941.01 Required Verification for a Child Experiencing a Disability or Significant Special Need (FAM)

SR 20-23 Dated 08/20

Previous Policy

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To be eligible for the differential payment for a child experiencing a disability or significant special need, it  must be verified on  Form 2690, Verification for a Child Experiencing A Disability or Significant Special Needs, for each child for whom additional funds are required to make accommodations or adaptations, including children age 13-17.

 

 Form 2690, Verification for a Child Experiencing A Disability or Significant Special Needs, is considered complete when the following items on the form are indicated:

 

Section I, the Child Care Provider has:

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Checked the certification box indicating the need for funds;

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Indicated the planned accommodation(s) or adaptation(s);

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Signed the form; and

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Dated the form.

 

Section II, the Licensed Professional has:

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Checked the appropriate certification box;

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Signed the form; and

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Dated the form.

 

Section III, the Parent/Guardian has:

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Signed the form; and

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Dated the form.

 

Authorize the differential payment for a child experiencing a disability or significant special need according to the date the licensed professional signed Form 2690, Verification for a Child Experiencing A Disability or Significant Special Needs.

 

The differential payment for a child experiencing a disability or significant special need becomes effective the Monday following the authorization date.

 

The DHHS authorized effective date for the disability or special need(s) is the date the  Form 2690 was received by DHHS, if received within 60 days of the form’s completion with the licensed professional’s signature. If DHHS does not receive the  Form 2690 within 60 days, the effective date becomes the date DHHS received the form and not the date the licensed professional signed the form.

 

To authorize the special need differential all sections of Form 2690, Verification for a Child Experiencing a Disability or Significant Special Needs, must be completed, signed and dated, including the length of duration of the disability/special need.  

If the need for funds to support the child continues following the initial verification, a new  Form 2690 must be provided at the end of the expected duration, annually, or when the child changes child care providers. However, if Form 2690 describes the child’s significant special need as permanent, no subsequent verification is needed.

 

References: He-C 6910.09(j), RSA 167:83,II(c) and (o), 45 CFR 98.20, 45 CFR 98.44