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Chapter 19 Child Care and Development Programs Subchapter 2.5 Utilization of the Regional Market Rate Ceiling Article 1 General Provisions Establishment of Reimbursement Rate   

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This section applies to providers as described in Sections 18074.2 (a)(1), (a)(2), and (a)(3) and shall become effective on July 1, 2004.

(a) Providers of child care and development services to subsidized families shall provide documentation to the contractor of all the rates they charge unsubsidized families. Providers who are unable or unwilling to meet the requirements of this section shall be subject to the requirements of Section 18074.4 or Section 18074.5, as applicable.

(b) Upon seeking to establish a rate, providers shall provide documentation as required by this section.

(1) The provider shall supply documentation for each rate paid by unsubsidized families. If providers have more than one rate for unsubsidized families, providers shall identify to the contractor each rate used by unsubsidized families, and the most commonly used rate by age group and time basis.

(2) Documentation for each rate paid by unsubsidized families shall be provided for:

(A) At least three consecutive months during the preceding 12 months.

(B) The period of time that the provider has been operating, only if the provider has been operating for less than three consecutive months during the preceding 12 months.

(3) If the provider has a valid license pursuant to Title 22 California Code of Regulations, Section 101151 et seq., the contractor shall assume that the provider has been continuously operating since the date the license was issued, unless evidence is provided that demonstrates that the provider operated for a shorter period.

(c) The documentation required by subsection (b) shall be included in the written policies adopted by the contractor.

(d) Documentation shall consist of any of the following:

(1) Written agreements signed by both the provider and a parent of unsubsidized children, including the hours of care, age of child, and payment amount.

(2) Declarations, signed under penalty of perjury by the parent(s) of unsubsidized children, indicating the hours of care, age of child, and payment amount.

(3) Copies of payment ledgers maintained by the provider that include the payment period.

(4) Documents retained for tax purposes by the provider showing the payment amount and the period covered by such payment.

(5) Any other documentation specified in the written policies of the contractor that is reasonably related to verification of the rate paid by unsubsidized families.

(e) Declarations, attestations, or affirmations by the provider are not sufficient documentation for the purpose of establishing a rate.

(f) The contractor may verify the documentation supplied by the provider. The verification process may be done by comparing the rate in the documentation to the rate in the database maintained by the local resource and referral agency, by telephone contact with the provider, by visiting the facility operated by the provider, or by other means as established in the written policies of the contractor. Contractors may request documentation of the rate paid by more than one unsubsidized family, if such documentation is reasonably related to verifying the rate or rates paid by unsubsidized families. Contractors shall retain a record of verification efforts and the results of those efforts.

(g) The documentation shall be treated as confidential information and maintained by the contractor in a secure location. Only authorized employees of the contractor, and authorized employees of the Department and the California Department of Social Services will have access to the documentation.

(h) In each county, all agencies operating pursuant to Article 15.5, commencing with Section 8350, of Chapter 2 of Part 6 of Division 1 of the Education Code shall develop a single policy regarding the documentation required in subsections (b) through (f) above and the transfer of documentation between agencies to facilitate provider reimbursement. Transfer of a family between agencies or stages of CalWORKs child care in the same county shall not be delayed or refused due to differences in policy regarding rate documentation.

(i) When none of the provider's established rates correspond to the certified need of the family, the contractor shall establish a derived rate as follows:

(1) Identify the rate category that corresponds to the provider's most commonly used established rate.

(2) Divide the provider's most commonly used established rate by the regional market rate ceiling for the same category. This will yield a percentage.

(3) Apply the resulting percentage to the regional market rate ceiling for the rate category to be used for reimbursement. This shall be considered the derived rate for that category.

(j) Reimbursement shall be the lesser of the amount the provider would charge unsubsidized families for the same hours of child care or the derived rate determined by subsection (i) above.

(k) If the family's need for care can be met by more than one rate category as defined in Section 18075, the contractor shall determine the derived rate in the category that will yield the lowest reimbursement.

Authority cited:

Education Code 8265

Education Code 8269

Reference:

Education Code 8222

Education Code 8265

Education Code 8266.5

Education Code 8269

Education Code 8357

(Amended by Register 2004, No. 24)