2.5 Promoting Continuity of Care

Lead Agencies must consider children’s development and promote continuity of care when authorizing child care services and must establish a minimum 12-month period for each child, both at the initial eligibility determination and redetermination. 2.5.1 Children’s development Describe how the Lead Agency’s eligibility, enrollment, reporting, and redetermination policies promote continuity of care in order to support children’s development. In order to ensure continuity of care, eligible children receive no less than 12 months of eligibility, even if the parent or caretaker loses employment or training. A child who turns 13 in between redeterminations remains eligible until the next redetermination. If the parent or caretaker leaves the household, the child remains eligible with the new parent or caretaker for the remainder of the original eligibility period, as long as the new parent’s or caretaker’s income does not exceed 85% SMI. The new parent or caretaker does not have to meet other eligibility criteria, such as work hour requirements, until redetermination. These policies ensure there is no disruption in the child care schedule, which supports the child’s development. 2.5.2 Minimum 12-month eligibility Lead Agencies must establish a minimum 12-month eligibility period for each child, both at the initial eligibility determination and at redetermination to support continuity in child care assistance and reduce barriers to families retaining eligibility. This requirement is: • Regardless of changes in income, Lead Agencies may not terminate CCDF assistance during the minimum 12-month period if a family has an increase in income that exceeds the Lead Agency’s income eligibility threshold but not the federal threshold of 85 percent of SMI; and • Regardless of temporary changes in participation in work, training, or educational activities. a. Does the Lead Agency certify that their policies or procedures provide a minimum 12- month eligibility period for each child at initial eligibility determination? [x] Yes. [ ] No. If no, describe: b. Does the Lead Agency certify that its definition of “temporary change” includes each of the minimum required elements? 1. Any time-limited absence from work for an employed parent due to such reasons as the need to care for a family member or an illness. 2. Any interruption in work for a seasonal worker who is not working between regular industry work seasons. 3. Any student holiday or break for a parent participating in a training or educational program. 4. Any reduction in work, training, or education hours, as long as the parent is still working or attending a training or educational program. 5. Any cessation of work or attendance at a training or educational program not listed above. In these cases only, Lead Agencies may establish a period of 3 months or longer. 6. Any change in age, including a child turning 13 years old during the minimum 12-month eligibility period. 7. Any changes in residency within the State or Territory. [x] Yes. [ ] No. If no, describe: c. Are the policies different for redetermination? [x] No. [ ] Yes. If yes, provide the additional/varying policies for redetermination: 2.5.3 Job search and continued assistance a. Does the Lead Agency consider seeking employment (engaging in a job search) as an eligible activity at initial eligibility determination and/or at the minimum 12-month eligibility redetermination? (Note: If yes, Lead Agencies must provide a minimum of 3 months of job search.) Check all that apply: i. [x] Yes. The Lead Agency does consider seeking employment (engaging in a job search) as an eligible activity at initial eligibility determination. If yes, describe: At application and redetermination, a family experiencing homelessness is eligible for 92 days while competing a job search. ii. [x] Yes. The Lead Agency does consider seeking employment (engaging in a job search) as an eligible activity at redetermination. If yes, describe: At application and redetermination, a family experiencing homelessness is eligible for 92 days while competing a job search. iii. [ ] No. The Lead Agency does not consider seeking employment (engaging in a job search) as an eligible activity at initial eligibility determination or redetermination. b. Does the Lead Agency continue assistance during the minimum 12-month eligibility period when a parent has a non-temporary loss or cessation of eligible activity? [x] Yes. The Lead Agency continues assistance. [ ] No, the Lead Agency discontinues assistance. i. If no, describe the Lead Agency’s policies for discontinuing assistance due to a parent’s non-temporary change: ii. If no, describe what specific actions/changes trigger the job-search period after each such loss or cessation: iii. If no, how long is the job-search period where a family can continue assistance (must be at least 3 months)? c. The Lead Agency may discontinue assistance prior to the next minimum 12-month redetermination in the limited circumstances listed below. Check and provide the policy for all circumstances in which the Lead Agency chooses to discontinue assistance prior to the next minimum 12-month redetermination: i. [ ] Not applicable. ii. [x] Excessive unexplained absences despite multiple attempts by the Lead Agency or designated entity to contact the family and provider, including the prior notification of a possible discontinuation of assistance. Provide the Lead Agency’s policy defining the number of unexplained absences identified as excessive: Pennsylvania defines unexplained absences as excessive when a child is absent for more than 60 consecutive days. The eligibility agency shall terminate subsidy for excessive unexplained absences after the subsidy has been suspended for a minimum of 60 consecutive days and the eligibility agency’s repeated attempts to contact the parent or caretaker regarding the child’s absences are unsuccessful and following proper notification to the family. iii. [x] A change in residency outside of the State or Territory. Provide the Lead Agency’s policy for a change in residency outside the State or Territory: The eligibility agency will terminate subsidy for families who no longer reside in Pennsylvania after providing proper notice. Any changes of address must be reported to the eligibility agency within 10 days. This information is outlined in the Family Handbook. iv. [x] Substantiated fraud or intentional program violations that invalidate prior determinations of eligibility. Provide the Lead Agency’s definition of fraud/intentional program violations that lead to discontinued assistance: Pennsylvania's defines fraud as "the intentional act of a parent or caretaker that results in obtaining, continuing or increasing child care subsidy for which the family is not eligible and that involves either a false or misleading statement or the failure to disclose information." Pennsylvania subsidized child care eligibility regulations define responsibilities of eligibility agencies and parents and caretakers to administer and maintain subsidy. Violations to the regulations may result in discontinued assistance. This includes failure to pay the copayment by the parent or caretaker. The information articulated in the Pennsylvania Subsidized Child Care Eligibility regulations at § 3042.95 Delinquent copayment, provides the definition of a delinquent copayment and subsequent actions related to non-payment of the copayment. (a) A copayment is delinquent if it is not paid by the last day of the service week. (d) To maintain eligibility for subsidized child care when a parent or caretaker incurs a copayment delinquency, the parent or caretaker shall pay all of the following prior to the expiration of the notification period: (1) The current weekly copayment. (2) The delinquent copayment. (3) The amount of any additional delinquencies accumulated during the notification period. Delinquent copayments are considered an Intentional Program Violation. Intentional Program Violations may result in the loss of benefits. 2.5.4 Reporting changes during the minimum 12-month eligibility period Lead Agencies may only require families to report changes that impact a family’s eligibility, including only if the family’s income exceeds 85 percent of the SMI, taking into account irregular fluctuations in income, or there is a non-temporary change in the parent’s work, training, or education status, during the 12-month eligibility period. Lead Agencies may also require families to report that enable the lead agency to contact the family or pay providers, such as a new telephone number or address. Note: The response below should exclude reporting requirements for a graduated phase-out, which are described in question 2.5.5. Does the Lead Agency limit what families must report during the 12-month eligibility period to the changes described above? [ ] Yes. [x] No. If no, describe: Pennsylvania requires families to report if the child no longer has a need for care, there is a change in the number of days or hours care is needed, there is a change in child care providers, or the child is no longer residing in the household. Reporting these changes is important to ensure the child care provider is being paid for the correct number of days for the month and at the correct full-time or part-time rate. It is also important if the child is attending less days, so that the child is not marked absent on the invoice for those days, which would then count towards the child’s 40 days of allowable absences. Families are also asked to report if a foster child in the household is adopted by a parent or caretaker so that the ELRC can evaluate if the family’s income is over 85% SMI. It is recommended that families report a change of address or change of phone number so that the ELRC can contact the family if needed and the family receives redetermination and other important information. Not reporting the information will not immediately affect eligibility, it could potentially if the family does not complete the redetermination because they did not receive the redetermination packet due to an address change. Pennsylvania received guidance from OCC Program Specialists indicating that non- compliance regarding increasing co-pays for intentional program violations and founded cases of fraud is to be included in this section. As such, the information below pertains to the noncompliance regarding increasing copays 98.21(a)(3). The date of preliminary notice issued by OCC was May 28, 2024. Pennsylvania is actively working with the OCC team and is receiving technical assistance on how to best address issues around collection of overpayments due to fraud or intentional program violations. • A brief description of the current policy, including the way in which it is out of compliance. Pennsylvania currently increases a family’s copay to include recoupment of overpayment. The amount of the recoupment does not exceed 5% of the family’s income. This practice is in place to support families by allowing them to pay one entity and dividing the sum of overpayment into smaller incremental payments. This process has been cited as an area of noncompliance because it was deemed as an increase to the actual copay however, the amount paid by families in this situation is the sum of the typical copay- with no increase and the incremental payment to recoup the overpayment. Please note, families are not responsible for an overpayment caused by administrative error. Pennsylvania has identified potential solutions that are being actively discussed with the Office of Child Care related to this area of non-compliance. These include: updating notices to distinguish between the amount of the copay and amount of overpayment, or waiting until redetermination to begin collecting the overpayment. 2.5.5 Policies and procedures for graduated phase-out of assistance at redetermination Lead Agencies that establish initial family income eligibility below 85 percent of SMI must provide a graduated phase-out of assistance for families whose income has increased above the Lead Agency’s initial income threshold at the time of redetermination but remains below the federal threshold of 85 percent of SMI. Lead Agencies that provide a graduated phase-out must implement a two-tiered eligibility threshold, with the second tier of eligibility (used at the time of eligibility redetermination) to be set at: (i) 85 percent of SMI for a family of the same size; or, (ii) An amount lower than 85 percent of SMI for a family of the same size but above the Lead Agency’s initial eligibility threshold that: (A) Takes into account the typical household budget of a family with a low income (B) Provides justification that the second eligibility threshold is: (1) Sufficient to accommodate increases in family income over time that are typical for workers with low incomes and that promote and support family economic stability (2) Reasonably allows a family to continue accessing child care services without unnecessary disruption At redetermination, a child must be considered eligible if their parents are participating in an eligible activity even if their income exceeds the Lead Agency’s initial eligibility income limit as long as their income does not exceed the second tier of eligibility. Note that once determined eligible, the child must be considered eligible for a full minimum 12-month eligibility period, even if the parents’ income exceeds the second tier of eligibility during the eligibility period, as long as it does not exceed 85 percent of SMI. A child eligible for services via the graduated phase-out of assistance is considered eligible under the same conditions as other eligible children with the exception of the co-payment restrictions, which do not apply to a graduated phase-out. To help families transition from child care assistance, Lead Agencies may gradually adjust co-payment amounts in proportion to a family’s income growth for families whose children are determined eligible under a graduated phase-out. Lead Agencies may require additional reporting on changes in family income but must still ensure that any additional reporting requirements do not constitute an undue burden on families. Check and describe the option that best identifies the Lead Agency’s policies and procedures regarding the graduated phase-out of assistance. a. [ ] Not applicable. The Lead Agency sets its initial eligibility threshold at 85 percent of SMI and therefore is not required to provide a graduated phase-out period. (If checked, skip to question 3.1.1.) b. [ ] The Lead Agency sets the second tier of eligibility at 85 percent of SMI. If checked, describe the policies and procedures: i. [ ] Lead Agency adjusts the family’s co-pay during the graduated phase-out period. If checked, describe how the Lead Agency gradually adjusts co-payment for families under a graduated phase-out period in proportion to a family’s income growth. Include information on the percentage or amount of change made in the co-payment during graduated phase-out: ii. [ ] Lead Agency requires additional reporting requirements during the graduated phase-out period. If checked, describe: c. [x] The Lead Agency sets the second tier of eligibility at an amount lower than 85 percent of SMI for a family of the same size but above the Lead Agency’s initial eligibility threshold. If checked, provide the following information: i. Provide the income level ($/month) and the percent of SMI for the second tier of eligibility for a family of three: $5,056, 65% ii. Describe how the second eligibility threshold takes into account the typical household budget of a low-income family: Families are initially determined eligible at application if their income is at or less than 200% of the FPIG. Parents remain eligible for a full 12-month period unless the family's annual income reaches 85 percent of the state median income. The upper income limits at redetermination, which is 235% of the FPIG, permit parents to receive raises and income increases without losing eligibility, while keeping copayments stable for the 12-month eligibility period. iii. Describe how the second eligibility threshold is sufficient to accommodate increases in family income over time that are typical for low-income workers and that promote and support family economic stability: Income is stabilized during the 12-month eligibility period. The 235 percent FPIG limit is only imposed at redetermination. The difference between the two limits permits the family's annual income to increase approximately 17 percent before the family reaches 235% of the FPIG. Data for July 2022 ￿ June 2023 shows that out of 123,900 children served during this time period, 2,307 children became ineligible for CCW because the family was over the 235% FPIG. Based on the data, this is less than 2% of children and the 17% increase is sufficient to support family economic stability and account for the increase in family income. iv. Describe how the second eligibility threshold reasonably allows a family to continue accessing child care services without unnecessary disruption: Income is stabilized, and families remain eligible until the 12-month eligibility period expires, even if the family's annual income exceeds 235 percent of the FPIG. v. [x] Lead Agency adjusts the family’s co-pay during the graduated phase-out period. If checked, describe how the Lead Agency gradually adjusts co-payment for families under a graduated phase-out period in proportion to a family’s income growth. Include information on the percentage or amount of change made in the co-payment during graduated phase-out: The family’s co-payment is only increased at redetermination. The amount of the co-payment change is based on the amount of the increase of income reported at redetermination. The co-payment is determined by Pennsylvania’s published copayment chart, which is based on the Federal Poverty Income Guidelines (FPIG). A family does not pay more than seven percent of the family’s annual income. The co-payment is never increased in between redeterminations. If the family reports a decrease in income in between redeterminations, the family’s co-payment may be decreased. vi. [ ] Lead Agency requires additional reporting requirements during the graduated phase-out period. If checked, describe: 3 Child Care Affordability CCDF subsidies make child care more affordable for eligible families, providing access to a greater range of child care options that allow parents to work, go to school, or enroll in training and they allow parents to access higher quality care options that better support children’s development. CCDF requires some families participating in CCDF to pay an affordable co-payment set by the Lead Agency to cover a part of their care. But co-payments can be a significant and destabilizing financial strain on family budgets and a barrier to parent employment, and the CCDBG Act requires that the co-payment amount not be a barrier to families participating in CCDF. Lead Agencies may not set parent co-payments above 7% of family income regardless of gradual phase- out policies and regardless of the number of children receiving assistance. Lead Agencies are encouraged to set co-payments much lower than 7% to make child care more affordable for more families and have broad flexibility to waive co-payments for to many participants. Lead Agencies must ensure that the total payment to a child care provider is not reduced because of family’s lowered or waived co-payment. In this section, Lead Agencies will identify how they determine an eligible family’s co-payment, the policies in place to waive or ensure co-payments are affordable for families, and how the Lead Agency improves access for children and families in economically and/or socially marginalized communities.