5101:2-16-07 County agency responsibilities for the administration of publicly funded child care.

Rule Summary and Fiscal Analysis (Part A)

Department of Job and Family Services

Agency Name

Division of Social Services Michael Lynch

Division Contact

OFC- 4200 E. 5th Ave., 2nd fl. J6-02 P.O. Box 183204 Columbus OH 43218-3204

614-466-4605 614-752-8298

Agency Mailing Address (Plus Zip) Phone Fax

Michael.Lynch@jfs.ohio.gov

5101:2-16-07

Rule Number

AMENDMENT

TYPE of rule filing

Rule Title/Tag Line County department of job and family services (CDJFS)

responsibilities for the administration of publicly funded child care.

RULE SUMMARY

1. Is the rule being filed consistent with the requirements of the RC 119.032 review? No

2. Are you proposing this rule as a result of recent legislation? Yes

Bill Number: HB483 General Assembly: 130 Sponsor: Amstutz

3. Statute prescribing the procedure in accordance with the agency is required to adopt the rule: 119.03

4. Statute(s) authorizing agency to adopt the rule: 5104.30, 5104.34, 5104.38

5. Statute(s) the rule, as filed, amplifies or implements: 5104.01, 5104.30, 5104.34, 5104.38

6. State the reason(s) for proposing (i.e., why are you filing,) this rule:

This rule is proposed for amendment to implement section 5104.34 of the Ohio Revised Code, as created by Amended Substitute House Bill 483 of the 130th

General Assembly.

7. If the rule is an AMENDMENT, then summarize the changes and the content of the proposed rule; If the rule type is RESCISSION, NEW or NO CHANGE, then summarize the content of the rule:

This rule is being amended to add a requirement that the county agency send a verification checklist to notify an applicant for publicly funded child of what is needed to complete the eligibility determination.

8. If the rule incorporates a text or other material by reference and the agency claims the incorporation by reference is exempt from compliance with sections

121.71 to 121.74 of the Revised Code because the text or other material is generally available to persons who reasonably can be expected to be affected by the rule, provide an explanation of how the text or other material is generally available to those persons:

This rule incorporates one or more dated references to the U.S. Code. This question is not applicable to any dated incorporation by reference to the U.S. Code because such reference is exempt from compliance with RC 121.71 to 121.74 in accordance with RC 121.75(A).

This rule incorporates one or more dated references to a federal act or acts. This question is not applicable to any dated incorporation by reference to a federal act because such reference is exempt from compliance with RC 121.71 to 121.74 in accordance with RC 121.75(C).

This rule incorporates one or more references to the Ohio Revised Code. This question is not applicable to any incorporation by reference to the Ohio Revised Code because such reference is exempt from compliance with RC 121.71 to 121.74 pursuant to RC 121.76(A)(1).

This rule incorporates one or more references to another rule or rules of the Ohio Administrative Code. This question is not applicable to any incorporation by reference to another OAC rule because such reference is exempt from compliance with RC 121.71 to 121.74 pursuant to RC 121.76(A)(3).

This rule incorporates one or more dated references to an ODJFS form or forms. Each cited ODJFS form is dated and is generally available to persons affected by this rule via the inner-web at http://innerapp.odjfs.state.oh.us/forms/inner.asp or on the inter-net at http://www.odjfs.state.oh.us/forms/inter.asp in accordance with RC 121.75(E).

9. If the rule incorporates a text or other material by reference, and it was

infeasible for the agency to file the text or other material electronically, provide an explanation of why filing the text or other material electronically was infeasible:

Not Applicable.

10. If the rule is being rescinded and incorporates a text or other material by reference, and it was infeasible for the agency to file the text or other material, provide an explanation of why filing the text or other material was infeasible:

Not Applicable.

11. If revising or refiling this rule, identify changes made from the previously filed version of this rule; if none, please state so. If applicable, indicate each specific paragraph of the rule that has been modified:

The following changes have been made for revise filing:

1) Paragraph (H)(2): the word "calendar" has been added to clarify when a checklist must be issued by the county agency.

2) Paragraphs (J) (5) and (6) have been promoted to a new paragraph (K) and timeframes for processing an approved payment has been defined.

3) Updated the JFS 01211 to add a signature and date area for county agency staff.

4) Updated the JFS 01292 to clarify the reasons for request for a payment adjustment.

12. 119.032 Rule Review Date: 5/1/2019

(If the rule is not exempt and you answered NO to question No. 1, provide the scheduled review date. If you answered YES to No. 1, the review date for this rule is the filing date.)

NOTE: If the rule is not exempt at the time of final filing, two dates are required: the current review date plus a date not to exceed 5 years from the effective date for Amended rules or a date not to exceed 5 years from the review date for No Change rules.

FISCAL ANALYSIS

13. Estimate the total amount by which this proposed rule would increase/ decrease either revenues /expenditures for the agency during the current biennium (in dollars): Explain the net impact of the proposed changes to the

budget of your agency/department.

This will increase expenditures.

$16,000,000

The implementation of Am. Sub. HB 483 will increase expenditures since the department will now be paying for care provided during the eligiblity determination period at approximately $4 million per year, as well as for continued care after the caretaker no longer has a qualifying activity for approximately $12 million per year. Currently care would not be paid in either circumstance.

14. Identify the appropriation (by line item etc.) that authorizes each expenditure necessitated by the proposed rule:

600-535

15. Provide a summary of the estimated cost of compliance with the rule to all directly affected persons. When appropriate, please include the source for your information/estimated costs, e.g. industry, CFR, internal/agency:

There are no anticipated new costs of compliance as a result of this amended rule.

16. Does this rule have a fiscal effect on school districts, counties, townships, or municipal corporations? No

17. Does this rule deal with environmental protection or contain a component dealing with environmental protection as defined in R. C. 121.39? No

S.B. 2 (129th General Assembly) Questions

18. Has this rule been filed with the Common Sense Initiative Office pursuant to R.C. 121.82?

19. Specific to this rule, answer the following:

A.) Does this rule require a license, permit, or any other prior authorization to engage in or operate a line of business? No

B.) Does this rule impose a criminal penalty, a civil penalty, or another sanction, or create a cause of action, for failure to comply with its terms? No

C.) Does this rule require specific expenditures or the report of information as a condition of compliance? No

ACTION: Revised DATE: 07/30/2014 3:15 PM

Ohio Department of Job and Family Services

PUBLICLY FUNDED CHILD CARE REQUEST FOR OHIO ECC PAYMENT ADJUSTMENT

COUNTY REQUEST PROVIDER REQUEST

County Department of Job and Family Services: send this form to child_care_adjustment@jfs.ohio.gov . Providers: send this form to the County Department of Job and Family Services.

SECTION I. PROVIDER AND CASE INFORMATION
Provider Name			Provider ID Number						Authorization Number
Caretaker First Name			Caretaker Last Name						Case Number (10 digits)
Child First Name		Child Last Name						Child ID Number (12 digits)
Service Week/Period (MM/DD/YYYY - MM/DD/YYYY) -					Settlement Date (MM/DD/YYYY)
SECTION II. REASON FOR REQUEST (only submit request if payment is being changed. You must use one form for each week.)
Reason for the request (check one) Swipe error (No new attendance) Authorization change Caretaker withdrew without notice (attendance record required) Manual Claim Error (County request only)
Describe the reason for this request
SECTION III. ATTENDANCE DURING SERVICE WEEK/PERIOD
Attendance (enter in and out time, including hours and minutes with AM or PM indicator) Enter Sunday Begin Date: (MM/DD/YYYY) for the service/week period of attendance you are submitting
Day of Week	Time in (HH:MM) check AM/PM			Time out (HH:MM) check AM/PM		Time in (HH:MM) check AM/PM				Time out (HH:MM) check AM/PM
Sunday	AM PM			AM PM		AM PM				AM PM
Monday	AM PM			AM PM		AM PM				AM PM
Tuesday	AM PM			AM PM		AM PM				AM PM
Wednesday	AM PM			AM PM		AM PM				AM PM
Thursday	AM PM			AM PM		AM PM				AM PM
Friday	AM PM			AM PM		AM PM				AM PM
Saturday	AM PM			AM PM		AM PM				AM PM
SECTION IV. SIGNATURES (By signing below, I agree that my child was in care at this provider during the dates and times entered above)
Caretaker Signature							Date Caretaker Signs (MM/DD/YYYY)
Caretaker Name (please print)							Phone Number of Caretaker
(By signing below, I agree that I provided care to this child at this provider during the dates and times entered above)
Provider/Designee Signature							Date Provider/Designee Signs (MM/DD/YYYY)
Provider/Designee Name (please print)							Phone Number of Provider/Designee
The total payment amount is subject to payment rules and procedures required by the Ohio Department of Job and Family Services. The provider must submit this completed form to the County Department of Job and Family Services to request a payment adjustment. This form must be received or post marked no later than 7 weeks from the last day of the week of service being submitted unless otherwise determined by the ODJFS Bureau of State Hearings.

JFS 01292 (Rev. 9/2014) Page 1 of 2

SECTION V. REVISED PAYMENT INFORMATION
Age Category of Child (check one)		infant toddler preschool school age summer school age
Customary Rate (from CP)		$
Appendix Rate (appendix to Rule 5101:2-16-41)		$
Child Special Needs (from EA)		$
Child Special Needs Waiver (from EA)		$
Non-traditional Care		$
Accreditation or Star Rating (from CP) NAEYC NAFCC NECPA COA NAC ACSI SUTQ Star Rated SUTQ 2 Star Rated SUTQ 3 Star Rated SUTQ 4 Star Rated SUTQ 5 Star Rated		$
Copayment Amount (from EA)		$
Original Payment Amount for Week $	Revised Payment Amount for Week $	Adjustment Amount $ Check one overpayment
				underpayment
SECTION VI. IN HOME AIDE (only complete if in home aide)
Customary Rate $	Weekly Cost of Care $		Copayment Amount $					Number of Children
Original Payment Amount for Week $	Revised Payment Amount for Week $		Adjustment Amount $ check one overpayment
					underpayment
SECTION VII. COUNTY CONTACT
County							County Worker Phone Number
County Worker First Name						County Worker Last Name
SECTION VIII. FOR COUNTY USE ONLY
Check here if Adjustment is denied and list reason. Keep in County files.

JFS 01292 (Rev. 9/2014) Page 2 of 2

PUBLICLY FUNDED CHILD CARE MANUAL CLAIM FOR ATTENDANCE

SECTION I. PROVIDER TO COMPLETE THIS SECTION (please print)
Provider Name (as printed on Certificate or License)				Provider ID Number			Authorization Number
Caretaker First Name		Caretaker Last Name					Case Number (10 digits)
Child First Name		Child Last Name					Child ID Number (12 digits)
SECTION II. REASON FOR MANUAL CLAIM (check only one reason below for which services could not be completed within the back swipe period)
Authorization prior to back swipe period (MCPB) Caretaker awaiting swipe card (MCAC) State Hearing decision (MCSH) Caretaker withdrew without notice during back swipe period POS device not installed (MCND) (MCCW)
SECTION III. ADDITIONAL INFORMATION (include details regarding claim below)

SECTION IV. ABSENT DAY
Enter Sunday Begin Date: (MM/DD/YYYY) for the week of attendance you are submitting indicate day(s) of the week the Absent Day(s) requested and the date in the format of MM/DD/YYYY Sun. Mon. Tues. Wed. Thurs. Fri. Sat.
SECTION V. CARETAKER OR PROVIDER TO COMPLETE THIS SECTION (please print)
Attendance (enter in and out time including hours and minutes with AM or PM indicator) Enter Sunday Begin Date: (MM/DD/YYYY) for the service week/period of attendance you are submitting
Day of Week	Time in (HH:MM) check AM/PM		Time out (HH:MM) check AM/PM		Time in (HH:MM) check AM/PM			Time out (HH:MM) check AM/PM
Sunday	AM PM		AM PM		AM PM			AM PM
Monday	AM PM		AM PM		AM PM			AM PM
Tuesday	AM PM		AM PM		AM PM			AM PM
Wednesday	AM PM		AM PM		AM PM			AM PM
Thursday	AM PM		AM PM		AM PM			AM PM
Friday	AM PM		AM PM		AM PM			AM PM
Saturday	AM PM		AM PM		AM PM			AM PM
SECTION VI. SIGNATURES (by signing below, I agree that my child was in care at this provider during the dates and times entered above)
Caretaker Signature (not needed if caretaker withdraws without notice)						Date Caretaker Signs (MM/DD/YYYY)
Caretaker Name (please print)						Phone Number of Caretaker
(By signing below, I agree that I provided care to this child at this provider during the dates and times entered above)
Provider/Designee Signature						Date Provider/Designee Signs (MM/DD/YYYY)
Provider/Designee Name (please print)						Phone Number of Provider/Designee
The total payment amount is subject to payment rules and procedures required by the Ohio Department of Job and Family Services. The provider must submit this completed form to the County Department of Job and Family Services to request payment for a manual claim. This form must be received or post marked *no later than 7 weeks from the week of service being submitted* unless otherwise determined by the Bureau of State Hearings.
SECTION VII. FOR COUNTY USE ONLY
Check here if Manual Claim is denied and list reason below

JFS 01261 (rev.9/2014)

REQUEST FOR PAYMENT OF PUBLICLY FUNDED CHILD CARE SERVICES

PROVIDED FOR A DENIAL OF APPLICATION

SECTION I. PROVIDER TO COMPLETE THIS SECTION (please print)
Provider Name			Provider ID Number		Date of Application		Date of Denial
Caretaker First Name		Caretaker Last Name				Case Number (10 digits)
Child First Name		Child Last Name				Child ID Number (12 digits)
Pursuant to rule 5101:2-16-35 of the Administrative Code, a child may be authorized for child care for the period of time between the date the county agency receives the completed application and the date of denial plus five days, not to exceed a full-time authorization. Please complete the attendance information below and submit to the county agency within seven weeks from the date of denial of the caretaker's application for payment consideration.
SECTION II. CARETAKER OR PROVIDER TO COMPLETE THIS SECTION (please print) Attendance (enter in and out time including hours and minutes with AM or PM indicator) *Attach Attendance Records for verification
Enter Sunday Begin Date: (MM/DD/YYYY) for the service week/period of attendance you are submitting
Day of Week	Time in (HH:MM) check AM/PM		Time out (HH:MM) check AM/PM	Time in (HH:MM) check AM/PM				Time out (HH:MM) check AM/PM
Sunday	AM PM		AM PM	AM PM				AM PM
Monday	AM PM		AM PM	AM PM				AM PM
Tuesday	AM PM		AM PM	AM PM				AM PM
Wednesday	AM PM		AM PM	AM PM				AM PM
Thursday	AM PM		AM PM	AM PM				AM PM
Friday	AM PM		AM PM	AM PM				AM PM
Saturday	AM PM		AM PM	AM PM				AM PM

Enter Sunday Begin Date: (MM/DD/YYYY) for the service week/period of attendance you are submitting
Day of Week	Time in (HH:MM) check AM/PM		Time out (HH:MM) check AM/PM	Time in (HH:MM) check AM/PM				Time out (HH:MM) check AM/PM
Sunday	AM PM		AM PM	AM PM				AM PM
Monday	AM PM		AM PM	AM PM				AM PM
Tuesday	AM PM		AM PM	AM PM				AM PM
Wednesday	AM PM		AM PM	AM PM				AM PM
Thursday	AM PM		AM PM	AM PM				AM PM
Friday	AM PM		AM PM	AM PM				AM PM
Saturday	AM PM		AM PM	AM PM				AM PM

Enter Sunday Begin Date: (MM/DD/YYYY) for the service week/period of attendance you are submitting
Day of Week	Time in (HH:MM) check AM/PM		Time out (HH:MM) check AM/PM	Time in (HH:MM) check AM/PM				Time out (HH:MM) check AM/PM
Sunday	AM PM		AM PM	AM PM				AM PM
Monday	AM PM		AM PM	AM PM				AM PM
Tuesday	AM PM		AM PM	AM PM				AM PM
Wednesday	AM PM		AM PM	AM PM				AM PM
Thursday	AM PM		AM PM	AM PM				AM PM
Friday	AM PM		AM PM	AM PM				AM PM
Saturday	AM PM		AM PM	AM PM				AM PM

JFS 01211 (9/2014) Page 1 of 2

Enter Sunday Begin Date: (MM/DD/YYYY) for the service week/period of attendance you are submitting
Day of Week	Time in (HH:MM) check AM/PM	Time out (HH:MM) check AM/PM		Time in (HH:MM) check AM/PM		Time out (HH:MM) check AM/PM
Sunday	AM PM	AM PM		AM PM		AM PM
Monday	AM PM	AM PM		AM PM		AM PM
Tuesday	AM PM	AM PM		AM PM		AM PM
Wednesday	AM PM	AM PM		AM PM		AM PM
Thursday	AM PM	AM PM		AM PM		AM PM
Friday	AM PM	AM PM		AM PM		AM PM
Saturday	AM PM	AM PM		AM PM		AM PM

Enter Sunday Begin Date: (MM/DD/YYYY) for the service week/period of attendance you are submitting
Day of Week	Time in (HH:MM) check AM/PM	Time out (HH:MM) check AM/PM		Time in (HH:MM) check AM/PM		Time out (HH:MM) check AM/PM
Sunday	AM PM	AM PM		AM PM		AM PM
Monday	AM PM	AM PM		AM PM		AM PM
Tuesday	AM PM	AM PM		AM PM		AM PM
Wednesday	AM PM	AM PM		AM PM		AM PM
Thursday	AM PM	AM PM		AM PM		AM PM
Friday	AM PM	AM PM		AM PM		AM PM
Saturday	AM PM	AM PM		AM PM		AM PM

Enter Sunday Begin Date: (MM/DD/YYYY) for the service week/period of attendance you are submitting
Day of Week	Time in (HH:MM) check AM/PM	Time out (HH:MM) check AM/PM		Time in (HH:MM) check AM/PM		Time out (HH:MM) check AM/PM
Sunday	AM PM	AM PM		AM PM		AM PM
Monday	AM PM	AM PM		AM PM		AM PM
Tuesday	AM PM	AM PM		AM PM		AM PM
Wednesday	AM PM	AM PM		AM PM		AM PM
Thursday	AM PM	AM PM		AM PM		AM PM
Friday	AM PM	AM PM		AM PM		AM PM
Saturday	AM PM	AM PM		AM PM		AM PM
SECTION III. SIGNATURES (by signing below, I agree that my child was in care at this provider during the dates and times entered above)
Caretaker Signature (not needed if caretaker withdraws without notice)					Date Caretaker Signs (MM/DD/YYYY)
Caretaker Name (please print)					Phone Number of Caretaker
(By signing below, I agree that I provided care to this child at this provider during the dates and times entered above)
Provider/Designee Signature					Date Provider/Designee Signs (MM/DD/YYYY)
Provider/Designee Name (please print)					Phone Number of Provider/Designee
The total payment amount is subject to payment rules and procedures required by the Ohio Department of Job and Family Services. The provider must submit this completed form to the County Department of Job and Family Services to request payment. This form must be received or post marked *no later than 7 weeks from the date of denial of the caretaker's application* unless otherwise determined by the Bureau of State Hearings.
SECTION IV. FOR COUNTY USE ONLY
Check here if Reimbursement Request is denied and list reason			County Agency Signature				Date

JFS 01211 (9/2014) Page 2 of 2

Visit the Official Version

Document Information

File Date:: 2014-07-30
CSI:: Yes
Rule File:: 5101$2-16-07_PH_RV_A_RU_20140730_1515.pdf
RSFA File:: 5101$2-16-07_PH_RV_A_RS_20140730_1515.pdf
Related Chapter/Rule NO.: (1): Ill. Adm. Code 5101:2-16-07. County agency responsibilities for the administration of publicly funded child care