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: The Lead Agency reimburses providers based on attendance 2 weeks in arrears. The Lead Agency does not meet this provision of the final rule and will file a waiver. The Lead Agency received a preliminary finding of non-compliance with Payment Practices to Providers. The Lead Agency does not pay a provider within no more than 21- calendar days of receiving a complete invoice for services. The Lead Agency will implement Oklahoma Administrative Code changes and process changes with an anticipated effective date of August 2026. 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. [x] 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: The Lead agency reimburses providers based on attendance with some absent days. The Lead Agency does not meet this provision of the final rule and will file a waiver. [ ] 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: 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)? [x] Yes. [ ] 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: b. Does the Lead Agency pay for reasonable mandatory registration fees that the provider charges to private-paying parents? [ ] Yes. If yes, identify the fees the Lead Agency pays for: [x] No. If no, identify the data and how data were collected to show that paying for fees is not a generally-accepted payment practice: Based on the data from the 2024 MRS, the majority of facilities did not charge a registration fee. As a result, charging a mandatory registration fee is not considered a generally accepted practice in Oklahoma. 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: The Lead Agency publishes a Child Care Subsidy Provider Handbook https://childcarehandbook.oucpm.org/ The rates paid by DHS for child care are determined by the following factors: Star status of the facility, Setting in which child care is provided (child care center or family child care home), Child’s age, Unit type that is approved (full-time, part-time, blended, weekly, or special needs), Add-on rates in addition to base rate include Non-Traditional Hours, and Child Welfare. The EBT payment week begins every Sunday at 12:01 a.m. and ends every Saturday at midnight. Electronic settlements are deposited into provider's account each week. Each deposit is for attendance two weeks before the current week. This allows for providers to void any incorrect swipes and clients to enter any missed swipes. The payment calendar is located in Section K, Links and Forms in the provider handbook. There are no fees charged to providers. Payment disputes in which a provider is underpaid for a child's attendance is handled via a Child Care Claim. This form is used by child care centers and homes whenever an adjustment is requested. The provider must clearly document why attendance was not correctly recorded on the POS machine. The form is then submitted to OKDHS Finance via email to EBTChildCare@OKDHS.org. Manual claims are not processed until after the 20th of the month following the claim month. In the case of overpayments, providers are responsible for voiding the incorrect transactions made by the parent within 10 days. If the provider does not get the information updated in the allotted time frame, they are required to notify OKDHS Finance immediately at EBTChildcare@okdhs.org. 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: Computer-generated notice is mailed to providers for all approvals, closures, and changes to child care authorizations. In addition, providers can access the Provider Web for real time information about authorizations of children in their care. e. Describe the Lead Agency’s timely appeal and resolution process for payment inaccuracies and disputes: Upon notification of a payment inaccuracy or dispute, the Lead Agency finance division reviews the problem and attempts to resolve all payment issues as soon as possible, usually within a week. 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? Oklahoma Human Services payment rates for care and payment practices are uniform across the state so that families have access to a wide range of providers. DHS does not have a waiting list and all eligible families requesting subsidy are assisted in locating licensed child care. Seventy percent of licensed providers in Oklahoma accept children who receive subsidies.