Policy Effective: December 1, 2025

There are special provisions for children with disabilities who have special childcare needs. Increased payments are available if the child has a physical, social, or mental condition with special health care needs which require:

Assistance with basic movements, including but not limited to the following: standing, sitting, standing up, sitting down, moving up and/or down stairs, walking, etc.(outside of age-appropriate abilities)

Assistance with toileting (outside of age-appropriate abilities).

Use of a feeding tube.

Assistance with eating, and/or drinking (outside of age-appropriate abilities).

Administration of medications during child care hours, which requires the provider to have specialized procedures/training.

Use of special medical equipment while in child care.

Intensive supervision, which requires additional staff or specialized training.

Assistance due to limited vision and/or hard of hearing, including being blind, deaf or nonverbal (outside of age-appropriate abilities).

Any other condition that substantially limits one or more major life activities of the child.

Verification will need to be provided to establish that a child is disabled and has special needs while in a child care setting.

a. The Form 923 Request for Special Needs or written statement including the required information to demonstrate the child needs special provisions in a child care setting may by completed from one of the following sources:

Licensed Medical Physician

Advanced Practice Registered Nurse (APRN)

Division of Services for People with Disabilities (DSPD)

Local School representative (for students with an Individualized Education Program (IEP) plan

Licensed Psychologist (LP) or Certified Psychologist (CP)

Mental health professional

Baby Watch Early Intervention Program (BWEIP)

Physician’s Assistant (PA)

b. The verification to support a child is disabled with a special need must be dated, signed by the agency or health care professional, and include the following;

i. the child's name,

ii. a description of the child's disability, and

iii. the date the condition requiring special needs began, and

iv. the special provisions that justify a higher payment rate.

Verification that a child is a Supplemental Security Income (SSI) recipient is not sufficient without additional supporting documentation of the child’s special needs.

Example: A six-year-old child, Jackie, is receiving SSI. This income is based on her parent being disabled and not her. This would not qualify her for special needs child care. Her older brother, Max, is also receiving SSI and is disabled. His SSI is based on his parent’s disability and his own. In order for him to qualify for the special needs childcare, a completed Form 923 or a written statement including the required information to demonstrate the child has a disability and needs special provisions in a childcare setting will need to be submitted. The case worker will determine if the qualifying criteria is met.

The Department of Workforce Services may require additional information and reserves the right to deny requests if adequate or complete information or justification of the child’s disability and special need is not provided.

The disability and special need for child care will be reviewed an updated verification will be required every 12 months or at the next review whichever is later.

a. Exception:

i. If the child has a permanent disability requiring special child care accommodations, the special needs verifications will only be needed one time.