Attachment E: Protective Services Child Care
Definition and Purpose
Protective services child care is a purchased child care service for children who are receiving preventive services or treatment for child abuse or neglect. Child care services are based upon the child's need for child care as part of the Family Plan for Change developed with the child's family.
Policy Statements Relating to Eligibility and Payment
The Children’s Service Worker must document that child care services are indicated using the CD-14, FCS Family Assessment Packet, in the family's case record.
Under no circumstances may a child remain eligible for PS child care after the PS case is closed.
Children in out-of-home care are also eligible for protective services child care. Their need for child care services must be documented in the narrative of the child's case record.
Protective services child care must be authorized and paid through the SEAS system by the Children’s Service Worker, or person designated for SEAS transactions.
The child care provider must be a licensed contracted child care vendor.
Special Instructions for HIV Children
The Children’s Service Worker shall utilize the team approach to determine the most appropriate child care setting for a child who tests HIV positive. Team members should include:
- The child's physician;
- Public health representative;
- The child's parent or caretaker;
- Children’s Division (CD) Worker;
- Potential child care provider; and,
- Child care licensing representative.
The HIV child in child care has the right to privacy. This right, necessary to protect the child from harm and persecution, requires that only those persons directly responsible for the child's care should be informed of his/her condition. The child care provider should be informed of the child's condition and advised of the prohibition against further disclosure.
Procedures for Authorizing Protective Services Child Care
To authorize protective services child care, the Children’s Service Worker shall:
- Document that child care services are indicated using the CD-14 FCS Family Assessment Packet, in the family's case record.
- Conduct an Emergency Assistance (EAS) assessment when an emergency situation exists for the family.
- Complete the CS-67 and have it immediately entered into the SEAS system.
- Obtain clearance to complete an authorization for PS child care from the authorizing designee, according to local policy.
- If unable to authorize, place the client on the waiting list.
- If funding and a provider are available:
- Arrange the child care referral with the provider. Identify the provider is to contact if there are problems with an authorization or invoice regarding services for this client.
- Complete CS-67A to authorize services. Enter appropriate service codes, per forms instructions.
- Obtain the signature of the authorizing designee prior to data entry.
- Have CS-67A entered into the system immediately.
- When a client is in need of immediate or emergency child care services, and notification is required within five (5) calendar days, enter authorization into the system, then:
- Request an "Immediate Emergency Authorization" notice be printed.
- Provide client with this notice to hand-deliver to the provider.
- File second copy in the case record;
- Inform client that an ongoing authorization letter will follow to both him/her and the provider.
- Review CS-67 and CS-67A turnarounds upon receipt to ensure correctness of all information.
- Update CS-67A when the frequency of service is to be increased (i.e., a child in child care, authorized for three (3) days per week, needs to attend five (5) days per week.)
- Set up or update case record. The record should include:
SEAS will produce appropriate notification to the client and the provider the evening following data entry. A copy of all client notifications generated by the SEAS system will be sent to the authorizing worker. Provider notification will be sent to county director/designee. Review copies of this correspondence to assure that correct information has been forwarded to the client and provider.
Children in out-of-home care will not receive system generated letters. The Children’s Service Worker will continue to send any necessary authorization information to the out-of-home care provider. The child care provider will receive system generated authorization notices.
- The documented need for protective services child care on the CD-14, FCS Family Assessment Packet. (Document this need in the narrative section of the child's record in out-of-home care cases.)
- Ongoing narrative summary of child care services provided that it is included in the CD-14 packet for the treatment period. (Summarize these services in the narrative section of the child's record in out-of-home care cases.)
- The CS-67 and CS-67A.
- Copies of letters, other forms, etc.
The record shall be in the name of the Family-Centered Services or Out-of-Home Care case name.
Monitoring Ongoing Use of Protective Services Child Care
As case manager, the Children’s Service Worker must monitor the progress of the treatment plan, including the work of contracted providers. The worker shall be in regular contact with the contracted provider and family.
The Children’s Service Worker/authorizing worker shall monitor the parent/child use of child care. He/she shall discuss any concerns about the appropriate use of the service with the family. Verbal communication should occur continuously between the worker, provider, and the family.
Procedures for Changing or Terminating Protective Services Child Care
To change or terminate protective services child care, the Children’s Service Worker/authorizing worker shall:
- Close the authorization(s), using the CS-67A turnaround, when changing providers, the frequency of child care is reduced, a client moves to another county, or the case plan indicates PS child care is no longer needed.
- Complete a new authorization (CS-67A) for an alternate provider, when needed.
- Complete a new authorization (CS-67A) indicating reduced frequency of service.
- When a client presently authorized for a service moves to another county/area, he/she shall be immediately authorized to continue to receive the service if:
- He/She continues to need the service; and
- A provider is available to provide the service.
- Review the turnaround for correctness upon receipt.
- When a child in out-of-home care is placed in a permanent placement (i.e., adoptive home, birth parent, independent living) outside the present county of residence, child care services, whether or not presently received in the county of residence, shall be provided if:
- Child care is vital to the success of the placement; and
- There is a child care provider available.
NOTE: The new county of residence will be responsible for completing the CS-67 and CS-67A to authorize services.
NOTE: The transfer county will close the CS-67A and transfer the CS-67 by entering the new county office code and the client's new address, if known. The new county office will update the CS-67 and reauthorize client using the CS-67A.
- Notify the client at least ten (10) calendar days in advance, via form CS-41, when it becomes known from child care licensing staff that the provider's license will lapse. An unlicensed provider cannot receive state payments.
- Submit a copy of the CS-41 to the provider.
- Assist the family, if requested, in securing an alternate provider.
- Close the CS-67A to an unlicensed provider on the date of license expiration, or earlier, if the child moves to another provider.
- Complete a new CS-67A for the new provider, if child moves to another provider.
- Notify the client in writing at least ten (10) calendar days in advance when it is known that a provider's contract will not be renewed. A non-contracted provider cannot receive state payments.
- Submit a copy of the letter to the provider.
- Assist the family in securing an alternate provider.
- Close the CS-67A to a non-contracted provider on the date of contract expiration, or earlier, if the child moves to another provider.
- Complete a new CS-67A for the new provider, if child moves to another provider.
- Notify the client at least ten (10) calendar days in advance when PS child care is terminated due to lack of need or case closing.
- Enter any necessary information into the system, via the CS-67 and/or S-67A, for any changes or closings, ten (10) days prior to the final action date.
- A system-generated letter will be produced indicating the effective date services are closed.
- Review the CS-67 and/or CS-67A turnaround and copies of client letters to assure that closing information is correct.
- Record the use of child care services in the case narrative, as appropriate, but at a minimum of every 30 days.
- Refer the family to the Family Support Division (FSD) for an Income Maintenance (IM) or Income Eligible (IE) child care eligibility determination if:
- Their PS Child Care case is being closed; and
- They express an interest in these programs.
Child Care Services Maximum Payment Rates and Special Guidelines Relating to Payment
The maximum allowable payment for child care services is listed on page 14 of this attachment. These rates are determined by the following criteria:
- The age of the child, age 0 - 2 (infant), age 2 - 5 (pre-school), or age 5 and up (school age);
- The type of child care facility being utilized (i.e., family child care home, child care center, or group child care home);
Service authorization codes for protective services child care are identical to the authorization codes used in other child care programs.
| Infant Age 0 – 2 |
Pre-school Age 2 - 5 |
School Age 5 and Up |
|
|---|---|---|---|
| Child Care Center | CINF CINH CINP |
CPSF CPSH CPSP |
CSAF CSAH CSAP |
| Family Child Care Home | FINF FINH FINP |
FPSF FPSH FPSP |
FSAF FSAH FSAP |
| Group Child Care Home | GINF |
GPSF GPSH GPSP |
GSAF GSAH GSAP |
The first letter of a service authorization code indicates the type of child care facility providing the service: "C" denotes center child care; "F" denotes family child care home; and "G" denotes group child care home.
The next two letters indicate the age of the child receiving child care: "IN" denotes the child is an infant, age 0 through age 2; "PS" denotes the child is pre-school, age 3 through age 5; "SA" denotes the child is school-age, age 5 and above.
The last letter of the service authorization code indicates whether the child is receiving: full-child care, denoted by "F"; half-child care, denoted by "H"; or part-child care, denoted by "P". (See the definitions in this attachment for the explanations of full, half, or part child care.)
Daily Maximum Protective Services Child Care Prices by Type of Care and County
| Type of Care | Metro | Sub-Metro | Rest of State |
|---|---|---|---|
| Center Infant Full | 25.75 | 17.95 | 14.00 |
| Center Infant Half | 18.08 | 15.50 | 8.00 |
| Center Infant Part | 15.25 | 14.00 | 6.00 |
| Group Infant Full | 19.00 | 13.00 | 12.00 |
| Group Infant Half | 15.00 | 8.00 | 8.00 |
| Group Infant Part | 15.00 | 7.75 | 5.00 |
| Family Infant Full | 15.00 | 13.00 | 10.00 |
| Family Infant Half | 9.75 | 8.00 | 6.50 |
| Family Infant Part | 5.00 | 4.64 | 4.64 |
Metro - St. Louis City, St. Louis County, Jefferson, Franklin, St. Charles, Greene, Jackson, Cass, Clay, Lafayette, Platte, Ray,
Sub Metro - Newton, Christian, Jasper, Buchanan Johnson, Boone
| Type of Care by Facility |
St. Louis City,
St. Louis County, Jefferson, Franklin, St. Charles | Jackson, Johnson, Ray, Platte, Cass, Clay, Lafayette | Greene Christian |
Jasper Newton |
Boone | Buchanan | Rest of State |
|---|---|---|---|---|---|---|---|
| Center Pre-School Full | 15.30 |
15.00 |
12.00 |
9.88 |
15.30 |
12.63 |
10.00 |
| Center Pre-School Half | 9.90 |
9.90 |
8.00 |
7.26 |
9.90 |
7.90 |
6.00 |
| Center Pre-School Part | 6.90 |
6.90 |
5.00 |
4.50 |
6.90 |
4.65 |
4.00 |
| Center School Age Full | 15.00 |
12.85 |
11.50 |
10.80 |
15.30 |
11.40 |
9.19 |
| Center School Age Half | 9.90 |
9.90 |
8.00 |
7.01 |
9.90 |
8.50 |
6.00 |
| Center School Age Part | 6.90 |
6.90 |
5.00 |
4.00 |
6.10 |
4.75 |
4.00 |
| Group Pre-School Full | 13.00 |
12.00 |
10.00 |
9.00 |
12.00 |
10.00 |
8.75 |
| Group Pre-School Half | 8.00 |
7.25 |
6.50 |
6.00 |
8.00 |
6.00 |
6.00 |
| Group Pre-School Part | 5.00 |
4.13 |
4.00 |
4.00 |
4.00 |
4.00 |
4.00 |
| Group School Age Full | 12.00 |
10.00 |
10.00 |
8.75 |
12.00 |
10.00 |
8.75 |
| Group School Age Half | 8.00 |
7.00 |
6.00 |
6.00 |
8.00 |
6.00 |
6.00 |
| Group School Age Part | 5.00 |
5.00 |
4.00 |
4.00 |
4.00 |
4.00 |
4.00 |
| Family Pre-School Full | 13.00 |
12.00 |
10.00 |
9.00 |
12.00 |
10.00 |
8.75 |
| Family Pre-School Half | 8.00 |
7.25 |
6.50 |
6.00 |
8.00 |
6.00 |
6.00 |
| Family Pre-School Part | 5.00 |
4.13 |
4.00 |
4.00 |
4.00 |
4.00 |
4.00 |
| Family School Age Full | 12.00 |
10.00 |
10.00 |
8.75 |
12.00 |
10.00 |
8.75 |
| Family School Age Half | 8.00 |
7.00 |
6.00 |
6.00 |
8.00 |
6.00 |
6.00 |
| Family School Age Part | 5.00 |
5.00 |
4.00 |
4.00 |
4.00 |
4.00 |
4.00 |
Special Guidelines Relating to Payment
Policy states that if a child is in CD custody and is in need of childcare, CD must use a licensed contracted provider. All staff are encouraged to use licensed, contracted providers. However, extenuating circumstances may prevent this, for example, no licensed, contracted providers may be available. If staff is going to pay a non-licensed provider, the non-licensed provider must apply to be a registered childcare provider through FSD. This will ensure that the background checks are completed. FSD will assign that provider a vendor number once they are registered. Staff Cannot use this vendor number to authorize child care on the 67-67A. The provider must be paid each month on a CS-65 using vendor type and program area DC-DC. The service codes used must be child care service codes (CINF, FPSH, etc.). They should be paid the contracted childcare rate for the specific area.
- When paying a provider using a CS-65, always use DC-DC and the child care service codes. The system will not accept codes such as OTHR or TRAN under childcare.
- If the child is funded through adoption subsidy, put the adoption subsidy fund code for that child on the CS-65 so it can be paid out of the appropriate fund (03, 04 or 05).
- Due to the 25% Special Needs increase, CD will no longer pay co-pays for children in foster care. CD will only pay the contracted rate. This includes reimbursement to the foster/relative home.
- Please attach all documentation, especially sign in sheets, to the CS-65 in case a question should arise. Full days, part days, half days, vacation days and absent days must be broken down on separate lines on the CS-65.
Special Needs - Effective with services provided on September 1, 1999, childcare providers are eligible for an increase of twenty-five (25%) over the rate they normally receive for services provided to a child with special needs. The service code is SPND. All children in the custody of the Children’s Division, receiving adoption subsidy payments, or in a protective service household (open on an SS-63) are eligible for this additional payment. This payment is child specific. The system will automatically add the special needs payment for qualifying children whenever a child care payment is entered into the system when payroll is processed overnight on the payroll close date. Staff does not need to add this on to the 65 when making payment.
Accreditation Differential - Beginning with services provided on September 1, 1999, childcare providers who have obtained accreditation by an organization recognized by the Children’s Division may receive an increase of twenty percent (20%) over the rate they normally receive. The increase in payment is specific to the vendor, therefore the entries required are made through the vendor system. The screen that staff will be utilizing to view whether a provider has been determined eligible for this increased payment is VACI. IM Child Care staff, Central Office, are responsible for entering and updating the information regarding accreditation. The system will automatically add the accreditation payment, service code ACRD, for qualified child care providers whenever a child care payment is entered into the system. Staff do not need to add this on to the CS-65 when making payment.
Disproportionate Share - Beginning with services provided on 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 Children’s Division, may qualify for an increase of thirty percent (30%) over the rate they normally receive. This increase is specific to the vendor. A provider is eligible for this increase if the number of CD subsidy children is at least 50% of the total number of children in their care. The eligibility for this increase is based on the number of children in their care rather than a percentage of the provider’s capacity. IM Child Care staff, Central Office, are responsible for entering and updating the information regarding disproportionate share. The system will automatically add the disproportionate share payment, service code DISP, for qualifying child care providers whenever a child care payment is entered into the system. Staff do not need to add this onto the CS-65 when making payment.
- The rate change from infant to toddler is made the first day of the month following the child's second birthday. SEAS will make this change automatically. Notification will be generated to clients and providers. Copies will be sent to the local office.
- Child care providers shall not charge PS child care clients a co-pay.
- Activity books and field trip expenses for protective services clients are not to be considered co-pay, as they are not normally considered part of the per diem rate. PS child care clients are responsible for paying for activity books and field trips.
NOTE: Foster parents may be reimbursed for these expenses via form CS-65 using the code of "OTHER." Payment should be from HDN funds.
- Registration and insurance are normally considered part of the per diem rate and, therefore, should be considered as part of the daily CD reimbursement.
- The maximum number of paid absences per month, including holidays, shall not exceed five (5) full, five (5) half, or five (5) part days for the child who has care authorized for at least five (5) days per week.
- The maximum number of paid absences per month, including holidays, shall not exceed three (3) full, three (3) half or three (3) part days for the child who has care authorized for less than five (5) days per week.
- Payment for absences is allowed only for days for which child care services are authorized.
NOTE: A provider cannot bill for an absence after a child has left care. Absences shall not be paid to any provider for any days after the last day of the child's actual attendance.
- Holidays include any of the standard legal holidays listed below or any "local holidays" which are substituted in lieu of any of the legal holidays. Local holidays may include the facility closing due to inclement weather. In no event will the Children’s Division reimburse contractors for more than 11 holidays in any given fiscal year. A child must be authorized for the day on which a holiday falls in order for the child care provider to receive holiday payment for that child.
| New Year's Day | Martin Luther King's Birthday |
| Lincoln's Birthday | Washington's Birthday |
Truman's Birthday |
Memorial Day |
| Fourth of July | Labor Day |
| Veterans Day | Thanksgiving |
| Christmas |
- A provider cannot bill for a holiday that occurs after a child has left care.
- Holidays shall be tracked on a fiscal year (July 1 - June 30) basis.
Definitions Relating to Protective Services Child Care
Absences - (Child Care) If the provider was available to provide services, they will receive payment with the following limitations:
- Payment will be made for a maximum of five (5) full, half or part days absence, per month, including holidays, for the child authorized care five (5) days per week, depending on the plan established for the child; or
- Payment will be made for a maximum of three (3) full, half or part days absence, per month, including holidays, for the child authorized less than five (5) days per week, depending on the plan established for the child.
Authorization Period - A period of time of up to one (1) year, whereby a client is authorized, per form CS-67A, to receive child care services.
Co-Pay - Money paid by the FSD/IE child care client for the daily rate which exceeds the contracted amount paid by CD.
Child Care - Care of a child away from his/her own home for any part of the 24-hour day, for compensation or otherwise. Child care is a voluntary supplement to parent responsibility for the child's protection, development, and supervision. State reimbursed child care may be provided in a licensed and contracted child care home or child care center.
Child Care Center - A facility other than the provider's permanent residence, or separate from the provider's living quarters, which is licensed to provide care for children for any part of the 24-hour day. A child care center may be reimbursed from the state for services to their employee's children (other than the owner's), if the employee meets all other need and eligibility criteria.
Child Care Facility - A child care center, family child care home, or group child care home, whether known or incorporated under another title or name.
Group Child Care Home - A facility other than the provider's permanent residence, or separate from the provider's living quarters, which is licensed to provide care for 11 to 20 children, not related to the child care provider, for any part of the 24 hour day. This type of facility must be staffed by at least two (2) caregivers.
Child Care Provider and Other Child Care Personnel Requirements - The provider shall be l8 years of age or older, shall have knowledge of the needs of children, shall be capable of handling emergency situations promptly and intelligently, shall have a medical examination report on file, and shall be willing to cooperate with the person responsible for placing the child in the home, as well as with the licensing authority.
- If there is one (1) adult provider, the home may be licensed for up to six (6) children including a maximum of three (3) children under the age of two (2) years, or for up to ten (10) children including a maximum of two (2) children under the age of two (2) years.
- If the provider has an assistant, the home may be licensed for up to ten (10) children, including a maximum of four (4) children under the age of two (2) years, or for up to eight (8) children who are all under the age of two (2) years.
Child Care Unit - One unit of child care consists of one calendar day that the child spends in care paid to one provider. This could be a full-day, half-day or part-day depending on the need of the client.
Family Child Care Home - A family home, occupied as a permanent residence by the child care provider, which is licensed to provide family-like care to no more than ten (10) unrelated children, for any part of the twenty-four (24)-hour day.
Full-Child Care - During the course of one calendar day, any combination of hours of care equaling five (5) or more hours.
Full Time Child Care - Recipient determined eligible to receive child care service (either full, half, or part day) five (5) days per week.
Half-Child Care - During the course of one calendar day, any combination of hours of care equaling at least three (3) but less than five (5) hours, and including either a meal or a snack.
Holidays - Any of the standard legal holidays or any "local holidays" which are substituted in lieu of any legal holidays. In no event, however, will the Children’s Division (CD) reimburse Child Care Providers for more than eleven (11) holidays in any given fiscal year. See above table for legal holidays.
Income Eligible (IE) Child Care - Child care services for applicants determined eligible due to low family unit income and who are employed, in school, in training for employment, receive evaluation for trainability/employability, or need child care services due to the incapacity of the parent, specified relative or guardian. Administration of this program is through the Family Support Division.
Income Maintenance (IM) Child Care - Child care services for recipients of AFDC who are employed, in school, in training for employment, receive evaluation for trainability/employability, or need child care services due to the incapacity of the parent, specified relative or guardian. Administration of this program is through the Family Support Division.
Part-Child Care - During the course of one calendar day, any combination of hours of care equaling at least one and one-half (1 1/2) but less than three (3) hours of care (a snack may be provided but is not required).
Part Time Child Care - Recipient determined eligible to receive child care service (either full, half or part day) for less than five (5) days per week.
Protective Services (PS) Child Care- Children receiving services for treatment of child abuse and neglect. Services are based upon the child's need for child care as a part of the treatment plan developed with the child's family.
Waiting List - A county list of clients who are determined eligible for child care, during a period when child care funds or providers are not available. Names are added as clients are determined eligible for child care on a first come, first serve basis. Names are removed from the list as child care funding and slots become available or the client does not continue to need child care.