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Working Connections Child Care (WCCC) Manual  

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Payments

L.  PAYMENT REDUCTIONS AND TERMINATIONS

Revised:  August 15, 2005

In this section:

  1. Terminations and Denials

  2. Advance and Adequate Notice of Payment Changes

A. Terminations and Denials

Revised: December 2004

WAC 388-290-0110 What circumstances might affect my eligibility for WCCC benefits and when might I be eligible again?

  1. 1. We stop your eligibility for WCCC benefits when you do not:

    1. Pay copayment fees assessed by us and you do not make mutually acceptable arrangements with your child care provider to pay the copayment;

    2. Complete the requested reapplication before the deadline noted in WAC 388-290-0105 (2) (a);

    3. Meet other WCCC eligibility requirements; or

    4. d. Cooperate with the quality assurance review process or with the division of fraud investigations.

  2. You might be eligible for WCCC again when you meet all WCCC eligibility requirements, and:

    1. Back copayment fees are paid,

    2. You make mutually acceptable payment arrangements with your child care provider; or

    3. You cooperate with the quality assurance review process or with the division of fraud investigations.

WAC 388-290-0107 When do I receive a denial letter?

We send you a denial letter when you have applied for child care and you:

  1. Withdraw your request;

  2. Are not eligible due to your;

    1. Family composition;

    2. Income; or

    3. Activity.

  3. Did not provide information necessary to determine your eligibility according to WAC 388-290-0012.

WAC 388-290-0108 What happens if I meet eligibility requirements after I receive a denial letter?

If you turn in information or otherwise meet eligibility requirements after we send you a denial letter, we determine your benefit begin date by:

  1. WAC 388-290-0095 if you are TANF; or

  2. WAC 388-290-0100 if you are non-TANF.

B. Advance and Adequate notice of payment changes

Effective May 28, 2004

WAC 388-290-0115  When does the WCCC program provide me with advance and adequate notice of payment changes?

  1. The WCCC program provides you with advance and adequate notice for changes in payment when the change results in a suspension, reduction, termination, or forces a change in child care arrangements, except as noted in WAC 388-290-0120.

  2. "Advance and adequate notice," means a written notice of a WCCC reduction, suspension, or termination that is mailed at least ten days before the date of the intended action which includes the Washington Administrative Code (WAC) supporting the action, and your right to request a fair hearing.

clarifying information

  1. Payments made after the consumer's change in circumstances and during the advance notice period are considered overpayments if the consumer is not eligible. See Overpayments.

  2. Reductions in payments can include situations such as the copayment increasing, authorized care being reduced from full to part-time, or a child’s ineligibility. These situations can occur during an authorization period or at reapplication. Advance and adequate notice to the client of a reduction in benefits at reapplication is not necessary. However, a reduction in benefits during the eligibility period requires specific notification to the client. Those steps are outlined in the following worker responsibility section.

  3. The WAC 388-290-0115 for advance and adequate notice does not apply to child care providers.  However, every attempt should be made to notify the provider in advance of the termination or reduction of services.  The provider will receive advance notice at reapplication when the DSHS 14-430A Child Care End Date Reminder is sent automatically through WCAP.

    A Social Service Notice is sent to the payee (licensed provider or consumer for in-home/relative care) when service lines on the SSPS authorization are closed, terminated, or changed. The provider will again receive advance notice when changes are made immediately to the SSPS authorization.

worker responsibilities

  1. Terminate WCCC benefits when:

    1. The circumstances in WAC 388-290-0110 apply, or

    2. The consumer:

      1. Moves to another state, or;

      2. Requests termination.

  2. When terminating or reducing WCCC benefits:

    1. Notify the consumer at least ten days in advance per WAC 388-290-0120. Use the DSHS Form 15-247 WCCC Denial/ Termination Notice. Include the appropriate WAC reference for the termination if it is not already on the form.

    2. Inform the consumer about other child care subsidy programs.

    3. Give the child care provider advance notice whenever possible. Although it is not required, advanced notice fosters good working relationships with the provider.

    4. Using correct dates per policy, close/terminate/change the SSPS authorization lines of service the same day the client is notified of the action. This action will cause a Social Services Notice to be sent to the payee (licensed provider or consumer for in-home/relative care) and will alert the payee of  the termination or change in services.

    5. Document your actions in the WCCC case notes.

Example 1

On 6/8, a provider reports that her last day of service to a client was 5/31. The AW is unable to verify the client’s need for ongoing care. A termination notice is sent with an end date of 6/18 to allow for advance and adequate notice. Remind the provider they should bill zero for June since they reported care was last used 5/31.  Following is an example of how to write up the termination notice for this type of situation.

EXAMPLE 2

On 7/15 the worker discovers and verifies that a consumer last worked on 5/25. Applying the advance and adequate notice rule, a termination letter is sent to the consumer with an effective date of 7/25. The worker immediately retrieves the current authorization and terminates all the open lines of service with an effective date of 7/25. The worker calls the provider with courtesy notification of termination.

In this example, the July invoice has not been sent and payment could technically be stopped. However, retroactive termination of the child care is not correct procedure and should not be done.

Effective May 28, 2004

WAC 388-290-0120  When doesn't advance and adequate notice of payment changes apply to me?

We do not give you advance and adequate notice in the following circumstances:

  1. You tell us you no longer want WCCC;

  2. Your whereabouts are unknown to us;

  3. You are receiving duplicate child care benefits;

  4. Your current eligibility period is scheduled to end;

  5. Your new eligibility period results in a change in child care benefits;

  6. The location where child care occurs does not meet requirements under WAC 388-290-0130(2); or

  7. We determine your in-home/relative provider:

    1. Is not of suitable character and competence;

    2. May cause a risk of harm to your children based on the provider's physical or mental health; or

    3. Has been convicted of, or has charges pending for crimes posted on the DSHS secretary’s list of permanently disqualifying convictions for ESA. You can find the complete list at  http://www1.dshs.wa.gov/esa/dccel.

clarifying information

  1. Advance and adequate notice is not required when:

    1. The department has received a written or verbal statement from the consumer that they no longer want or need benefits.  Verbal notification should be well documented in the case notes.  Be sure to confirm with the provider when the consumer last used care.

    2. Department mail to the consumer has been returned by the Post Office indicating no known forwarding address;

    3. The consumer is receiving child care assistance in another catchment area or another state.

  2. When a case is up for reapplication, the consumer will receive the DSHS 14-430 Reapplication Letter which serves as a reminder that the child care authorization is scheduled to end on a specific date. There is no need to send a 10-day termination notice to the consumer, per WAC 388-290-0120 (4) above.

EXAMPLE

A consumer is authorized for care from 1/1-5/31. On 5/25, the AW discovers the client became ineligible for WCCC on 4/25. There are not enough days between 5/25 and 5/31(the scheduled eligibility end date) to give 10-day advance notice. The AW sends a termination notice with 5/31 as the termination date and does not extend the eligibility period to include the full 10-day advance notice period.

For a more complete description of advance and adequate notice, refer to EA-Z Manual (Letters, and Change of Circumstances).
 

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