SR 15-23 Dated 09/15

 

STATE OF NEW HAMPSHIRE

INTER-DEPARTMENT COMMUNICATION

 

FROM OFFICE OF THE DIRECTOR, DFA:

Terry R. Smith

FROM OFFICE OF THE DIRECTOR, DCYF:

Lorraine Bartlett

DFA SIGNATURE DATE:

8/26/15

DCYF SIGNATURE DATE:

8/25/15

AT (OFFICE):

Division of Family Assistance

Division for Children, Youth and Families

TO:

District Office Supervisors

NHEP Teams

Child Development Bureau Staff

SUBJECT:

Disability is now referred to as Significant Special Needs; Obsoletion of DCYF/DFA Form 2628, Verification for a Child with a Disability; New Form 2690, Verification for a Child Experiencing Significant Special Needs replaces Form 2628; Service level for individuals who have been continuously self-employed for less than two years is now based on the reported number of hours worked; No longer require verification of date and place of birth for members of the assistance group other than the children for whom the parent is requesting the NH Child Care Scholarship; and Children in a single parent household, whose parent is disabled, may receive the NH Child Care Scholarship, if the parent is participating in an approved activity.

EFFECTIVE DATE:

September 1, 2015

 

 

SUMMARY

 

This SR releases the following changes and clarifications to child care policy:

      A child with a disability is now referred to as a child experiencing a significant special need;

      The disability differential payment is now referred to as the differential payment for a child experiencing a significant special need;

      Form 2628, Verification for a Child with a Disability, has been revised, renumbered and renamed to Form 2690, Verification for a Child Experiencing Significant Special Needs;

      The child care provider must now certify on Form 2690, Verification for a Child Experiencing Significant Special Needs, the need for funds to provide accommodation or classroom adaptation in a child care setting for a child experiencing a significant special need, to receive the differential payment for that child;

      New Form 2690, Verification for a Child Experiencing Significant Special Needs, now requires the:

o     child care provider to certify, indicate an accommodation, sign and date the form,

o     the licensed professional to certify, sign and date the form,

o     the parent/guardian to sign and date the form;

      New Form 2690, Verification for a Child Experiencing Significant Special Needs, is required for all children who are experiencing a significant special need for whom funds are required for accommodation or classroom adaptation. This now includes children age 13 through 17, for whom a statement from the licensed professional was previously acceptable verification;

      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 DCYF Form 2690 describes the child's significant special need as permanent, no subsequent verification is needed.

 

      Self-employed individuals are now allowed to self-report, for the first two years of continuous self-employment, the number of hours worked each week in a self-employment activity to determine the service level;

      No longer require verification of date and place of birth for members of the assistance group other than the children for whom the parent is requesting the NH Child Care Scholarship; and

      Children in a single parent household, whose parent is disabled, may receive the NH Child Care Scholarship, if the parent is participating in an approved activity.

FORMER POLICY

NEW POLICY

A child for whom disability differential payments were made was referred to as a child with a disability.

The need for additional funds for the child care provider to make accommodations or classroom adaptations was not required to receive the disability differential payment.

A child with a disability is now referred to as a child experiencing a significant special need;

The disability differential payment is now referred to as the differential payment for a child experiencing a significant special need;

The child care provider must certify the need for funds to provide accommodation or classroom adaptation in a child care setting for a child experiencing a significant special need, to receive the differential payment for that child.

Form 2628, Verification for a Child with a Disability required only the signature of the child's attending physician, physician's assistant, advance practice registered nurse or licensed mental health professional and the date the form was signed.

 

 

 

 

Acceptable verification for a child with a disability age 13 through 17 was a signed and dated statement from the child's attending physician, physician's assistant, advance practice registered nurse or licensed mental health professional describing the child's condition and specifying the need for supervision.

Verification must be provided annually. However, if DCYF Form 2628 describes the child's disabling condition as permanent, no subsequent verification is needed.

New Form 2690, Verification for a Child Experiencing Significant Special Needs, now requires the:

  child care provider to certify, indicate an accommodation that requires additional funding, sign and date the form;

  the licensed professional to certify, sign and date the form;

  the parent/guardian to sign and date the form.

New Form 2690, Verification for a Child Experiencing Significant Special Needs, is now required for all children who are experiencing a significant special need, including children age 13 through 17.

 

 

 

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 DCYF Form 2690 describes the child's significant special need as permanent, no subsequent verification is needed.

The calculation used to determine the service level for self-employed individuals was applied regardless of the length of time the individual had been in the self-employment activity.

If the parent has no income or a negative monthly net income, hours for self-employment cannot be determined, and therefore, self-employment cannot be allowed as an activity.

Now, for the first two years of continuous self-employment, allow the individual to self-report the number of hours they are engaged in their self-employment activity each week. Use these hours in determining the service level.

The policy which required income to determine a service level does not apply for the first two years of continuous self-employment.

The date and place of birth of each member of the assistance group must be verified by one or more of the following documents:

. His/her birth certificate;

. His/her baptismal certificate; or

. His/her US passport.

The date and place of birth for each child in the assistance group for whom the parent is requesting the NH Child Care Scholarship must be verified by one or more of the following documents:

. His/her birth certificate;

. His/her baptismal certificate; or

. His/her US passport.

Children in a single parent household are not eligible for NH Child Care Scholarship if the single parent is disabled.

Children in a single parent household are not eligible for NH Child Care Scholarship if the single parent is disabled and not participating in an approved activity.

 

BACKGROUND

 

Several rules regarding employment-related child care have been changed in He-C 6910 to accomplish the following: increase accountability for the differential payment for a significant special need, allow parents to begin self-employment and receive an adequate number of hours of child care, eliminate an unnecessary reporting requirement regarding place and date of birth for some members of the household, and clarify a previous policy regarding eligibility of a single parent who is disabled.

 

POLICY

 

The term "disability", when referring to the child or the differential payment made, has been changed to "a significant special need" to use more current and sensitive language. Form 2628, Verification for a Child with a Disability has been redesigned, renamed and renumbered to Form 2690, Verification for a Child Experiencing Significant Special Needs. Child care providers are now required to certify on Form 2690, Verification for a Child Experiencing Significant Special Needs, the need for funds to provide an accommodation or classroom adaptation for a child with a significant special need in order to receive the differential payment. For a description of the new form, see "Description of Revisions Made to Forms" below.

 

When accepting Form 2690 to authorize the provider to receive the differential payment for a child experiencing a significant special need, the Family Service Specialist (FSS) or Employment Counselor Specialist (ECS) is not required to make a determination of whether or not the significant special need or the accommodation or classroom adaptation meets the need for funding, rather, the FSS or ECS is to ensure that the following items on the form are complete:

      Section I, the Child Care Provider has:

o     Checked the certification box indicating the need for funds;

o     Indicated the planned accommodation(s) or adaptations(s);

o     Signed the form; and

o     Dated the form

      Section II, the Licensed Professional has:

o     Checked the appropriate certification box;

o     Signed the form; and

o     Dated the form

      Section III, the Parent/Guardian has:

o     Signed the form; and

o     Dated the form

If any of these items are not completed, reject the form and inform the parent of the need for additional information.

 

Form 2690 is now required for all children experiencing a significant special need for whom additional funds are required to make accommodations or adaptations, including children age 13-17. When the licensed medical or mental health professional checks the certification box for a child age 13-17, they are also verifying that the condition of the child of that age limits the child's ability to care for himself/herself or he/she would cause harm to himself/herself or to others without supervision. A statement is no longer acceptable or required as verification for this age group.

 

The special need differential payment continues to be authorized for the expected length of duration as indicated on Form 2690 or for 12 months, unless the special need is a permanent condition as indicated by the licensed professional on Form 2690. New HEIGHTS does not allow a future end date to be entered into the system to automatically end the payment authorization at the end of the expected duration or 12 months. It is, therefore recommended that the FSS set an expected change to end date the authorization and/or request a new Form 2690 from the parent, if the significant special need still exists. If the licensed professional indicates that the condition is permanent, an expected change does not need to be set.

 

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 DCYF Form 2690 describes the child's significant special need as permanent, no subsequent verification is needed. In that case, the FSS must enter the special needs differential authorization for the new provider.

 

When a parent reports self-employment as their employment activity, allow the parent to self-report, for two continuous years of self-employment, the number of hours they are working in their self-employment activity. Use this number of hours in determining the service level for child care. The parent may change self-employment activities during the two years, but once the two continuous years have been reached, the manual calculation released in SR 14-16, dated 04/14, must be used to determine the approved service level for self-employment. It is recommended that the FSS or ECS set an expected change in New HEIGHTS for the end of the two continuous years to alert the FSS or ECS to ask for income to perform the manual calculation to determine the service level. If a parent is in a self-employment activity and changes activity and then returns to self-employment, the two continuous years begin again.

 

Verification of the date and place of birth is now only required for the child or children for whom child care assistance is being requested. It is no longer required to verify the place and date of birth of each member of the assistance group. This information is used to determine whether or not additional verification for citizenship is required. According to Title IV of the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) of 1996, only the child or children for whom assistance is being provided are required to be citizens, not the parents or other members of the household. Acceptable verification of date and place of birth continues to be:

. the child's birth certificate;

. the child's baptismal certificate; or

. the child's US passport.

 

Policy released in SR 14-16, dated 04/14, and in FAM 915, stated, "Children in a single parent household are not eligible for NH Child Care Scholarship if the single parent is disabled." As written, this policy implied that in a single parent household, where the parent is disabled, the parent could never receive child care assistance. However, if the disabled parent of a single parent household is participating in an approved activity and meet all other eligibility requirements, the parent may receive the NH Child Care Scholarship. For clarity, the policy now reads, "Children in a single parent household are not eligible for NH Child Care Scholarship if the single parent is disabled and not participating in an approved activity."

 

NEW HEIGHTS SYSTEMS PROCEDURES AND IMPLEMENTATION

 

No changes to New HEIGHTS screens have been made as a result of the policy changes in this SR. Continue the existing process for using the Assign Child to Child Care Provider screen, Additional Information tab for children under 13, and the Disability Screen for Children age 13-17.

 

As a reminder, when the child is under age 13, child care does not 'pend' when the worker answers the question "Is this a disabled child age 12 or under?" with a yes response and the verification as Not Yet Verified. The FSS must either add free form text to the Verification Checklist (AE0026), or if it's the only missing verification the worker will need to use the 'Required Verification' screen and create the custom checklist (AE0055).

 

UNRELATED OR RELATED POLICY CLARIFICATIONS OR TECHNICAL CORRECTIONS

 

The examples for calculating child care payments in PART 939 DETERMINING THE NH CHILD CARE SCHOLARSHIP PROVIDER REIMBURSEMENT AMOUNT (FAM), have been updated to reflect the Child Care Scholarship Program- Employment Related Maximum Weekly Standard Rates effective June 29, 2015.

 

DESCRIPTION OF REVISIONS MADE TO FORMS

 

Form 2628, Verification for a Child with a Disability has been redesigned, renumbered and renamed to Form 2690, Verification for a Child Experiencing Significant Special Needs;

 

Form 2690 is now divided into 3 sections titled; Section I Child Care Provider, Section II Licensed Professional and Section III Parent/Guardian.

 

Section I asks for identifying information of the child care provider and now requires the child care provider to check a certification box, indicating that the child's need is significant enough that the child requires additional funds for accommodation or classroom adaptation in the child care setting. The child care provider must indicate in a text box provided, the planned accommodation or adaptation for this child. The child care provider must sign and date the form.

Section II asks for identifying information of the licensed professional and the type of significant special need(s) the child is experiencing.

      It the licensed professional is the child's attending physician, physician's assistant, advance practiced registered nurse or licensed mental health professional, indicate the diagnosis and if the significant special need is a permanent condition. If the condition is not permanent, indicate the expected duration of the significant special need. This licensed professional must check a certification box indicating that he or she is providing ongoing treatment, that the child's need(s) is significant enough that the child requires additional support in the child care setting, and, if the child is 13-17 years of age, the child's condition limits the child's ability to care for himself/herself or he/she would cause harm to himself/herself or others without supervision. The licensed professional must sign and date the form.

      If the licensed professional is the SAU Special Education Director or an Area Agency Director, indicate if the child has a current Individual Education Plan, Individual Family Services Plan, or 504 Plan. This licensed professional must certify that he or she is the SAU Special Education Director or an Area Agency Director and the child's special need(s) is significant enough that the child requires additional support in a child care setting. The licensed professional must sign and date the form.

 

Section III, asks for identifying information of the parent/guardian. The parent/guardian must sign and date the form.

 

Instructions for this form were revised accordingly.

 

Either the parent or licensed professional may return the completed form to DHHS.

 

Form 2628, should be recycled and the new Form 2690 should be used immediately for all new and pending child care cases. The form is available electronically, for Department staff only, on the Lotus Notes Family Services Database and for everyone on the DHHS website at www.dhhs.nh.gov/dcyf/cdb/documents/specialneeds.pdf. A Certificate of Destruction has been included with this SR.

 

POLICY MANUAL REVISIONS

 

Revised Family Assistance Manual Topics

 

PART 904 NH CHILD CARE SCHOLARSHIP AUTHORIZED LEVEL OF SERVICE

Section 909.01 Changes in New Hampshire Child Care Scholarship Due to Birthdays

PART 915 NH CHILD CARE SCHOLARSHIP PROGRAM CRITERIA

Section 915.01 Verification of Name, Date and Place of Birth, Citizenship, and Current Address

PART 919 AGE CATEGORIES FOR NEW HAMPSHIRE CHILD CARE SCHOLARSHIP

Section 919.01 Required Verification

PART 939 DETERMINING THE NEW HAMPSHIRE CHILD CARE SCHOLARSHIP PROVIDER REIMBURSMENT AMOUNT

PART 941 NH CHILD CARE SCHOLARSHIP DIFFERENTIAL PAYMENT RATES FOR A CHILD EXPERIENCING A SIGNIFICANT SPECIAL NEED

Section 941.01 Required Verification for a Child Experiencing a Significant Special Need

 

IMPLEMENTATION

 

For all new and pending child care cases, this policy is effective September 1, 2015.

 

Form 2628, should be recycled and the new Form 2690 should be used immediately for all new and pending child care cases. Beginning September 1, the new Form 2690, Verification for a Child Experiencing Significant Special Needs, is the only acceptable form of verification for a child with a significant special need; Form 2628, is no longer an acceptable form of verification. The form is available electronically, for Department staff only, on the Lotus Notes Family Services Database and for everyone on the DHHS website at www.dhhs.nh.gov/dcyf/cdb/documents/specialneeds.pdf. A Certificate of Destruction has been included with this SR.

 

For currently open cases with a child authorized for a disability differential payment, the Child Development Bureau (CDB) sent a letter to the parent informing them of the need for a new Form 2690. Parents were informed to send the new completed Form 2690 directly to the Child Development Bureau no later than September 30, 2015. CDB will track the return of the new Form 2690 and send this form to the Central Scanning Unit. After September 30, 2015, CDB will end date the authorization for the differential payment in New HEIGHTS for children age birth through 12 for whom the new form has not been received. CDB will enter a case comment in New HEIGHTS when this action is taken. CDB will contact the FSS to end date the authorization for the differential payment on the disability screen for any child age 13-17 for whom the new form has not been received. After September 30, 2015, all new and renewing Form 2690 should be sent to the Central Scanning Unit. Use the date the licensed professional signs the form as the effective date, but no more than 90 days prior to the date the form was received.

 

The FSS must continue to review the need to update the form at each redetermination and according to the expected change.

 

When an individual reports they are self-employed, the FSS or ECS must review the case to determine that the individual has been continuously self-employed for less than two years, and if so ask the client how many hours they are working in their self-employment activity. Use this number to update the Child Care Responses screen with the reported number of hours for self-employment. It is recommended that the FSS or ECS set an expected change for the end of the continuous 2-year period.

 

CLIENT NOTIFICATION

 

Notification of these child care policy changes was published in the New Hampshire Rule Making Register Office of Legislative Services, on April 23, 2015. A public hearing on the amended Administrative Rules was held on May 19, 2015.

 

On August 20, 2015, a client letter titled, Changes to Child Care Service Level for Parents who are Self-employed, was sent to 270 caseheads where at least one parent is self-employed. Individuals were informed that if they have been continuously self-employed for less than 2 years, they may now self-report the number of hours they are working in their self-employment activity. That number will be used in the determination of the service level for child care. If a change in service level is determined, the new service level will be effective the date the hours of self-employment are reported to DHHS.

 

On August 20, 2015, a client letter was sent to 64 parents who have at least one child for whom their child care provider is receiving the disability differential payment on the child's behalf. Parents were informed that the language has been changed from disability to significant special need and that a new Form 2690 changes the requirements for receiving the differential payment. This form now requires information, signature and date from the child care provider along with previously required information from a licensed professional and the parent's signature. All three sections of the new Form 2690 must be completed and returned to the Child Development Bureau by September 30, 2015.

 

On August 20, 2015, a provider letter was sent to 41 child care providers who are linked to at least one child who is receiving the disability differential payment. Child care providers were informed that the language has been changed from disability to significant special need and that a new Form 2690 changes the requirements for receiving the differential payment. This form now requires information, signature and date from the child care provider along with previously required information from a licensed professional and the parent's signature. All three sections of the new Form 2690 must be completed and returned to the Child Development Bureau by September 30, 2015.

 

TRAINING

 

No special training is planned.

 

FORMS MANUAL POSTING INSTRUCTIONS

 

Remove and Destroy

Insert

 

Forms Manual

 

 

 

DCYF/CDB Form 2628, Verification for a Child with a Disability and DCYF/CDB Form 2628(i) Instructions to the "Verification for a Child with a Disability"

CDB SR 12-17/May, 2012

1 sheet, double-sided

DCYF/CDB Form 2690, Verification for a Child Experiencing Significant Special Needs and DCYF/CDB Form 2690(i) Instructions to the "Verification for a Child Experiencing Significant Special Needs"

CDB SR 15-23/September 2015

1 sheet, double-sided

 

DISPOSITION

 

This SR may be destroyed or deleted after its contents have been noted and the revised manual topics released by this SR have been posted to the On-line manuals.

 

DISTRIBUTION

 

This SR will be distributed according to the electronic distribution list for Division of Family Assistance policy releases. This SR, and revised On-Line Manuals, will be available for agency staff in the On-Line Manual Library, and for public access on the Internet at www.dhhs.nh.gov/DFA/publications.htm, effective September 28, 2015. Additionally, this SR, and printed pages with posting instructions, will be distributed under separate cover to all internal hard copy holders of the Family Assistance and Forms Manuals.

 

CDB/KEB:s

 

CERTIFICATE OF DESTRUCTION

I certify that all copies of Form 2628, dated 4/12, CDB SR 12-17, have been destroyed.

District Office Manager of Operations:

 

District Office:

 

 

 

Return this certificate to the DFA Policy Unit, 129 Pleasant St, Brown Bldg, 3rd Floor, Concord, NH 03301, after the instructions in the SR have been carried out.