5101:2-16-35 County agency responsibilities for determining eligibility for publicly funded child care benefits.

 

 

 

5101:2-16-35               Eligibility determination.

 

 

 

(A)   The caretaker shall apply for child care benefits by completing the JFS 01138 "Child Care Application" and shall submit the application to the eligibility determiner in the county in which they reside.

 

(B)   At the time of initial determination and redetermination of eligibility, the eligibility determiner shall provide the caretaker with the following information:

 

(1)   State hearing rights and procedures pursuant to applicable rules in division level designation 5101:6 of the Administrative Code;

 

(2)    Utilization of child care services is a condition of eligibility for continued enrollment and the specific time limitation on utilization of child care services in accordance with paragraph (I)(5) (J)(5) of this rule.

 

(3)   The caretaker shall complete and provide a copy of the child's health record to the child care provider by the first day of the child's attendance.

 

(4)   A copy of the rights and responsibilities section of the JFS 01138 "Child Care Application", or a CDJFS equivalent, that is signed and dated by the caretaker.

 

(C)   The initial determination of the family's eligibility for child care benefits shall begin at the time the caretaker submits a completed application within thirty days from the date the eligibility determiner receives a completed application, the caretaker shall sign the application and submit supporting documentation. Failure of the caretaker to complete the eligibility determination process within the thirty day period shall result in the denial of the application. When providing notice of approval for child care benefits the eligibility determiner shall use the JFS 04074 "Notice of Approval of Your Application for Assistance". When providing notice of denial for child care benefits the eligibility determiner shall use the JFS 07334 "Notice of Denial of Your Application for Assistance".

 

(D)   The initial eligibility determination for each application shall be completed no later than thirty days from the date the eligibility determiner receives a completed application. The family's eligibility period shall be valid for twelve months, unless the family's eligibility is denied or terminated pursuant to paragraph (I) (J) of this rule.

 

(E)    Concurrent with the initial eligibility determination, the CDJFS shall pay for child care services provided between the date the eligibility determiner receives  the initial completed application and the date the family is subsequently determined to

 

 

 

be eligible after submission of supporting documentation. If the family is subsequently determined to be ineligible, the family shall be responsible for the cost of services rendered by the provider.

(F) The caretaker may apply for medicaid benefits at the time of application for child care benefits by completing the JFS 01137 "Child Care/Healthy Start and Healthy Families Supplement". The CDJFS may make this form available with the JFS 01138 "Child Care Application".

(1) Upon receipt of the JFS 01137 "Child Care/Healthy Start and Healthy Families Supplement", the eligibility determiner shall copy the entire JFS 01138 "Child Care Application" and supporting documentation and forward it and the JFS 01137 to the appropriate unit within the CDJFS for processing medicaid applications.

(2) The medicaid eligibility unit shall consider the JFS 01138 and JFS 01137 together as a complete application for the purpose of determining medicaid eligibility.

(F)(G) Every twelve months the family's child care eligibility shall be redetermined, and the family shall submit a newly signed and completed application and supporting documentation by the end of the twelfth month. Failure of the caretaker to complete the redetermination process by the end of the twelfth month shall result in the termination of child care benefits. When the eligibility determiner proposes to reduce or terminate chid child care benefits at the time of redetermination, the family shall be provided prior written notice of the action. The eligibility determiner shall use the JFS 04065 "Prior Notice of Right to a State Hearing", and the notice shall be mailed or personally delivered no less than fifteen calendar days prior to the proposed action. The eligibility determiner shall notify the family in writing of the need to have their eligibility redetermined no later than the first day of the twelfth month of the family's current eligibility period.

(G)(H) The eligibility determiner is not required to conduct a face-to-face interview with the caretaker if the required information for determining the family's eligibility for child care benefits is already on file with the CDJFS and/or the required information can be obtained through another method.

(H)(I) When conducting eligibility determinations, the CDJFS shall follow procedures established by ODJFS making alternative means available to families through telephone, fax, computer, and other means at locations other than the CDJFS that are convenient and accessible for families. These procedures shall include, but are not limited to, the following:

(1)    The CDJFS may contract with child care providers or resource and referral

organizations to make all or any part of the eligibility determinations.

(2)    The CDJFS may contract with child care providers or resource and referral organizations to collect information for use by the CDJFS in determining eligibility for child care benefits.

(3)      The CDJFS or other eligibility determiner shall make application forms available at appropriate locations and shall make arrangements that enable applicants to complete the application process at times outside their normal working hours and at locations convenient and accessible to the applicant. Arrangements may include:

(a)     Stationing agency personnel at various sites in the county to assist applicants in completing the application process and to make eligibility determinations at those locations;

(b)    Assigning agency personnel to hours of employment outside the normal working hours of the agency to collect information relevant to application for child care and to make eligibility determinations;

(c)    Providing training and technical assistance to appropriate individuals to qualify them in providing assistance in completing the application process and making eligibility determinations.

(4)    The eligibility determiner may complete or receive the child care application with information provided over the telephone, fax, the ODJFS child care web site at http://www.state.oh.us/odjfs/cdc, or via computer. Failure of the caretaker to provide an original signature on the application and submit supporting documentation shall result in the denial or termination of child care benefits.

(I)(J) The eligibility determiner shall deny or terminate a family's eligibility for child care benefits, unless exempted in paragraph (K) (L) of this rule and after provision of appropriate hearing notice as required by applicable rules in division-level designation 5101:6 of the Administrative Code, when any of the following occurs:

(1)   The family does not meet current eligibility requirements;

(2)    The family does not cooperate in determining eligibility, in accordance with paragraph (G) (F) of rule 5101:2-16-71 of the Administrative Code;

(3)   Repayment in full of a child care overpayment is owed to the CDJFS as a result

of child care fraud, in accordance with paragraph (E)(1) of rule 5101:2-16-73 of the Administrative Code;

(4)   The family does not enter into or comply with an agreement with the CDJFS to repay a child care overpayment caused by recipient error or agency error, in accordance with paragraph (E)(2) of rule 5101:2-16-73 of the Administrative Code;

(5)    The family does not use child care services for a period of time of thirty-one consecutive days, unless exempted pursuant to paragraph (K) (L) of this rule;

(6)      The family does not pay the required monthly child care copayment in accordance with paragraph (A) of rule 5101:2-16-39 of the Administrative Code, unless the family makes arrangements to pay delinquent copayments;

(7)    The family's monthly child care copayment exceeds the cost of care for more than thirty-one consecutive days;

(8)   The family relocates to another county in accordance with paragraph (M) (N) of this rule.

(J)(K) Ineligibility for child care benefits shall continue as long as:

(1)   Delinquent copayments are owed to the child care provider, unless satisfactory arrangements are made to pay delinquent copayments; or

(2)   Repayment in full of a child care overpayment is owed to the CDJFS as a result of recipient fraud or the family fails to make or comply with satisfactory arrangements to repay a child care overpayment cause by recipient error or agency error.

(K)(L) The eligibility determiner shall not terminate child care benefits if families meet one of the following criteria:

(1)    Families who have not utilized child care benefits due to a gap, not to exceed one quarter or semester, in the caretaker's participation in an education or training activity which prepares the caretaker for paid employment;

(2)   Families who have not utilized child care benefits due to an inability to arrange placement with an eligible provider of the caretaker's choice;

(3)   Families who have not utilized child care benefits due to a gap in the caretaker's participation in employment or training due to documented medical reasons;

(4)     Families who have not utilized child care benefits due to visitation with a non-residential caretaker;

(5)   Families who have not utilized child care benefits due to a gap in employment resulting from a layoff;

(6)    Families with a Head Start eligible child who is enrolled in a head start/child care partnership program pursuant to paragraph (L) of rule 5101:2-16-30 of the Administrative Code. Only the child in the Head Start/child care partnership program remains eligible for child care benefits.

(L)(M) The eligibility determiner shall assist migrant families in obtaining appropriate eligibility documentation in order to expedite the migrant familys' determination of eligibility for child care benefits.

(M)(N) A family's relocation to another county shall result in the following:

(1)   When a family has relocated to another Ohio county, the eligibility determiner in the previous county of residence shall terminate the family's child care eligibility after provision of appropriate hearing notice pursuant to applicable rules in division level designation 5101:6 of the Administrative Code. Upon the request of the eligibility determiner in the new county of residence, the eligibility determiner in the previous county of residence shall forward requested information from the case record.

(2)    Upon relocation, the family shall be required to submit an application to the eligibility determiner in the new county of residence for redetermination of continued eligibility as established by administrative order pursuant to section

5104.39 of the Revised Code.

(3)    If the family fails to apply in the new county of residence within thirty-one consecutive days from the effective termination date of the hearing notice, the family shall be required to meet initial eligibility as established by administrative order pursuant to section 5104.39 of the Revised Code at the time of application, unless exempted in paragraph (K) (L) of this rule which was in effect at the time of transfer. The family is not eligible for child care benefits from the date of termination provided in the hearing notice until the date of application in the new county of residence.

(N)(O) Notice and hearing requirements contained in division-level designation 5101:6 of the Administrative Code shall apply to the provision of child care benefits. The eligibility determiner shall issue notice of a change in child care benefits to the family within ten days from the date the change of circumstance was reported by the caretaker.

(O) The eligibility determiner shall issue notice of a change in child care benefits to the family within ten days from the date the change of circumstance was reported by the caretaker.

(P)   A caretaker shall not be paid by the CDJFS for the provision of child care services for a child who resides in the household, and who they are responsible for as the caretaker.

(Q)   The eligibility determiner shall not authorize child care services for an eligible family when a caretaker is available in the home and can provide appropriate care of the child, except when the family provides written verification to the eligibility determiner from a licensed physician, licensed psychologist or psychiatrist or public children services agency (PCSA) that the caretaker cannot provide appropriate care of the child. This exception shall only apply to a family with more than one caretaker.

(R)   A caretaker receiving child care benefits shall be required to report to the eligibility determiner any changes which would affect the family's eligibility for child care benefits, including family income, employment, participation in a program of education or training, household composition, or relocation to another county. Such changes shall be reported by the caretaker within ten days of the date the change occurred. Failure of the caretaker to comply with the ten day reporting requirement may result in action by the CDJFS to pursue a determination of child care fraud, pursuant to paragraph (D)(2) of rule 5101:2-16-71 of the Administrative Code, and the recovery of child care overpayments, pursuant to rule 5101:2-16-73 of the Administrative Code.

Effective:                                04/01/2003 R.C. 119.032 review dates:                           11/30/2006

CERTIFIED ELECTRONICALLY

Certification

03/18/2003

Date

Promulgated Under:   119.03

Statutory Authority:   5104.38, 5104.34

Rule Amplifies:           5104.30, 5104.32, 5104.34,

5104.38, 5104.381

Prior Effective Dates: 7/29/91, 11/1/91 (Emer.),

1/20/92, 1/1/94, 1/2/96,

(Emer.), 3/1/96, 10/1/97 (Emer.), 12/30/97, 1/1/99, 2/14/02