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340:40-9-2. Case changes

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Revised 6-1-09

(a) Case changes. The client must report within ten calendar days any changes in his or her circumstances that would result in an increase or decrease in subsidized child care benefits. • 1 The worker acts on changes that increase or decrease the subsidized child care benefits regardless of whether the client is a semi-annual reporter. • 2 Failure to report changes timely may result in an overpayment assessment against the client. • 3 Examples of changes the client must report include:

(1) household income;
(2) household composition;
(3) names and number of household members in child care;
(4) the reason child care is needed;
(5) parent's or caretaker's work or school schedule or any other change affecting the days and hours child care is needed;
(6) the client's address or telephone number;
(7) the child care facility the child is attending;
(8) child care is no longer being used or needed; and
(9) family size.

(b) Change of payee. When a change of payee is reported, the worker refers to policy at OAC 340:40-7-6(c) regarding temporary absence. If the situation is not temporary, a new application must be taken. See OAC 340:40-3-1 for application processes.

(c) Additional child request. When an additional child requires subsidized child care benefits, the worker completes the request within two working days of the client providing all necessary verification to determine eligibility. If eligible, the child can be approved for subsidized child care benefits beginning with the date of request. Family share co-payment increases due to adding an additional child to the subsidized child care benefits are effective the month after the month the client requests subsidized child care benefits for that child. • 4

(d) Changes that increase the subsidized child care benefits. When the client reports a change timely that increases the subsidized child care benefits, the client and the worker jointly plan the effective date of the change. • 5 When the client does not report changes timely, the earliest date the worker increases the subsidized child care benefits is the first day of the month in which the client reports the change.

(e) Changes that decrease the subsidized child care benefits. When possible, the worker plans with the client changes that decrease the subsidized child care benefits before implementing the change. When the client reports an increase in income, the worker uses Oklahoma Department of Human Services (OKDHS) Appendix C-4, Child Care Eligibility/Co-payment Chart, to determine whether the household meets income guidelines in accordance with OAC 340:40-5-1(8). • 6

(f) Change in provider. When a client reports a change in provider, the change is effective the date the change in provider occurs, regardless of whether the client reports this change timely. • 7 The worker completes provider changes within two working days of the date the client reports the change.

(g) Closure of the subsidized child care benefits. When advance notice is required, the worker closes the subsidized child care benefits ten days from the date action is taken. Ten day advance notice is not required when the client gives written permission agreeing to an earlier closure date. • 8

(h) Reopen action. When a client's subsidized child care benefits close, they can be reopened using current eligibility information if policy and procedures were not administered correctly or if human services center staff receive new or additional information within 30 calendar days of the effective date the benefits terminated that shows the family continues to be eligible. • 9 The client must complete a new application when:

(1) a 30 calendar day period of job search was given because the client lost his or her job or successfully completed school and the subsidized child care benefits were closed; • 10
(2) expedited eligibility processing is used and requested verification is not returned within 30 calendar days of the application date. See OAC 340:40-3-1(b); or
(3) the payee for the child care case changes.

INSTRUCTIONS TO STAFF 40-9-2

Revised 6-1-09

1. The worker completes case changes within ten calendar days of receiving notification of the change. The worker confirms with the client any case changes reported by persons other than the client before processing the change.

2. The worker acts on all reported case changes whether the household is considered a semi-annual reporting household. The system determines which changes affect benefits in other programs. See OAC 340:50-9-5(i) for information about the semi-annual reporting process for food benefits. See OAC 340:40-9-1(b) and (c) for information about the benefit reporting process for child care.

3. See OAC 340:40-15-1 for information regarding overpayments. See (c) of this Section and Instruction to Staff 5 for more information when the client requests increased child care benefits for a previous period of time.

4. (a) The worker notes in Family Assistance/Client Services (FACS) Case Notes:

(1) the date of request;

(2) the name and birth date for the child;

(3) what days and hours the client needs child care;

(4) how child care needs were previously met; and

(5) whether child support or any other income must be pursued for the child.

(b) The client must also declare the citizenship or lawful alien status of the child by signing Form 08MP022E, Declaration of Citizenship Status, prior to adding the child to the child care benefits. If the child is 14 years of age or older, he or she is also subject to additional citizenship requirements at OAC 340:65-3-1(g).

(c) If one or both of the child's parents is absent from the home, the worker informs the client that he or she must complete required child support forms prior to adding the child to the child care benefits. If the client does not complete required forms, the worker closes child care benefits for all siblings of this child. See OAC 340:40-7-9 for information about the mandatory pursuit of child support and other potential income.

(d) If the child brings additional income to the household, the worker adds the child's income to current household income for the next effective month.

(e) The worker chooses "social services" in the "benefit" field F24 and "added to the benefit" in the "status" field F25 to add the child in the Household tab of FACS. The worker enters in the Child Care tab a change in the "action taken" field E3, the following month in the "effective date" field E5, and the correct number of children in care in the "number of children receiving child care" field E52. The system recalculates the family share co-payment. The worker enters the authorization for the child in the Auth. Daycare tab. The system maps the copay for the current month from the Child Care tab to the "copay" field K70 for the new authorization. After this action is cleared, the worker must make one more change to the Child Care tab so the system maps the new family share co-payment for the next effective month.

5. (a) The worker documents changes, if applicable, in the FACS Interview Notebook under the Income and Child Care tabs and in the FACS Eligibility Notebook under Auth. Daycare and Child Care tabs. If the change action results in a change in family share co-payment, the system maps the co-payment change to the authorization. This generates a notice to the client. The worker does not make a change in the Auth. Daycare tab for a co-payment only change. The worker must enter a change action in the Auth. Daycare tab when the unit type or number of days and hours the client needs child care changes.

(b) Changes that increase subsidized child care benefits include, but are not limited to:

(1) a change in income resulting in a decrease in family share co-payment. The client's family share co-payment for the month he or she reports the change is based on actual income. Prior to reducing the family share co-payment for the current or earlier month, the client must provide verification of the actual income for that month. The earliest date the change is made in the "effective date" field E5 of the FACS Eligibility Notebook Child Care tab (Section E) is the first day of the current month;

(2) a change in the number of persons needing child care. See (b) of this Section and Instructions to Staff 4 for additional child requests. The change in family share co-payment is effective the month after the child is removed.

(A) If the child left the home, he or she is "removed from the benefit section" in the "status" field F25 of the Household tab in FACS. If the child is still in the home, he or she is "not included in benefit - income and resources are considered in benefit computation" in the "status" field F25.

(B) The worker closes the authorization in the Auth. Daycare tab with the appropriate reason code. The earliest date the worker closes the child care authorization is the date action is taken.

(C) The worker enters a change action to the Child Care tab for the next effective month and the correct number of children in care in the "number of children receiving child care" field E52. This change action causes the system to recalculate the family share co-payment and map it to the "copay" field K70 for the remaining authorizations;

(3) an increase in the unit type or number of days or hours the client needs child care.

(A) The worker makes the change as needed and planned for each affected child when the client reports the change within ten calendar days.

(B) When the change is not reported timely, the earliest date the worker increases days and hours is the first day of the month the client reports the change.

(C) The number of days approved for the first month may be less than a full month of care if the increased level of care was not needed for the entire month; and

(4) an increase in the rate paid by the Oklahoma Department of Human Services (OKDHS) after the worker completes the approval process described at OAC 340:40-7-3.1 for one of the higher special needs rates.

(A) The worker makes the change effective the first of the month following the month of the OKDHS Oklahoma Child Care Services (OCCS) licensing staff's approval in Section IV of Form 08AD006E, Certification for Special Needs Child Care Rate.

(B) If the child waits to start child care until after OCCS licensing staff approves the facility for the special needs rate, the special needs rate begins effective the first day the child enters the facility.

(c) The child care provider must submit Form 10AD121E, Child Care Claim, to request supplemental payment for any increase because the client did not correctly record attendance. Unless extenuating circumstances beyond the client's and/or provider's control exist, OKDHS Finance Division staff does not supplement the provider when the client fails to swipe attendance correctly. Circumstances beyond the client's and/or provider's control include, but are not limited to, some type of worker or system error.

(d) The worker submits Form 10EB004E, Report of EBT Child Care Payment Adjustments, to OKDHS Finance Division to request a supplement for the child care provider to correct problems not associated with correct attendance swiping. Some examples of when the worker completes Form 10EB004E include a decrease in the family share co-payment, an incorrect birth date being entered, an incorrect rate being given, or when the client correctly recorded the times of attendance but the swipes were denied. The worker enters correct data into the system for the current month prior to submitting Form 10EB004E.

6. (a) The worker enters a change action in the Child Care tab. If the change action results in a change in family share co-payment, the system maps the co-payment change to the authorization, which generates a notice to the client. The worker must enter a change action in the Auth. Daycare tab when the unit type or days and hours the client needs child care changes.

(b) The worker documents changes, if applicable, in the FACS Interview Notebook under the Income and Child Care tabs and in the FACS Eligibility Notebook under Auth. Daycare and Child Care tabs. See OAC 340:40-9-3(e) for changes requiring advance notice. Changes include:

(1) a change in income resulting in an increased family share co-payment. The worker makes the change in accordance with deadline changes requiring advance notice shown on OKDHS Appendix B-2, Deadlines for Case Actions;

(2) a change in the number or names of children requiring subsidized child care benefits. If the client requests subsidized child care benefits for an additional child, see (b) of this Section and Instruction to Staff 4. If the worker is removing a child from the subsidized child care benefits, see Instruction to Staff 5(a)(2);

(3) a decrease in the number of days the client needs child care or a change between part-time, full-time, blended, or weekly authorized care. The earliest date the worker makes the change is the first day of the current month as long as care was not given.

(A) If the client and provider differ on their report of the dates and amounts of care actually given, the worker checks time and attendance through the electronic benefit transfer (EBT) Daycare system.

(B) If care was given, the worker makes the change in accordance with deadline changes requiring advance notice as shown in OKDHS Appendix B-2.

(C) If OKDHS has already paid for care for which the client was not eligible, the worker completes an overpayment memo per OAC 340:40-15-1;

7. (a) A change in provider is considered a non-adverse action when no other change occurs in the plan of service.

(1) The worker closes the authorization for the first provider using "change in providers" in the "reason" field K16 and "advance notice not required" in the "notice indicator" field K92 in the Auth. Daycare tab. The earliest date the authorization can be closed is the date action is taken.

(2) The worker opens the authorization for the new provider beginning with the date the change occurs and uses "change of providers" in the "notice indicator" field K92.

(b) The worker enters a change action in the Child Care tab. If the number of children in care changes, the worker also enters the correct number of children in the "number of children receiving child care" field E52 so that the system recalculates the family share co-payment. This maps the co-payment to the "copay" field K70 of each open authorization that has "N" in the "copay exempt" field K78.

(c) The point-of-service (POS) machine for the new provider shows the entire family share co-payment owed for the month. The worker calls the new provider and explains:

(1) the client used a different provider for part of the month so the entire family share co-payment is probably not owed for the initial month;

(2) the provider cannot determine exactly how much, if any, co-payment is owed until he or she receives the Totals Report for the first week the children start care with him or her. Prior to receiving payment for that payment week, the provider has the option of:

(A) requiring the client to pay the entire co-payment again until the provider knows how much of that month's co-payment was actually applied at his or her facility; or

(B) accepting a receipt from the client showing how much co-payment he or she paid to the first provider and waiting until the Totals Report confirms part of the co-payment is still owing before charging the client for that co-payment; and

(3) if the provider requires the client to pay the entire co-payment again, he or she must reimburse the client for the amount of co-payment that was not applied to his or her facility after receiving payment from OKDHS.

(d) If the client pays the entire family share co-payment to the first facility and that much care was not given, the first provider reimburses the client for the difference. If the provider refuses to do so, the worker contacts Family Support Services Division Child Care Subsidy Section or the Office of the Inspector General for assistance.

(e) If the first provider reports to the worker the client left without paying the full family share co-payment owed, the provider is advised OKDHS is only able to pay for services provided after the family share co-payment is deducted. It is the provider's responsibility to collect the family share co-payment from the client. The worker counsels with the client about the importance of paying his or her family share co-payment.

(f) In most instances when the child care authorization closes on a reason code other than "change of providers" before the new provider is authorized, the worker must enter a new authorization using "application approval" rather than "change of providers" in the "notice indicator" field. The system only accepts "change of providers" in the "notice indicator" field when the reason code on the closed authorization is:

(1) 4 – change in providers;

(2) 7 – ineligible provider;

(3) 7A – provider contract terminated – State Office use only;

(4) 36 – FSS BR-1 (Form 08MP004E) not completed; or

(5) 99 – State Office use only.

(g) If the change in provider comes to the attention of the worker after subsidized child care benefits were closed and benefits are not reopened, the worker only authorizes care for this provider through the date of the original closure. In this instance, the worker enters a begin and end date on the authorization.

8. (a) The earliest date the worker can close the subsidized child care benefits when advance notice is not needed is the date action is taken. Closures effective for the current month must be entered in the system by the 27th day of that month. If a closure action is taken between the 28th and 31st of the month, the earliest date the worker enters a closure action is the first day of the next month.

(b) When the worker closes the subsidized child care benefits because the client's income exceeds the levels on OKDHS Appendix C-4, Child Care Eligibility/Co-payment Chart, the worker must first determine whether the client's income for the current month exceeds the levels on OKDHS Appendix C-4.

(1) If the client will not receive enough income during the current month to cause the client to become ineligible, the earliest date the worker closes the subsidized child care benefits is the last day of the current month. This can happen when the client starts new employment.

(2) If the client provides income information showing he or she has already received enough income to make him or her ineligible for the current month, the worker closes the subsidized child care benefits ten calendar days from the date the worker takes the action. This can happen when the client provides income information for benefit reporting.

(c) When the worker closes the subsidized child care benefits for any other reason that requires advance notice, the worker closes the benefits ten calendar days from the date he or she takes action. Possible reasons include:

(1) lack of cooperation. This can include when the client does not:

(A) respond to a request for an interview or verification;

(B) pursue potential income or refuses to accept increased income;

(C) cooperate with Oklahoma Child Support Services (OCSS); or

(D) cooperate with the Office of Inspector General (OIG).

(2) no longer meeting the need factor for child care. See OAC 340:40-7-8(a)(6) when the client requests a 30 calendar day period of job search after losing a job or completing a formal education or training program;

(3) not using care for more than 30 calendar days as evidenced by a lack of swiped attendance at the child care facility; or

(4) change in payee.

(d) The system automatically closes the subsidized child care benefits on the last day of the current month when the client fails to timely return the computer-generated Form 08MP004E, Benefit Review Report.

9. (a) Using current eligibility information means negative action notice time frames do not apply. For example, the client's case closed on lack of verification. The client provides current income information within 30 calendar days that increases the family share co-payment. The worker applies the increase effective the first of the month after subsidized child care benefits reopen. If subsidized child care benefits close on the last day of the month, the worker applies an increased co-payment for the first of the next month. If subsidized child care benefits close on the 13th of the month and reopen on the 14th, the increased co-payment applies to the first of the next month.

(b) To reopen subsidized child care benefits, the worker enters in the Child Care tab an R in the "action taken" field E3 and the "children in day care" field E52. The worker must also update the "benefit" and "status" fields F24 and F25 for those persons included in the benefit household in each person's Household tab in the FACS Interview Notebook. To reopen the child care authorization, the worker must enter R in the "action taken" field K12, "application approval" in the "notice indicator" field K92, as well as any other fields requiring changes in the Auth. Daycare tab.

(c) The worker has ten calendar days to reopen benefits from the date new or additional information is received or he or she realizes benefits were closed in error. When the ten day time period extends past the 30 day reopen period and the system does not allow the worker to reopen the authorization, the worker must e-mail the Family Support Services Division Child Care Subsidy Section for assistance with the reopen action. When the worker does not take action timely, he or she must enter a new authorization.

(d) If the client reports a change in child care providers, the worker enters a new authorization rather than using the reopen action.

(e) If the client does not meet the criteria to reopen the subsidized child care benefits, the client must reapply using the processes described at OAC 340:40-3-1.

10. See OAC 340:40-7-8(a)(6) and OAC 340:40-3-1(a).

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