CHILD SPECIFIC RATE INCREASES:

EVENING/WEEKEND DIFFERENTIAL

Effective October 1, 1998, child care providers were eligible for an increase of fifteen percent (15%) over the rate they normally receive for services provided in the evening from 6:01pm-5:59am, and on the weekend from 6:00am Saturday-6:00pm Sunday.  The Child Care Eligibility and Authorization system will now accept Evening/Weekend codes in the IM and CS systems (ICCR, ICEA, and ICAU).  In order for the system to generate these payment increases, staff must enter the individual child authorization using the evening/weekend service codes to ensure proper payment.

If a child requires care between 6:01pm and 5:59am, or between 6:00am Saturday and 6:00pm Sunday, the authorization must be entered with an evening/weekend service code.  Staff will no longer determine the number of hours that are evening/weekend.  If any hours of care are provided during the evening or weekend, all hours of care are paid at the evening/weekend rate.

The FAMIS Child Care provider registration system captures evening/weekend rate information for payment of the shift differential.  IM staff need to review the provider's registration to ensure evening rates are entered if a caregiver provides evening/weekend care.

To authorize a child for evening or weekend care:

1. Select the appropriate authorization screen from the Individual Authorization Menu.

 
2. Complete the identifier fields as usual:

• Head of Household DCN,
• Individual DCN,
• Provider DVN,
• Relative and Voucher data, if authorizing in ICCR,
• Eligibility Begin Date and End Date.

3. Enter the eligible service using the existing and updated service codes:

• First character is the type of provider:  (C)=Center, (G)=Group, and (F)=Family;
• Second character indicates the age of the child:  (I)=Infant, (P)= Preschool, and (S)= School Age;
• Third character indicates evening and weekend care (E);
• Fourth character shows the amount of care:  (F)=Full-time, (H)=Half-time, and (P)=Part-time care.

4. Enter the appropriate frequency to indicate the number of days the child is eligible for care.

 
5. Enter the appropriate code for Special Needs and Function Age.

 
6. Enter "Y" to indicate an exception and to add a message if appropriate.

 
7. Enter "nighttime" in the "Time of Day" field.

 
8. Enter authorization message:  "Child is authorized for evening/weekend care, five nights per week".

All child care providers receiving payment from the Division of Family Services are eligible for the Evening/Weekend Differential rate increase.

Once the individual authorization has been entered, no additional entries are required by county office staff when processing the invoices for payment.

The IM-65E Income Maintenance which has been utilized to process evening/weekend payments is obsolete once the authorization for evening/weekend care has been completed.  The CS-65 will continue to be used to issue manual payments when child care payment can not be made through the invoice payment process.

This policy revision replaces the evening/weekend policy defined in memorandum IM-134 dated October 20, 1998, IM-137 dated November 4, 1998, and IM-161 dated December 4, 1998.

CHILD WITH SPECIAL NEEDS DIFFERENTIAL

Effective September 1, 1999, child care providers are eligible for an increase of twenty-five percent (25%) over the rate they normally receive for services provided to a child with special needs.  For the present time, anyone who has a Special Needs Indicator in the Individual Authorization of "Y" will receive the payment increase.

Essentially there is no change in the way the Individual Child Authorization is entered.  To authorize a child with special needs for the increased reimbursement:

1. Select the appropriate authorization screen from the Individual Authorization Menu.

 
2. Complete the identifier fields as usual:

• Head of Household DCN,
• Individual DCN,
• Provider DVN,
• Relative and Voucher data, if authorizing in ICCR,
• Eligibility Begin Date and End Date.

3. Enter the eligible service using the existing and updated service codes:

• The first character is the type of provider:  (C)=Center, (G)=Group, and (F)=Family;
• The second and third characters indicate the age of the child:  (IN)=Infant, (PS)=Preschool, and (SA)=School Age;
• If care is needed in the evening or on the weekend, the third character will indicate evening/weekend care (E);
• The fourth character shows the hours of care:  (F)=Full-time, (H)=Half-time, and (P)=Part-time care.

4. Enter the appropriate frequency to indicate the number of days the child is eligible for care.

 
5. Enter a "Y" in the "Special Needs Indicator".

 
6. Enter the appropriate code in the "Functional Age Indicator":  (IN) if at an Infant level, (PS) if at a Preschool level, or (SA) if at a School Age level.  The code entered in the "Functional Age" field determines which code should be used in the "Service Code" field.

 
7. Enter a "Y" or "N" to indicate if an exception is needed and to add a message if appropriate.

 
8. Enter "daytime" or "nighttime" in the "Time of Day" field.

 
9. Enter an authorization message, if appropriate.

It is important that the correct functional age is entered in order for a provider to receive the correct reimbursement rate.

All child care providers receiving payment from the Division of Family Services are eligible for the Child with Special Needs rate increase.

Once the individual authorization has been entered, no additional entries are required by county office staff when processing the invoices for payment.

PROVIDER SPECIFIC RATE INCREASES:

ACCREDITATION DIFFERENTIAL

Beginning September 1, 1999, child care providers who have obtained accreditation by an organization recognized by the Division of Family Services may receive an increase of twenty percent (20%) over the rate they normally receive.  The increase in payment is specific to the vendor, so the entries required are made through the vendor system.  The screen staff will be utilizing to view whether a provider has been determined eligible for this increased payment is VACI.  Central Office staff are responsible for entering and updating the information regarding accreditation.

DISPROPORTIONATE SHARE DIFFERENTIAL

Beginning September 1, 1999, licensed providers who are contracted or registered and provide care for a disproportionate share of children receiving child care assistance from the Division of Family Services may qualify for an increase of thirty percent (30%) in the rate they normally receive.  This increase is specific to the vendor, so the entries required are made through the vendor system.  The screen staff will be utilizing to view whether a provider has been determined eligible for this increased payment is VACI.  A copy of the screen is attached.  Central Office staff are responsible for entering and updating the information regarding disproportionate share.  A provider is eligible for this increase if the number of DFS subsidy children is at least 50% of the total number of children in their care.  Note:  We are determining eligibility for this increase based on the number of children in their care rather than a percentage of the provider's capacity.

To view whether a provider has been determined eligible to receive the accreditation and/or disproportionate share increase in payment:

1. Access the VACI screen.  Enter the vendor number.  Press Enter.

 
2. The provider's name will appear after "vendor name".

 
3. Under the provider's name are three types of service categories.  They are:

• Accredited (DC) - (daycare)
• Accredited (RT) - (residential treatment)
• Disproportionate (DS) - (disproportionate share)

4. Below the service categories are a number of columns.  The first is the "BEGIN DATE" column.  The date is in the format CCYYMMDD, for example, 19991001 for an accreditation begin date of October 1, 1999.  The begin date is always the first day of a month, and cannot be before September 1, 1999.

For a disproportionate share provider, the "BEGIN DATE" is the begin date of their contract with the Division of Family Services.  The begin date is in the CCYYMMDD format, and can not be before September 1, 1999.

5. The "END DATE" column, will indicate the accreditation end date or, the end date of the contract with the Division of Family Services for a disproportionate share provider.  This is also in the CCYYMMDD format.

 
6. The "PERCENT" column reflects the percent of payment increase that will be given to the provider.  For those providers who are accredited under the "DC" Accreditation, the percentage is always twenty (20).

For those providers who are accredited under the "RT" Accreditation, the percentage is always zero (0).

For those providers who are disproportionate share "DS" providers, the percentage will always be thirty (30).

7. The "CONT TYPE" column shows for which type of service the begin and end dates are valid.  DC = Daycare Accreditation, RT = Residential Treatment Accreditation, and DS = Disproportionate Share.

 
8. For Accredited providers, the next three columns titled "ACC TYPE (IN)", "ACC TYPE (PS)", and "ACC TYPE (SA)", refer to the specific age group the provider is accredited for and with which accrediting organization they are certified.  The "X" is placed under the appropriate age group for which the provider is accredited (infant, preschooler, or school age children) AND under the appropriate number according to the following code listing:

• 1 = Missouri Accreditation
• 2 = National Association for the Education of Young Children
• 3 = National Association of Family Child Care
• 4 = Other

All child care providers receiving payment from the Division of Family Services are eligible for the Accreditation rate increase.

Only those child care providers receiving payment from the Division of Family Services who are licensed are eligible for the Disproportionate Share rate increase.

Once Central Office staff have made the accreditation and/or disproportionate share entries, the appropriate increase(s) will be system generated.  No additional entries will be required by the county when processing an invoice.

EFFECTIVE DATES

With the exception of evening/weekend the above rate increases are available to providers effective September 1, 1999.  Any authorizations and vendor specific information entered prior to the printing of September invoices for child specific authorizations will include these rate increases.  Any authorizations or entries made after that time will require a CS-65 to be completed for the amount of the increase(s).

Those increases that are provider specific will be included in the payment the provider receives if the accreditation and/or disproportionate share information has been entered in the system prior to the payroll closing the invoice is entered.

Since providers did not receive information regarding the rate increases in order to provide the information on or before September 1, 1999, they may receive the increase effective September 1, 1999 if the following occurs:

• the evening/weekend authorization is a determined need of the family as of September 1, 1999;
• the special needs authorization is a determined need of the family as of September 1, 1999;
• the accreditation certification must have a begin date prior to or on September 1, 1999;
• the disproportionate share provider must have a valid license with the Department of Health Bureau of Child Care as of September 1, 1999, as well as a valid contract with the Division of Family Services.  There will be a few licensed providers that are registered, and they must also have a valid registration with DFS as of September 1, 1999.

In order for current providers to access these increases effective September 1, 1999, they should provide the county office with proof of their eligibility for these increases by September 30, 1999.  Information received after that date will have a rate increase effective with the first day of the month received if eligible on the first day of that month.  If not eligible the first day of the month received, then the rate increase occurs the first day of the following month.

Increased payments for individual child authorizations will begin the date of the child's eligibility for child care services.  Documentation of the need for evening/weekend or special needs child care should be obtained at application and reinvestigation.

For those providers who do not meet the above but are interested in the increase, the first day of the month following the month in which they provide the county office with documentation of their eligibility for a specific type of rate increase is the effective date of their payment increase.

PROVIDERS ELIGIBLE FOR MULTIPLE RATE INCREASES

In most cases, the individual authorization and provider information will be entered in a timely manner and county office staff will not have to manually issue the rate increases.  When this is not possible, the following procedure will be used to determine the payment due to the provider.  In these situations, county office staff will issue the increased payment via CS-65 using the appropriate service codes:

• determine the provider's base rate or state maximum rate, whichever is lower;
• multiply this rate by the appropriate type of rate increase;
• multiply that amount by the number of days care was provided;
• this is the amount of the increase due to the provider;
• repeat this process for each type of rate increase for which the provider is eligible.

If the county office believes a provider is due payment for accreditation or disproportionate share, contact the Child Care Program and Policy Unit at (573)751-9488.  Central Office staff will review the situation with the county office and determine if the provider was eligible for the increase and will be responsible for issuing any payment necessary.  County office staff will not receive any service codes for accreditation or disproportionate share.

COUNTY OFFICE PROCEDURES

The letters sent out to child care providers instructed them to contact the County Office regarding actions needed to access these rate increases.  A copy of the letter registered and licensed child care providers received is attached.

Registered providers were instructed to update their registration if they are willing to provide evening/weekend care, care to special needs children, or if they are accredited.

• To update the provider's registration for evening/weekend or special needs child care, the provider needs to complete a new IM-91 to reflect the evening/weekend rates.

 
• A revision of the IM-91 will soon be available to staff.  This new IM-91 asks if the provider is willing to care for children with special needs.  The letter instructed the provider to have the parent contact the county office if they believed they care for a child with special needs.  It is only through the individual child authorization that the provider will receive the increased rate.

 
• To verify accreditation, request the provider send a copy of their accreditation certificate.  County office staff will keep a copy for the provider's file and forward a copy of the certificate with a copy of the IM-91 to the Child Care Program and Policy Unit in Central Office.  Not all accrediting organizations are recognized by DFS as eligible for this rate increase.  Central Office staff will use this information to enter and authorize the payment increase when appropriate.  If the accrediting organization is not recognized by DFS, Central Office staff will attempt to obtain the information necessary to determine if the accrediting organization meets DFS requirements.  A list of the accrediting organizations recognized by DFS as of September 1, 1999, is attached.

• Contracts must be amended to reflect the licensed providers evening/weekend rates.

 
• Providers were instructed to have parents contact the county office if they believed they care for a child with special needs.  The individual child authorization must be entered correctly in order for this rate increase to occur.

 
• If accredited, follow the same procedures outlined for registered providers above.

 
• Licensed providers were not informed in the letter of the disproportionate share percentage required to receive the increase.  County office staff need to inform the provider of the minimum of 50% of children in care.  Providers currently contracted with DFS will have the opportunity to provide this information until September 30, 1999.  The only time this information will be requested is at initial contract or at renewal of a contract.  Once determined, the provider is either eligible for the increase the entire contract period, or not.  The provider's eligibility for this increase will not be determined on a monthly basis.  Once this information is obtained by the county office, a copy is maintained in the provider's file and a copy is to be forwarded to the Child Care Program and Policy Unit in Central Office.  Central Office staff will make the entry into the vendor system authorizing the rate increase.  This information should be included with any new contracts or renewals in the future.

SUMMARY

DFS anticipates that with the implementation of these rate increases there will be an increase in the availability of child care for those families needing evening/weekend care and care for children with special needs.  The quality of care provided to those families we serve will increase as a result of incentives for child care providers to go beyond licensure requirements and obtain accreditation.  Many quality programs that were inaccessible to low income families due to high co-payments may now be an affordable option.

Child Care System enhancements have allowed these increases to occur without additional data entry by local staff and eliminated some of the data entry previously required.

• Review this memorandum with appropriate staff.
• Effective immediately, begin implementing the changes discussed in this memorandum.
• Effective immediately, update any individual authorizations for evening/weekend care in all active child care cases.
• Issue payments for evening/weekend shift differential by invoice.
• Effective immediately, disregard evening/weekend policy defined in IM-134 dated October 20, 1998, IM-137 dated November 4, 1998, and IM-161 dated December 4, 1998.
• Effective immediately, forward copies of the accreditation certificates with IM-91 or contract information to the Child Care Program and Policy Unit in Central Office.
• Effective immediately, forward copies of documentation of disproportionate share providers to the Child Care Program and Policy Unit in Central Office.