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Presentation on theme: "1 EEC FINANCIAL ASSISTANCE REGULATIONS AND POLICIES January 2011."— Presentation transcript:


2 2 EEC Financial Assistance Program Governance EECs Financial Assistance Program is governed by federal and state laws and policies: The Child Care and Development Block Grant Act (42 USC 9858), as amended, and section 418 of the Social Security Act (42 USC 618), as amended Federal Regulations CFR Parts 98 and 99 Federal Policies, Program Instructions and Other Guidance:( law/index.htm#guidance) EEC Subsidy Regulations CMR et al EEC Policies -- EEC Financial Assistance Guide

3 3 EEC Financial Assistance Regulations and Polices EEC Subsidy Regulations last updated in November 2006 Policy Guide developed and released in July 2007 Question and Answer document added to the Guide in 2008, Several updates issued through EEC Management Bulletins (EMBs) and messages from the Commissioner reflecting new or edited policies and instruction for providers to reprint selected chapters. Access limitations to Income Eligible financial assistance (November 3, 2008), Access opening last fiscal year have resulted in a number of other EMBs and memos to clarify and revise policies.

4 4 Financial Assistance – Table of Contents for both EEC Regulations and Policy Guide Table of Contents: EEC Regulation 10.01: Introduction 10.02: Definitions 10.03: General Provisions 10.04: Income Eligible Child Care Subsidy 10.05: Employment Services Program 10.06: Supportive Child Care 10.07: Teen Parent Child Care Services 10.08: Trial Court Child Care 10.09: Child Care for Special Populations 10.10: Caregivers 10.11: Reimbursement 10.12: Termination and Reduction of Services 10.13: Review Process 10.14: Applicability Table of Contents: EEC Policy Guide Chapter 1: Eligibility Chapter 2: The EEC Centralized Waiting List for Financial Assistance Chapter 3: Documentation of Eligibility Chapter 4: Service Need Chapter 5: Parent Co-Payments Chapter 6: Reassessment Chapter 7: Terminations and Reductions Chapter 8: EEC Financial Assistance Complaint and Investigation Process

5 5 5 EEC Financial Assistance Regulations and Policies Many factors contribute to the need to update the Guide and Amend the Regulations including: Improper Authorizations for Payment (IAP) exercise results Response from ACF regarding our State Plan Unique challenges/ weaknesses identified due to recent fiscal constraints/ system restructuring (e.g., ongoing closure of, or limited access to, EEC financial assistance and CPC transition) Capability to monitor programs determination of financial assistance eligibility (fraud/waste/abuse) Recent GAO Report Identified Fraud, Waste and Abuse findings in Head Start programs

6 6 6 User Feedback As EEC providers, CCR&Rs and internal staff have used the Guide, issues have been identified, including: Ability to update and communicate changed or new policies Structure of and clarity of policy information Documentation of eligibility requirements Outdated, confusing policies Existing policies outside of the Guide (recently added as appendices) Missing policies Ease of finding needed information CCR&R and Provider Feedback Confirms need to improve Financial Assistance Polices, including the Request for Review process, Recoupment procedure, and Documentation requirements Raises other concerns regarding improving Communication (w/ EEC, DTA and DCF staff)

7 7 Status of policy updates requested Quick Fixes – Policies UpdatedLong Term Fixes – Regulation Changes or Data Exchanges Needed Break in service need of parent Eligibility self reporting significant changes in income (20% rule) Travel time for calculation of service need Waitlist management enhancements Redraft Provider voucher manual and agreement (Jan roll out) Identity/ legal immigration status documentation Codified Variance Process Special Need Forms (Child/Parent) Self Employment Verification Special Need Access Regulations Streamline Review Process Child Support Requirement Second parent in Household Clarify Recoupment Process Redraft Financial Assistance agreement/ termination notices Excessive Absences of Children Schedule of Care Interfaces with other agencies: RMV, DOR (wage matches) or other agency systems 7 Key = Policy issue reviewed and updated = Policy issue reviewed and requires regulation change to update

8 8 Highlights of Proposed Regulation Changes While many of the issues identified to date have been addressed by revising the Policy Manual, and improving the process for updating policies, some revisions are necessary to EECs Financial Assistance regulations, including: Redefine Special needs of parent/ child Reduce Allowable Absences Streamline Review Process and recoupment process Redefine Self Employment Allow for eligibility verifications through inter- agency data matches

9 9 Summary of Proposed Changes to Subsidy Regulations

10 : Definitions: The addition of new or revised definitions are needed to aid in the interpretation of the regulations. Child Care Educator/Provider Contracted Child Care Educator/Provider Excessive Absence Explained Absence Full Time Care Protective Services

11 11 Family Size and Household Composition (codifies existing practice) o Clarifies verification of household members is necessary for purposes of determining eligibility and establishing parent fees. Identity, Residency & Citizenship Status (codifies existing practice) o Requires verification of applicants identity and residency, as well as the citizenship or immigration status of each child seeking child care financial assistance. Child Support Enforcement Requirement (new) o Requires single parent applicants to submit evidence of child support and/or cooperation with the Commonwealths Child Support Enforcement agency, as a condition of eligibility. Child Attendance/ Reimbursment Requirements (amends current requirements) o Requires children to regularly attend early education and care programs subsidized by the Commonwealth or risk termination 10.03(1): General Provisions, Eligibility

12 12 Identity, Residency & Citizenship Status EEC seeks to formally codify the Citizenship and Immigration Status policy issued in April 2010, in order to: o Address the deficiency in EECs regulations and policies identified by ACF the Federal Improper Authorization for Payment review Massachusetts, along with all other Year 2 States, were given a one time exemption to implement this requirement o Achieve consistency between regulations and policies and to ensure efficient and uniform outcomes for families

13 13 Child Support Enforcement Requirement EEC proposes a requirement to mandate cooperation with the MA Child Support Enforcement (CSE) agency OR other proof of child support as a condition for child care assistance for single parent families At least 20 States currently impose a CSE requirement Benefits of instituting a Child Support Enforcement policy: o Keep families out of poverty o Provide adequate food, shelter and clothing o Increased access to medical services & sense of security o Add to the overall stability, security and well-being of families and children o Intended to lessen the existing burdens of second parent in the household documentation Key issues to consider during implementation of policy: o How many families seeking assistance are currently enrolled – avoid duplication o Identify exceptions (i.e., domestic violence or child protection) o Required documentation o Monitoring and evaluation of effectiveness

14 14 Strengthen Child Attendance Requirement Current Regulatory Definitions, 606 CMR 10.02: o Excessive absence = more than 3 consecutive unexplained absences or 11 or more explained absences w/in a 30 day period. o Explained absences = any absence due to illness, emergency, or max. of 10 days vacation/ year. EECs regulations related to absences give rise to potential abuse/waste. EECs annual billing for FY08-10 shows: o Average annual billing by the CCR&Rs - $18.5M o Average annual billing by contract providers - $18.5M o Over each of past 3 years, providers have billed EEC for over $37M related to absent days o Absence rates for some children approach 50% o Providers acknowledge billing for regularly scheduled absences, such as families that only need 4 days/week

15 15 Strengthening Child Attendance Requirement In preparing its recommendations, EEC reviewed research which shows that chronic absenteeism in the early years, such as kindergarten, predicted continuing absences in later grades. In addition, we looked at other states to identify best practice: o Ohio – limits absences to 10 in 6 months o Maryland – limits absences to 60 in 12 months o Delaware – limits absences to 5 per month MA public schools limit absences to 7 in 6 months These examples have ramifications on both families (termination) and providers (billing) giving incentive for proper use of funds and encouraging attendance/ good outcomes for children

16 16 Strengthening Child Attendance Requirement Options for implementation – excused absences: Limit absences to 5 per month Limit absences to 15 per 3 months Limit absences to 30 per 6 months* Limit absences to 60 per 12 months Limit absences to 7 in 6 months, in accordance with ESE policies *The Recommendation above reflects an average of 5 absences per month enforced over a 6 month period. EEC does not propose any changes related to the definition of excessive absence.

17 17 Special Needs (Protective Services) (amends current requirements) o New definition of protective services to include parents and children with documented disability and/or special need. o Eliminates child with special need as a single service need. Limitations on Self-Employment (amends current requirements) o Imposes restrictions on certain work-related service need activities, in particular at home self-employment o Changes methodology for calculating service need – total earnings divided by minimum wage to establish amount of care needed. Travel Time (codifies existing practice) o Requires applicants to present a minimum of 20 hours of service need before allowing travel time to be factored in. Amendments to Financial & Service Need Eligibility Criteria, 606 CMR 10.04(1)

18 18 In order to be eligible for CCDF-funded child care services, children must: Reside with a family whose income does not exceed 85% of SMI; and Reside with parent(s) who are working, or participating in job training or an education program, or are receiving or need to receive protective services. Special Needs – Protective Services

19 19 In reviewing the MA CCDF State Plan, ACF identified two instances where EEC regulations and policy may not align with these mandatory requirements: Children with Special Needs – 1) allowing children to remain in care up to 100% SMI and 2) allowing a categorical waiver of the work, education and training requirement for families w/ children with special needs. See 606 CMR 10.04(1)(a)1 and (b) Parents with Special Needs – 1) allowing children to remain in care up to 100% of SMI, and 2) not clearly defining such families in need of protective services. See 606 CMR 10.04(1)(a)1 Special Needs – Protective Services

20 20 CCDF regulations do allow states some flexibility for families receiving or at risk of receiving protective services: Children residing in a family that is receiving or needs to receive protective intervention services may be eligible for CCDF-funded child care, if they remain in the home, even if the parent(s) is not working or in an education or training program. See 45 CFR 98.20(a)(3)(ii). Additionally, states have the discretion to waive the 85% SMI limitation if a child is residing in a family that is receiving or needs to receive protective intervention services if determined necessary on a case by case basis. See 45 CFR 98.20(a)(3)(ii)(A) Special Needs – Protective Services

21 21 Special Needs of Children– Protective Services Current practice: Parents are not required to engage in work, education and/or training activities Families may enter care at 85% SMI and exit at 100% Children are eligible for full-time care regardless of need Issues: Exemption was originally based on assumption special needs children are educationally at risk Misaligned with federal exemption definition of in need of protective services Research based risk factors show that ALL low-income children are educationally at risk Streamlining and coordinating resources: Other agencies are charged with providing services to special needs children -- ESE (IEP) or DPH (IFSP) EEC should support ESE and/or DPH with wrap-around services, for otherwise eligible children

22 22 Special Needs of Children – Protective Services Proposed change: Align EEC regulations with Federal regulations and require parents of children with special needs must participate in work, education or training No Change: Families will continue remain eligible at the 85%/100% income levels Eligible children may continue to qualify for full-time care, regardless of their parents service need EEC will continue to work with other state agencies to provide the necessary wrap around support for eligible children

23 23 The Department has identified the following concerns when reviewing its child care subsidy regulations and policies and makes the following findings/observations – for Parents: In practice, special need of parent definition misaligned with federal in need of protective services intention. Examples identified through central office review: headaches, backaches, carpal tunnel syndrome. Data shows inordinate number of special need of parent service needs approvals in contract slots Special need of parent service need currently approved for indefinite time period irrespective of the stated need Federal laws prohibit use of CCDF funding for respite care Special Needs of Parents – Protective Services

24 24 Special Needs of Parents– Protective Services EEC will seek to amend current policies related to Child Care Financial Assistance eligibility requirements for families with special needs Parents to: Only allow for new access through vouchers Heighten the bar on what is deemed at risk of needing protective service Only allow these to be short term vouchers 12 months, renewable once– with the intended purpose of helping to serve as a bridge while parents seek other resources to address the protective service issue and/or become employable.

25 25 States are required to define protective services in the CCDF State Plan, if they choose to fund services to this population. See 45 CFR 98.16(e)(7) Currently, Massachusetts defines protective services as: Families are eligible for supportive child care services when they have active protective needs documented in a supported report of abuse or neglect within the previous 12 months or when there is a determination of need to begin or continue supportive child care at a Department of Children and Families Progress Supervisory Review. Proposed definition: Families, who have active protective needs documented in a supported report of abuse or neglect within the previous 12 months or when there is a determination of need to begin or continue supportive child care at a Department of Children and Families Progress Supervisory Review, will be deemed to be in need of protective services. Additionally, children may be deemed at risk of needing protective services in special circumstances, wherein families are unable to provide child care for any portion of a 24 hour day due to a crisis situation of domestic violence or homelessness, a physical, mental, emotional or medical condition, or participation in a drug treatment or drug rehabilitation program, or court-ordered community service. Special Needs – Protective Services

26 26 Limitations on Self-Employment EEC proposes to limit the types of work-related activities that satisfy the service need requirement: 1.No home-based self-employment, unless the work performed: creates a clear and present danger to children requires regular face-to-face meetings or appointments with clients, which prevents direct supervision of children 2.Propose a launch/grace period for new self-employment business – 3 month start up 3.Implement new mechanism for confirming minimum wage Current practice – divide gross income by estimated hours to determine hourly rate Proposed practice – divide gross income by MA minimum wage rate to determine hours

27 27 Eligibility Determinations – Documentation Requirements The following new or revised provisions are required to respond to comments and/or feedback from internal and external stakeholders. Additional documentation (clarifies existing practice) o Authorizes providers and/or CCR&Rs to request additional documentation related to the residency of unreported parents, if file indicates application inaccuracies/ contradictions. Data Sharing and/or Interfaces (new requirement) o Authorizes EEC to request and/or provide information to/from other government agencies, contracted providers, other states and banks or other financial institutions for purposes of verifying eligibility.

28 28 Parent submits a Request for Review after Termination, Reduction or Denial of Subsidy EEC Financial Assistance Specialist reviews Request and makes Determination to Uphold or Overturn If upheld, Parent submits Request for Hearing and EEC Hearing Officer conducts informal hearing and issues a Written Decision OVERVIEW OF REVIEW PROCESS

29 29 Review Process: Issues Caseload volume (by calendar year) 2008 = 756 Requests for Review 2009 = 1,438 Requests for Review 2010 = to date, 829 Requests for Review Incomplete documentation Significant lag times within caseload processing Appellants have several bites of the same apple Child care may continue for several additional weeks or months pending the outcome of the review and/or the informal hearing

30 30 Review Process: Proposal Proposed updates to EEC Review Process regulations include: Dismissals for failure to prosecute Clarify appropriate grounds for appeal Clarify documentation timelines Grant opportunity for appeal related to recoupment amounts

31 31 GOALS FOR THE REVIEW PROCESS EEC seeks to revise the Termination and Reduction of Services and the Review Process sections to: Streamline and Manage Efficiencies Address Federal and State Mandates to Recoup Fees Parent recoupments (by calendar year) 2008: 4 repayment agreements; 7 referrals to BSI/ AGO referrals. 2009: 196 repayment agreements; 5 BSI/ AGO referrals. 2010: to date, 336 repayment agreements; 1 BSI/AGO referral Provide clarification for Parents, CCR&Rs and Contracted Providers

32 Termination and Reduction of Services (1) Reasons for Denial or Termination: Currently, there are 6 reasons for issuing a denial or termination of subsidized child care: Lack of continuing service need Lack of financial eligibility Non-payment or late payment of fees Unexplained or excessive absence Failure to submit the required documentation at reassessment Failure to comply with EECs, CCR&Rs or contracted providers policies EEC seeks to add two additional reasons: Submission of False or Misleading Information and/or Documentation to the contracted provider, CCR&R or EEC Outstanding child care debt owed to the Commonwealth

33 Termination and Reduction of Services (contd) (2) Reasons for Reduction: EEC seeks to modify the existing reason for reduction: Parent(s) service need changes from full time to part time and add a new reason for reduction: If a change in the total household income results in an increase to the parent(s)co-payment fee, in accordance with EECs fee schedule

34 Review Process (1) Reasons for Review: EEC seeks to add an additional reason for review: assesses a fee or an outstanding child care debt that the parent believes is not in accordance with EEC policy (2) Scope of Review: EEC seeks to clarify scope of review by adding a new scope to reflect recoupment: Requests for Review that are solely related to the existence and/or the amount of a debt owed are outside the scope of the review process, if: (a) the parent(s) has already entered into an agreement to repay the outstanding debt; or (b) the parent(s) claim is limited to financial hardship imposed by the agreement to repay

35 Review Process (contd) (6) Termination of Continued Subsidized Child Care: Currently there are 3 bases as to when subsidized child care can be terminated during the review process or subsequent appeal: a determination is made that the sole issue is a challenge to the validity of a particular law or regulation a change affecting the parents subsidy occurs subsequent to the filing of the request for review that makes the previously filed request moot the parent fails to comply with the requirements for continuing subsidized child care. EEC seeks to add the following as an additional basis: a determination is made that there is no genuine issue of material fact as presented by the parent in his/her request for review

36 Review Process (contd) (7) Preliminary Review: (d) Decisions: 1. How Made. Currently the EEC Review Officer reviews all information submitted by the parent and the provider or CCR&R and seeks clarification from the parties, if necessary. The Review Officer may take administrative notice of general, technical or scientific facts within his/her specialized knowledge and may use his or her experience and specialized knowledge in the evaluation of the evidence presented. EEC seeks to add the following provisions: The Review Officer may take administrative notice of public records or any information provided by other state agencies, the State Auditors Office and/or its Bureau of Special Investigations. If during the evaluation of the evidence presented, the EEC Review Officer determines that additional reasons for termination/reduction as enumerated in 606 CMR (1) and (2) are supported by the evidence, the Review Officer will identify these in the written decision.

37 Review Process (contd) (8) Informal Hearing: (e) Reasons for Dismissal: Currently there are 2 reasons as to when a request for informal hearing may be dismissed. EEC seeks to modify this provision and add two more reasons for dismissal as follows: 1. fails to appear at the informal hearing; 2. fails to prosecute his/her claim; 3. has already agreed in writing to repay the debt at issue; or 4. withdraws the request for Informal Hearing in writing or on the record at the hearing.

38 38 Proposed Regulation Promulgation Timeline TasksDate Vet Regulation Changes with Providers/ CCR&Rs; continue to make policy changes/ clarifications that do not require regulation changes Fall 2010 Board reviews first draft of proposed regulation changes; Committee discussions Jan/Feb 2011 Board vote to put regulations out for public comment Public comment period; meetings with providers/ advocates Board vote to promulgate regulations; Roll out implementation/ trainings 38


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