 2025. The final statute and funding will not be known until July 1, 2025. Ohio will then begin implementing the policies that were modified and funded through the state budget process. Ohio is currently piloting payment on enrollment via the Child Care Choice Program. On April 26, 2024, the Child Care Choice Program was introduced. In his State of the State speech, Governor DeWine announced child care choice program, which will be paid upon enrollment. The goal of this pilot is to expand an additional 8,000 vouchers to serve children from 146 percent of the federal poverty level (FPL) to 200 percent of the FPL. 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)? [ ] Yes. [x] 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: Ohio currently has an hourly rate of payment for children that attend a program less than 7 hours a week. This practice is currently under further review to ensure alignment with the new federal rules. Ohio has these 4 payment categories for each setting. If a child is in care for fewer hours then the authorized category, the payment is issued based on the time the child is in care. ODJFS also provides for an enhanced payment rate for programs serving special needs children or programs operating during non-traditional hours. The intent of the "hourly" category of authorization is for the following types of situations: 1. A child has a full time or part time authorization to a primary provider and needs a second provider for just a few hours a week. 2. The child needs just before or just after school care each week. 3. The parent is self-employed and the authorization is determined by dividing income by federal minimum wage (income left after deducting work expenses). Often the reported income is so low that only a few hours can be authorized. 4. Wrap-around care for Head Start. Ohio does not layer funds but does allow providers to do wrap-around care to supplement the Head Start day. This is similar to the before/after care scenario - sometimes only a few hours are left unpaid in the day and child care can make up that difference. This practice is currently under further review to ensure alignment with the new federal rules. This review is expected to be completed in conjunction with the changes being made to incorporate enrollment based prospective payments. A waiver request is being submitted for the enrollment and prospective based payments by 10/1/2024. b. Does the Lead Agency pay for reasonable mandatory registration fees that the provider charges to private-paying parents? [x] Yes. If yes, identify the fees the Lead Agency pays for: Ohio pays a $25 registration fee to programs that have a provider agreement in place to provide publicly funded child care (PFCC) services on January 1 of each year. The program will be paid a registration fee for each child receiving PFCC services who had at least one day of attendance in the previous calendar year. Additionally, the provider is not permitted to ask a caretaker to pay the difference between the registration fee paid for the child by The Department of Children and Youth (DCY) and the provider's customary registration fee charge to the public when the customary registration fee is higher. The requirement to be paid the registration fee also includes an indicator by the program that they charge registration fees. [ ] No. If no, identify the data and how data were collected to show that paying for fees is not a generally-accepted payment practice: 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: Programs electronically sign a provider agreement that includes information regarding provider payment policies, rates, schedules, and the dispute-resolution process. This signed provider agreement must be in place before the The Department of Children and Youth (DCY) automated system will allow for attendance to be paid. The provider agreement directs providers to payment policies rates and schedules listed in OAC 5101:2-16 which include the following: Chapter 5101:2-16 - Ohio Administrative Code | Ohio Laws- https://codes.ohio.gov/ohio- administrative-code/chapter-5101:2-16 Rates: https://codes.ohio.gov/ohio-administrative-code/rule-5101:2-16-10 Schedules: https://codes.ohio.gov/ohio-administrative-code/rule-5101:2-16-09 Payment is issued timely, once a child is authorized and care is received, in one of the following categories: 1) hourly rate is paid for services provided from 1-6.9 hours (hourly authorization category) 2) part time rate is paid for services provided from 7 - 24.9 hours (part time authorization category) 3) full time rate is paid for services provided from 25 to 60 hours (full time authorization category). 4) full time plus is paid for services over 60 hours and is the full time rate plus the hourly rate for time over 60 hours (full time plus authorization category) Ohio has these 4 payment categories for each setting. If a child is in care for fewer hours then the authorized category, the payment is issued based on the time the child is in care. DCY also provides for an enhanced payment rate for programs serving special needs children or programs operating during non-traditional hours. The intent of the "hourly" category of authorization is for the following types of situations: 1. A child has a full time or part time authorization to a primary provider and needs a second provider for just a few hours a week. 2. The child needs just before or just after school care each week. 3. The parent is self-employed and the authorization is determined by dividing income by federal minimum wage (income left after deducting work expenses). Often the reported income is so low that only a few hours can be authorized. 4. Wrap-around care for Head Start. Ohio does not layer funds but does allow providers to do wrap-around care to supplement the Head Start day. This is similar to the before/after care scenario - sometimes only a few hours are left unpaid in the day and child care can make up that difference. Payment of registration Fees: Ohio pays a $25 registration fee to programs that have a provider agreement in place to provide publicly funded child care (PFCC) services on January 1 of each year. The program will be paid a registration fee for each child receiving PFCC services who had at least one day of attendance in the previous calendar year. Additionally, the provider is not Ohio Page 137 of 304 permitted to ask a caretaker to pay the difference between the registration fee paid for the child by DCY and the provider's customary registration fee charge to the public when the customary registration fee is higher. The provider agreement states the following: The provider must • Acknowledge and agree that the provider agreement is valid for the license, certification or approval number; the address associated with that number and any care provided at that address. Payment will not be authorized if care is provided at an address that has not been approved by ODJFS. If payment has already been made for care provided at an unauthorized address, the provider agrees to repay the full amount of payment received. • Submit attendance data and fees only for authorized child care services actually performed. • Submit data to ODJFS for payment that is no more than the Provider's customary charge to other individuals for the same services. • Acknowledge and agree that payment for publicly funded child care is contingent upon the availability of Federal and appropriated state funds. • Submit accurate attendance data and fees for authorized publicly funded child care services provided to eligible individuals in accordance with procedures required by ODJFS. Data that contains errors, incorrect rates or non-covered services is subject to correction. • Accept the payment amount for authorized publicly funded child care services in accordance with Chapter 5101:2-16 Publicy Funded Child Care of the Ohio Administrative Code (OAC). • Accept the payment amount for all covered services as payment-in-full. The Provider shall not seek payment from the eligible individual for the difference between the payment rate and the Provider’s customary charge when the customary charge is higher. • Collect the assigned copayment in accordance with Chapter 5101:2-16 of the OAC. 17. • Cooperate with any Publicly Funded Child Care Program Integrity Review. Failure to cooperate with a review may result in suspension or termination of this agreement. Failure to provide requested records within the time frame defined in Chapter 5101:2-16 of the OAC for a Publicly Funded Child Care Program Integrity Review may result in a determination that no records exist for payment paid to the Provider for the child care reportedly rendered. Such determination shall result in the recoupment of all payments made for which no records are provided. • Accept responsibility for receiving, replying to and/or complying with any audit finding by an appropriate state or Federal audit or any identified exception directly related to the performance of this agreement. Responsibility includes repayment as follows: • The Provider agrees to repay the full amount of payment received for services not covered by this agreement in the time frame defined by ODJFS. • The Provider agrees to repay the full amount of payment received for duplicate or erroneous payments, deceptive claims, attendance tracking misuse or falsification. ￿Deceptive￿ means knowingly deceiving another, or causing another to be deceived, by misleading representation, by withholding information, by preventing another from acquiring information or by other act, conduct or omission which creates, confirms or perpetuates a false impression in another, including a false impression as to the law, value, state of mind or other objective or subjective fact. • Adhere to all applicable rules in Chapters 5101:2-12 Child Care Center Rules, 5101:2-13 Family Child Care Rules, 5101:2-14 In-Home Aide Rules, 5101:2-16 Publicly Funded Child Care Rules, 5101:2-17 Step Up To Quality Rules, and 5101:2-18 Child Day Camp Rules of the OAC. • Complete and submit an agreement with the vendor that contracts with ODJFS for the automated child care system for publicly funded child care. • Record attendance via the automated child care system. • Acknowledge and agree that upon breach or default of any of the provisions, obligations, or duties required in this agreement, or for inappropriate billings or violation of this agreement as determined by ODJFS or the county agency, ODJFS may exercise any administrative, contractual, equitable or legal remedies available without limitation. The waiver of any occurrence of breach or default is not a waiver of any subsequent occurrences, and ODJFS retains the right to exercise all remedies herein above mentioned. If the Provider or ODJFS fails to perform an obligation or obligations under this agreement and such failure(s) is (are) waived by the other party, such waiver shall be limited to the particular failure(s) so waived and shall not be deemed to waive other failure(s). Waiver by ODJFS shall be authorized in writing and signed by the authorized ODJFS representative. • Furnish ODJFS with information detailing the customary charges to other individuals for the same service, in order to assist in the accurate evaluation of market rates for child care services, by completing the required information and data requirements for payment in the automated system. Changes to the information contained in the automated system may be completed without prior notice and does not constitute an amendment of this agreement. • Acknowledge and agree that this agreement may be terminated by ODJFS upon 30 days written notice. The notice will state the effective date of termination and may include any basis of settlement. The Provider shall cease providing publicly funded child care under this agreement on the effective date of termination. This Provider agreement shall terminate immediately without written notice if: (1) the Provider's child care business closes; (2) the Provider fails to maintain licensure, certification or day camp accreditation/approval; (3) there is a determination of illegal conduct; (4) appropriated state or Federal funds are unavailable; or (5) there is failure to honor the terms of this agreement and related state, Federal or local law and regulation. • Agree that in the event of termination, the Provider shall be entitled to compensation, upon submission of all necessary data, for work performed prior to the termination and based on the payment rates in this agreement. ODJFS shall not be liable for any further claims. • Understand that the effective date of this agreement shall be the date the Provider submits the form to ODJFS, or the date that the provider becomes an eligible provider pursuant to Chapter 16 of the OAC, whichever is later. This agreement will remain in effect unless terminated by either the Provider or ODJFS. Fees charged to providers: DCY does not charge fees to providers. Dispute Resolution: DCY has a process that allows providers to request payment adjustments after a payment has been issued by submitting a request for payment adjustment in the automated child care system within four weeks of the payment date. No new attendance may be submitted for payment adjustments. If the incorrect payment amount is because of a county agency data entry error, the provider should contact the county agency to request correction of the error before the provider submits the request for payment adjustment. The request for adjustment may exceed four weeks from the original payment date. A provider may request in writing to DCY that a reconsideration review be conducted for any identified overpayment that is subject to recoupment. The written request must be received by DCY no later than fifteen calendar days after the date the provider receives an overpayment notice. 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: DCY provides information regarding eligibility status through an automated system which allows providers to view future authorizations in the automated system up to 3 days in advance of the authorization begin date. Additionally, programs can run a report from the automated system that includes future authorizations. Changes could be to authorization level (part-time/full-time), termination, change of authorization to another program or copayment change. Due to Manual Procedure Letter (MPL) 172 "JFS 01115 Publicly Funded Child Care Release of Information" created November 13, 2023, providers can now also reach out to the Child Care Policy Help Desk at childcarepolicy@jfs.ohio.gov or 1-877-302-2347, option 4, to get the status of a family’s application. MPL 172 JFS 01115 "Publicly Funded Child Care Release of Information" states the following: Background: Child care providers often request case information to assist families who are submitting an application for publicly funded child care (PFCC) and to determine when the provider may expect payment for care provided. The Ohio Department of Job and Family Services (ODJFS)/county department of job and family services (CDJFS) is not permitted to provide child care case information to anyone without permission of the caretaker or their designated authorized representative. Implementation: The JFS 01115 "Publicly Funded Child Care Release of Information" is now available to assist child care providers with obtaining child care application information on the families they serve. Caretakers can submit this form to their CDJFS or through the Ohio Benefits Self-Service Portal (SSP) to allow their child care provider to receive child care case information from their county agency and ODJFS. A child care provider cannot require the family to complete this form as part of their enrollment process and/or to receive child care. The following applies to caretakers who submit an application for PFCC benefits or have entered the recertification process for PFCC benefits. Scenario -When should the caretaker complete the JFS 01115 and submit it? Procedure - A caretaker may complete the JFS 01115 when a child care provider accepts their children into their program for care AND their application for PFCC benefits or recertification has not been completed. Scenario - Why should the caretaker complete the JFS 01115? Procedure-PFCC benefit case information is not allowed to be shared with anyone outside of ODJFS/CDJFS. The form will grant permission for child care providers to receive information concerning pending applications. Scenario -How can the JFS 01115 be cancelled? Procedure -The JFS 01115 consent may be canceled by the caretaker or caretaker’s Authorized Representative at any time by providing notice in writing to the county agency or through the SSP. Scenario - What information is ODJFS/CDJFS able to share about the status of an application if your child care program is listed on the PFCC application and the JFS 01115 has been submitted by the caretaker? Procedure -ODJFS/CDJFS may share the following: • Primary caretaker first and last name, address and phone number • First and last name and date of birth of children needing care. • Application information: • Application status, including denied without PAD (payment after denial) and pending application. • Verification documents needed. • Eligibility begin and end date. • Authorization information Scenario -What if the JFS 01115 has been submitted by the caretaker giving permission for a specific provider to have access to information, but this specific provider is not listed on the PFCC application? Procedure -If the caretaker has already submitted their PFCC application through the SSP and the provider identified by the family needs to be changed, then the caretaker can submit a change of provider through the SSP. If the caretaker has already submitted their PFCC application to the county and the provider identified by the family needs to be change, then the caretaker will have to contact the county to report the change in provider, unless their SSP account is already linked to their case in Ohio Benefits. The most recent version of the ODJFS form referenced in this procedure letter can be accessed through Forms Central. Please contact the Child Care Policy Help Desk at childcarepolicy@jfs.ohio.gov or 1877-302-2347, option 4, if you have any questions e. Describe the Lead Agency’s timely appeal and resolution process for payment inaccuracies and disputes: The Ohio Department of Children and Youth (DCY) payment system allows programs to electronically submit a message to DCY the same day the program discovers a payment issue or inaccuracy. Process: DCY allows providers to request payment adjustments after a payment has been issued by submitting a request for payment adjustment in the automated child care system within four weeks of the payment date. No new attendance may be submitted for payment adjustments. If the incorrect payment amount is because of a county agency data entry error, the provider should contact the county agency to request correction of the error before the provider submits the request for payment adjustment. The request for adjustment may exceed four weeks from the original payment date. A provider may request in writing to DCY that a reconsideration review be conducted for any identified overpayment that is subject to recoupment. The written request must be received by DCY no later than fifteen calendar days after the date the provider receives an overpayment notice. f. Other. Describe any other payment practices established by the Lead Agency: 4.4.3 Payment practices and parent choice How do the Lead Agency’s payment practices facilitate provider participation in all categories of care? Ohio’s payment practices allow for the provider participating in the publicly funded child care (PFCC) program to receive payment weekly if they choose. Ohio’s automated Time, Attendance and Payment (TAP) system allows families to easily check children participating in the PFCC program in and out, recording time in attendance. The program can submit this attendance weekly or the system will collect it after four weeks from the last day of the service week child care was provided. The TAP system calculates payments within a week. The TAP system is easy to use for families and programs and eases the administrative burden to the program. Having the TAP system has encouraged more programs to participate in the PFCC program. Programs are issued a free tablet for every 50 children enrolled in the PFCC program for families to record attendance