New Mexico Register / Volume XXXI,
Issue 22 / November 24, 2020
NOTICE OF RULEMAKING AND PUBLIC RULE HEARING
The New Mexico Children, Youth and
Families Department (CYFD) and the Early Childhood Education and Care Department
(ECECD) hereby gives notice as required under Section 14-4-5.2 NMSA 1978 and
1.24.25.11 NMAC that it proposes to adopt amendments to the following rules
regarding SOCIAL SERVICES CHILD CARE ASSISTANCE REQUIREMENTS FOR CHILD CARE
ASSISTANCE PROGRAMS FOR CLIENTS AND CHILD CARE PROVIDERS as authorized by
Section 9-2A-7 NMSA 1978:
8.15.2.7 NMAC - DEFINITIONS
8.15.2.8 NMAC - TYPES OF CHILD CARE
8.15.2.9 NMAC - PRIORITIES FOR
ASSISTANCE
8.15.2.10 NMAC - APPLICATION PROCESS
8.15.2.11 NMAC - ELIGIBILITY
REQUIREMENTS
8.15.2.12 NMAC - RECERTIFICATION
8.15.2.13 NMAC - CLIENT RESPONSIBILITIES
8.15.2.14 NMAC - CASE SUSPENSIONS AND
CLOSURES
8.15.2.15 NMAC
- PROVIDER REQUIREMENTS
8.15.2.16 NMAC - DEPARTMENT RESPONSIBILITIES
8.15.2.17 NMAC - PAYMENT FOR SERVICES
8.15.2.18 NMAC – UNDER PAYMENTS
8.15.2.19 NMAC - OVER PAYMENT AND
RECOUPMENT
8.15.2.20 NMAC - FRAUD
8.15.2.21 NMAC - SANCTIONS
No technical scientific information was
consulted in drafting these proposed rules.
Purpose of proposed rules: The purpose of the rulemaking is to promulgate
amendments to 8.15.2 NMAC, which were initially published as emergency amendments
effective September 18, 2020, along with additional necessary changes. Due to the COVID-19 health crisis and the
resulting executive orders and declarations, there was an emergency need for
amendments to 8.15.2 NMAC in order to protect the public from an imminent peril
to public health, safety and welfare of children and families in New Mexico.
Copies of the proposed amended rules
may be found at end of this notice and at ECECD’s website at https://www.newmexicokids.org/
30 days prior to the Public Hearing.
Notice of public rule hearing: The public rule hearing will be held on January
6, 2021, at 1:00 p.m. The hearing will
be held via internet, email, and telephonic means due to the concerns
surrounding COVID-19 and in accordance with Governor Michelle Lujan Grisham’s
Executive Order 2020-004, Declaration of Public Health Emergency and the March
12, 2020 Public Health Emergency Order to Limit Mass Gatherings Due to
COVID-19. The public hearing will be
conducted in a fair and equitable manner by a CYFD/ECECD agency representative
or hearing officer and shall be recorded. Any interested member of the public may attend
the hearing and will be provided a reasonable opportunity to offer public
comment, either orally or in writing, including presentation of data, views, or
arguments, on the proposed rules during the hearing. Individuals with disabilities who need any
form of auxiliary aid to attend or participate in the public hearing are asked
to contact ECECD at ECECD-ECS-PublicComment@state.nm.us
or call (505) 231-5820. ECECD will make
every effort to accommodate all reasonable requests, but cannot guarantee
accommodation of a request that is not received at least ten calendar days
before the scheduled hearing.
Notice of acceptance of written
public comment: Written public comment, including presentation
of data, views, or arguments about the proposed rules, from any interested
member of the public, may be submitted via email to ECECD-ECS-PublicComment@state.nm.us
with the subject line “8.15.2 NMAC Public Comment” or via first class mail to
P.O. Drawer 5619, Santa Fe, New Mexico 87502 – 5619. Written comments may be delivered to the Old
PERA building at 1120 Paseo De Peralta on January 6, 2021 from 1:00 pm to 3:00
pm. The comment period ends at the conclusion of the public hearing on January
6, 2021.
Any
interested member of the public may attend the hearing via the internet or
telephone and offer public comments on the proposed rule during the hearing. To access the hearing by telephone: place call 1-346-248-7799, access code 974
3902 4249. You will be able to hear the
full hearing and your telephone comments will be recorded. To access the hearing via the internet: please go to https://zoom.us/j/97439024249, and follow the instructions
indicated on the screen – Meeting ID (access code): 974 3902 4249#. This will be a live stream of the hearing. You may also provide comment via Chat during
the live streaming.
AVISO DE PROMULGACION DE LEYES ADMINISTRATIVAS Y
AUDIENCIA PÚBLICA
El Departamento de Niños, Jóvenes y Familias de Nuevo
México (CYFD) y el Departamento de Educación y Cuidado de la Primera Infancia
(ECECD) por este medio da aviso como se requiere bajo la Sección 14-4-5.2 de
los Estatutos Anotados de Nuevo México (NMSA) 1978 y 1.24.25.11 del Código
Administrativo de Nuevo México (NMAC), que propone adoptar enmiendas a las siguientes
leyes administrativas con respecto a los REQUISITOS DE ASISTENCIA DE CUIDADO
INFANTIL DE LOS SERVICIOS SOCIALES PARA PROGRAMAS DE ASISTENCIA DE CUIDADO
INFANTIL PARA CLIENTES Y PROVEEDORES DE CUIDADO INFANTIL según lo autorizado por la sección 9-2A-7 del NMSA
1978:
8.15.2.7 NMAC - DEFINICIONES
8.15.2.8 NMAC - TIPOS DE CUIDADO INFANTIL
8.15.2.9 NMAC - PRIORIDADES DE ASISTENCIA
8.15.2.10 NMAC - PROCESO DE SOLICITUD
8.15.2.11 NMAC - REQUISITOS DE ELEGIBILIDAD
8.15.2.12 NMAC - RECERTIFICACIÓN
8.15.2.13 NMAC - RESPONSABILIDADES DEL CLIENTE
8.15.2.14 NMAC - SUSPENSIÓN Y CIERRES DE CASOS
8.15.2.15 NMAC - REQUISITOS DE LOS PROVEEDORES
8.15.2.16 NMAC - RESPONSABILIDADES DEL DEPARTAMENTO
8.15.2.17 NMAC - PAGO DE LOS SERVICIOS
8.15.2.18 NMAC - PAGOS INSUFICIENTES
8.15.2.19 NMAC - PAGOS EXCESIVOS Y REEMBOLSOS
8.15.2.20 NMAC - FRAUDES
8.15.2.21 NMAC - MULTAS
No se consultó información científica o técnica cuando
se redactaron estas leyes administrativas propuestas.
Propósito de
las leyes administrativas propuestas: El propósito de las leyes administrativas es
promulgar enmiendas a la sección 8.15.2 del NMAC, que se publicaron
inicialmente como enmiendas de emergencia a partir del 18 de septiembre de
2020, junto con los cambios adicionales necesarios. Debido a la
crisis de salud del COVID-19 y las órdenes ejecutivas y declaraciones
resultantes, hubo una necesidad de emergencia de realizar enmiendas a la 8.15.2
del NMAC para proteger al público de un peligro inminente para la salud
pública, la seguridad y el bienestar de los niños y las familias de Nuevo
México.
Puede encontrar copias de las propuestas leyes
administrativas al final de este aviso y en el sitio web del ECECD en https://www.newmexicokids.org/ 30 días antes de la Audiencia Pública.
Aviso de Audiencia Pública de leyes administrativas: La audiencia
pública de leyes administrativas tendrá lugar el 6 de enero de 2021 a la 1:00 p.m.
La audiencia se llevará a cabo a través
de Internet, correo electrónico y medios telefónicos debido a las
preocupaciones en torno al COVID-19 y de acuerdo con la Orden Ejecutiva
2020-004 de la Gobernadora Michelle Lujan Grisham, la Declaración de Emergencia
de Salud Pública y la Orden de Emergencia de Salud Pública del 12 de marzo de
2020 para limitar las reuniones masivas debido al COVID-19. La audiencia pública se llevará a cabo de
manera justa y equitativa por un representante de la agencia del CYFD o el
ECECD o el funcionario de audiencias y será grabada. Cualquier miembro del público interesado puede
asistir a la audiencia y se le brindará una oportunidad razonable para ofrecer
comentarios al público, oralmente o por escrito, incluso una presentación de
datos, puntos de vista s o argumentos, sobre las propuestas. Las personas con discapacidades que necesiten
cualquier forma de ayuda auxiliar para asistir o participar en la audiencia
pública deben comunicarse con el ECECD en ECECD-ECS-PublicComment@state.nm.us
o llamar al (505) 231-5820. El ECECD hará todos los esfuerzos posibles para
acomodar todas solicitudes razonables, pero no puede garantizar acomodar
solicitudes que no sean recibas por lo menos diez días antes de la fecha programada
para la audiencia.
Aviso de aceptación de comentarios públicos por escrito: Los comentarios
públicos por escrito, incluso las presentaciones de datos, puntos de vista o
argumentos de cualquier miembro del público interesado, sobre las propuestas
leyes administrativas, pueden ser enviados s a través de correo electrónico aECECD-ECS-PublicComment@state.nm.us, especificando en
la línea de Asunto: “8.15.2 NMAC Public
Comment,” o por correo de primera clase a P.O. Drawer 5619, Santa Fe, New
Mexico 87502 – 5619. Los comentarios
escritos se pueden entregar en el edificio Old PERA en 1120 Paseo De Peralta el
6 de enero de 2021 de 1:00 p.m. a 3:00 p.m. El período de comentarios termina a la
conclusión de la audiencia pública el 6 de enero de 2021.
Cualquier miembro del público interesado puede asistir
a la audiencia a través de Internet o por teléfono y ofrecer comentarios
públicos sobre las leyes administrativas propuestas durante la audiencia. Para acceder a la audiencia por teléfono llame
al 1-346-248-7799, código de acceso 974 3902 4249. Podrá escuchar la audiencia completa y se
grabarán sus comentarios telefónicos. Para
acceder a la audiencia a través de Internet vaya a https://zoom.us/j/97439024249 y siga las instrucciones que se indican en la pantalla (ID de la reunión
- código de acceso: 974 3902 4249 #). Esta será una transmisión en directo de la
audiencia. También puede proporcionar
comentarios a través del chat durante la transmisión en directo.
Proposed Rules/Leyes administrativas propuestas
Explanatory sentence for purposes of
this Notice:
Frase explicativa para los
propósitos de este Aviso:
8.15.2.7 DEFINITIONS:
A. “Attending a job training or educational
program” means actively participating in [a job] an in-person or
online job training or educational program.
B. “At-risk
child care” means a program for families
at-risk [of child protective services involvement] as determined by the
department.
C. “CACFP” means the child and adult care
food program, administered by the children, youth and families department.
D. “Child with a disability or special
needs” means a child with an identified
disability, health, or mental health conditions requiring early intervention,
special education services, under an individualized education plan (IEP),
or other specialized services and supports; or children without identified
conditions, but requiring specialized services, supports, or monitoring.
[E. “Child support enforcement division”
means the child support enforcement program administered by New Mexico’s human
services department, which collects child support from non-custodial parents.]
E. “Client” means the parent or legal guardian of the child that the
department has determined is eligible for child care assistance benefits.
F. “Closure” means the client’s child care case is
closed with the department.
G. “Co-payment” means the portion of the
approved and agreed upon monthly child care cost for clients receiving child
care assistance that the client is required to pay to the child care
provider. The department’s payment to
the provider is reduced by the co-payment amount.
H. “Demonstration of incapacity”
means written documentation that an individual is unable to fulfill an
eligibility requirement, such as work, school, or the ability to provide child
care, and should otherwise be excluded, in whole or in part, from the
determination of eligibility. Written
documentation of incapacity includes, but is not limited to, the following: statements or letters on a physician’s/medical
professional’s/treatment provider’s letterhead stationary; statements, records
or letters from a federal government agency that issues or provides disability
benefits; statements, records or letters from a state vocational rehabilitation
agency counselor; records or letters from a treatment facility/counselor;
certification from a private vocational rehabilitation or other counselor that
issues or provides disability benefits.
[H.] I. “Department”
means the New Mexico children, youth and families department (CYFD).
[I.] J. “Earned
income” means income received as gross wages from employment or [as
profit from] self-employment.
K. “Fluctuation of earnings”
means a family with inconsistent or variable income throughout the year. To calculate fluctuation of earning the
department may:
(1) average
family earnings over a period of time (e.g., 12 months); or
(2) choose
to discount temporary increases in income provided that a family demonstrates
an isolated increase in pay (e.g., short-term overtime pay, temporary increase
to pay, etc.) and is not indicative of a permanent increase in income.
[J.] L. “Homeless
children
and youth” means individuals who lack a fixed,
regular, and adequate nighttime residence, which includes:
(1) Children
and youth who are temporarily sharing the housing of other persons due to loss
of housing, economic hardship, or a similar reason; are living in motels,
hotels, trailer parks (excludes mobile homes), or camping ground due to the
lack of alternative adequate accommodations; are living in emergency or
transitional shelters; are abandoned in hospitals; or are awaiting foster care
placement;
(2) children
and youth who have a primary nighttime residence that is a public or private
place not designed for or ordinarily used as a regular sleeping accommodation
for human beings;
(3) children
and youth who are living in cars, parks, public spaces, abandoned buildings,
substandard housing, bus or train stations, or similar settings; and
(4) migratory
children who qualify as homeless for the purposes of this subtitle because the
children are living in circumstances described in Paragraphs (1) through (3) of
this subsection.
M. “Household”
means the household as defined below in Paragraph (1) of Subsection C. of 8.15.2.11 NMAC.
N. “Household
income”
means household income as defined below in Paragraph (3) of Subsection C. of 8.15.2.11 NMAC.
[K.] O. “Incidental
money” means earnings of a minor child for occasional work performed such
as baby-sitting, cutting lawns, and other similar activities.
[L.] P. “Infant,
toddler, preschool, school age” means the age categories used for assigning
child care provider reimbursement rates, defined as follows:
(1) infant:
zero - 23 months;
(2) toddler:
24 -35 months;
(3) preschool:
three to five year olds; and
(4) school
age: six year olds and older.
[M.] Q. “Job training and educational program”
means participation in a short or long term educational or training program,
including online programs [which provides] that provide
specific job skills which allow the participant to enter the workforce and
directly relates to enhancing job skills, including but not limited to the
acquisition of a general equivalency diploma (GED), English as a second
language, literacy training, vocational education training, secondary education
including adult basic education and accredited high school programs, and
post-secondary institutions.
[N.] R. “National
accreditation status” means the achievement and maintenance of
accreditation status by an accrediting body that has been approved by
CYFD. CYFD determines the program
criteria and standards to evaluate and approve accrediting bodies.
(1) The
following are the only national accrediting bodies that are approved by CYFD:
(a) the
association of Christian schools international (ACSI);
(b) the
council on accreditation (COA) for early childhood education and after school
programs;
(c) the
international Christian accrediting association (ICAA);
(d) the
national accreditation commission for early care and education programs (NAC);
(e) the
national association for the education of young children (NAEYC) academy for
early childhood program accreditation;
(f) the
national association of family child care (NAFCC); or
(g) the
national early childhood program accreditation (NECPA).
(2) Effective
July 15, 2014 accrediting bodies that have been previously approved by CYFD
that are not on the above list will no longer be CYFD approved national
accrediting bodies.
[O.] S. “Non-temporary change in activity”
means the family has experienced a change in activity that does not meet the
definition of a “temporary change in activity” as defined in Section [CC]
HH below.
[P.] T. “Non-traditional
hours of care” means care provided between the afterhours of 7:00 p.m. and
7:00 a.m. Monday through Friday or care provided during weekend hours between
12:00 a.m. Saturday morning and 12:00 a.m. Monday morning.
[Q.] U. “Open case” means a case that has not
been closed as a result of a failure to recertify, or that has not been closed
due to becoming otherwise ineligible for child care assistance benefits.
[R.] V. “Overpayment”
means a payment of child care assistance benefits received by a client or
provider for which they are ineligible based on incomplete or inaccurate
information provided by either the client or the provider, or agency error.
[S. “Child Protective services (CPS) child care” means child care
services for children placed in the custody of the child protective services of
the department.]
[T.] W. “Provider
types” means the characteristics of child care providers, which determine
their approved reimbursement rate, capacity, staffing levels etc. as follows:
(1) “In-home” care means care provided in
the child’s own home.
(2) “Registered home” means child care
provided in the home of a provider who is registered with the department to care for up to four children. All registered homes receiving child care
assistance subsidies must be enrolled and participate in the child and adult
care food program (CACFP), unless they are exempt.
(3) “Licensed family child care home” means
child care provided in the home of a provider who is licensed by the department
to care for up to six children.
(4) “Licensed group child care home” means
child care provided in the home of a provider who is licensed by the department
to care for up to 12 children.
(5) “Licensed center” means child care
provided in a non-residential setting, which is licensed by the department to
provide such care.
(6) “Out-of-school time care” means child
care provided to a kindergartner or school age child up to age 13 immediately
before or immediately after a regularly scheduled school day or when regular
school is not in session.
(7) “Friend,
family, or neighbor (FFN)” means care to be provided temporarily in
a home to be self-certified by the parent or legal guardian and registered by
the department, not to exceed six months.
In the case of a public health emergency, the department may extend the
temporary status.
[U.] X. “Recertification”
means the process by which a client’s eligibility to continue to receive child
care assistance benefits are determined.
[V.] Y. “Registration/educational
fee” means a fee charged to private pay and families receiving child care
assistance for materials and supplies.
Z. “Sanctions”
means a measure imposed by the department for a violation or violations of
applicable regulations.
[W.] AA. “SNAP” means the supplemental nutrition assistance program
administered by the U.S. department of agriculture, which helps low-income
families purchase healthy food. SNAP was
previously referred to as food stamps employment and training program.
BB. “Special
supervision” means the special supervision for child(ren) as
defined below in Subsection G
of 8.15.2.11 NMAC.
[X.] CC. “Star level” means a license indicating
the level of quality of an early childhood program. A greater number of stars indicates a higher
level of quality.
[Y.] DD. “Suspension” means [that the child
care case remains eligible, but benefits are not paid to the provider] the
voluntary cessation of child care benefits at the client’s request, during
which the client remains eligible.
[Z.] EE. “TANF”
means the temporary assistance to needy families program administered by the
U.S. department of health and human services.
TANF is the successor to the aid to families with dependent children
(AFDC) program and provides cash assistance to qualified low-income families
with dependent children.
[AA.] FF. “Teen parent” means a biological parent under the age of 20 who is
attending high school, working towards a general equivalency diploma (GED) or
attending any other job skills training or educational programs directly
related to enhancing employment opportunities.
[BB.] GG. “Termination” means
the client’s child care case will be closed due to cause.
[CC.] HH. “Temporary change of activity” means
one of the following events that does not exceed three months:
(1) limited absence from work for employed parents or legal
guardians for periods of family leave (including parental leave) or sick
leave;
(2) interruption in work for a seasonal worker who is not
working between regular industry work seasons;
(3) student holiday or break for a parent or legal guardian
participating in training or education;
(4) reduction in work, training or education hours, as long as
the parent or legal guardian is still working or attending training or
education; and
(5) cessation of work or attendance at a training or education
program less than [90 days] three months.
[DD.] II. “Underpayment”
means a payment made by the department for services provided which did not
fully reimburse the client or provider.
[FF.] KK. “Working” means employment of any type,
including self-employment and teleworking. For TANF recipients, this includes work
experience or community service or any other activity that meets the TANF work
activity requirements.
[8.15.2.7 NMAC
- Rp, 8.15.2.7 NMAC 10/1/2016, A, 2/1/2017; A, 10/1/2019, A/E, 9/18/2020]
8.15.2.8 TYPES OF CHILD CARE:
These policies apply to child care assistance benefits provided to
eligible children for the following types of child care to ensure that parents
or legal guardians have a variety of child care services from which to
choose:
A. licensed child
care programs administered by public schools and post-secondary institutions
that provide on-site care for the children of students;
B. licensed child
care programs administered by tribal entities;
C. licensed child
care programs administered by church or religious organizations;
D. in-home care;
E. licensed child
care centers;
F. registered
family childcare homes;
G. licensed family
and group childcare homes;
H. licensed out of
school time programs; [and]
I. licensed
programs operated by employers for their employees[.]; and
J. FFN.
[8.15.2.8 NMAC
- Rp, 8.15.2.8 NMAC, 10/1/2016]
0
8.15.2.9 PRIORITIES FOR ASSISTANCE:
Any f0unds received by the department under the child care development
fund and other sources are expended for child care assistance pursuant to the
following priorities:
A. Priority
one: Clients receiving temporary
assistance to needy families (TANF) benefits to include TANF diversionary
payment, are considered priority one clients.
(1) Participation
exemption: The human services department
(HSD) grants participation exemptions to TANF clients who cannot locate
child care. The children, youth and
families department is responsible for the verification of the TANF
participant’s inability to locate child care.
Reasons for a participation exemption due to lack of child care are as
follows:
(a) the
unavailability of appropriate child care within a reasonable distance from the
individual’s home or work site;
(b) the
unavailability or unsuitability of informal child care by a relative or under
other arrangements; or
(c) the
unavailability of appropriate and affordable formal child care by a relative or
under other arrangements.
(2) A
person who applies for participation exemption for any or all of the above
reasons is referred to the children, youth & families department child care
resource and referral. The child care
resource and referral assists
the client with location of child care.
The final validation/verification of a client’s inability to locate
child care is determined by the child care services bureau supervisor in
conjunction with his/her supervisor. A
client who receives a participation exemption due to lack of child care is
required to re-apply for the exemption every six months. If a person disagrees with the determination
of their eligibility for a participation exemption, they may apply for a fair
hearing with [the human services department (HSD)] HSD. HSD is responsible for providing notice of the
approval or denial of a participation exemption.
B. Priority one A: [RESERVED]
C. Priority one B: Child care assistance for income eligible
families whose income is at or below one hundred percent of the federal poverty
level, adjusted annually in accordance with federal guidelines. The department prioritizes child care services
within priority one B for children with special needs, disabilities, homeless families,
and for teen parents.
D. Priority two: Families transitioning off TANF and clients
who have received a TANF diversionary payment. Clients must have received TANF for at least
one month, or a diversionary payment, in the past 12 months in order to
qualify for priority two. Only clients transitioning
off TANF whose TANF cases are closed at least in part due to increased
earnings or loss of earned income deductions or disregards are eligible
for priority two. Priority two clients
do not have to meet income eligibility requirements during their 12 consecutive
month period of eligibility for priority two child care.
E. Priority three: [RESERVED]
F. Priority four: Child care assistance for families whose
income is above one hundred percent of the federal poverty level but at or
below two hundred percent of the federal poverty level, adjusted annually in
accordance with federal guidelines.
These families are certified for a 12 month block of time and will
remain eligible at or below two hundred fifty percent of the federal poverty
level. Exceptions to the 12 month
certification period are included in 8.15.2.11 NMAC. The department prioritizes child care
services within priority four for children with special needs, disabilities,
homeless families, and for teen parents.
[G. Child
protective services (CPS) child care: The department pays for CPS child
care as determined by the protective services of the department. Income requirements and copayments are
waived for clients in this priority.]
[H.] G. [At-risk
child care] Priority five: In
addition to these priorities, the department pays for at-risk [protective
services] child care as approved by the department. Child care benefits are provided for a
minimum of six months to support the family.
Income, work and education requirements and copayments are waived
for clients in this priority.
[8.15.2.9 NMAC
- Rp, 8.15.2.9 NMAC, 10/1/2016; A; 10/1/2019, A/E, 9/18/2020]
8.15.2.10 APPLICATION PROCESS:
A. Clients apply
for child care assistance benefits by presenting the following documents to
establish eligibility [in person at the local child care office. Upon a need or request by the client, the
department may approve a client to submit their initial application by fax,
email, or mail. Clients shall have 14
calendar days after initial submission of an application to submit all other
required forms. Under documented
extenuating circumstances and with approval from the early childhood services
director, clients may be given longer than 14 days but no more than 30 days to
submit required documentation]:
(1) a
completed signed application form;
(2) [current
proof of earned income or participation in the temporary assistance to needy
families (TANF) program; social security numbers or assigned TANF
identification numbers may be used to verify TANF participation or receipt of
child care support] documentation of current countable earned and
unearned income as listed below and defined in Paragraph (5) of Subsection C of
8.15.2.11 NMAC;
(3) documentation of the applicant’s
TANF eligibility or participation, if applicable, and can include applicant’s
social security number or assigned TANF identification number;
[(3)] (4) school schedule or
verification of educational activity, if applicable;
(5) demonstration of incapacity for
parent or legal guardian, if applicable;
[(4)] (6) verification of
birth for all applicant’s household children;
(7) documentation of qualifying
immigration status, as defined by the United States Department of Health and
Human Services, Administration for Children & Families, Office of Child
Care, for all children requesting child care assistance;
[(5) proof
of unearned income;]
[(6)] (8) [proof] documentation
of New Mexico [home address] residency; and
[(7)] (9) [CYFD] department
approved provider.
B. The
department may approve a client to submit their initial application by fax,
email, electronic submission, or mail.
Clients shall have 14 calendar days after initial submission of an
application to submit all other required forms. Upon approval from the child care regional
manager, clients may be given longer than 14 calendar days, but no more than 30
calendar days, to submit required documentation.
[B.] C. Assistance is provided effective the first day of the month of
application if all of the following apply:
(1) the
client is utilizing child care services;
(2) the
client is employed, attending school or a training program. In the case of a public health emergency, the
department secretary may waive the requirement for employment, attending school
or a training program; and
(3) the
[eligible] provider is eligible to be paid [was providing care
from the first day of the month forward].
[8.15.2.10
NMAC - Rp, 8.15.2.10 NMAC, 10/1/2016; A/E, 03/16/2020; A, 8/11/2020, A/E,
9/18/2020]
8.15.2.11 ELIGIBILITY REQUIREMENTS:
Clients are eligible for child care assistance benefits upon meeting the
requirements for eligibility as determined by the department and federal
regulation.
A. Child
care staff will initiate communication at the initial [eligibility]
determination of their eligibility period to provide outreach and consumer
education with a case management approach and coordination of services to
support families.
B. Eligibility period: Based upon the client meeting all eligibility
requirements, a 12-month certification period will be granted.
(1) Eligibility
may be granted for less than 12 months at the parent or legal guardian’s
request.
(2) [Eligibility
for CPS and a at] At-risk child care may be granted for less than 12
months as determined by the department.
(3) Eligibility may be granted for up
to three months for seeking employment.
The eligibility may be closed if the client fails to obtain a qualifying
activity within three months. The
department has the discretion to extend the job search period.
[(3)] (4) The client will remain
eligible if a temporary change of activity occurs.
[(4)] (5) If a client experiences a
non-temporary change in activity, the client will no longer be eligible to
receive assistance if another activity is not obtained within the three-month
grace period.
C. Income eligibility determination:
(1) The
household: The household includes
biological parents, stepparents, [and] legal guardians of the
child(ren) for whom child care assistance is sought, and any legal dependents
of the aforementioned, living in the
household, thereby constituting an economic unit[, and any dependents of the
aforementioned who are under 18 years of age.
Grandparents will be considered household members only if they are legal
guardians of the children, are providing for the physical and emotional needs
of the children, and are applying for child care benefits on behalf of the
children]. Grandparents who are
not legal guardians living in the household are counted as members of the
household, but their earned and unearned income is excluded from the
eligibility calculations.
(a) Periods of absences: A household member may be absent from the home
and will be considered as living in the home and be counted in the household
composition as long as the absent household member plans to return to the
home. Any parent or legal guardian who
remains in the home must be working, attending school, or participating in a
job training or educational program.
Temporary absence may include, but are not limited to, attending school,
working, training, medical or other treatment, or military service.
(2) [Allowed exclusions from the household for co-payment
calculation only: Excluded from the
household for co-payment calculation purposes only are grandparents or legal
guardians who have taken custody/guardianship of children due to circumstances
such as but not limited to death of biological parents or other documented
circumstances such as mental or physical incapacity of biological parents to
care for the child or children.
Grandparents or legal] Legal guardians who are not the
parents of the child(ren) for child care assistance is sought, in this
situation, are required to qualify for child care assistance as per
Paragraph [(4)] (3) below and, upon qualification, have the
required co-payment waived.
[(3) Adult dependent children:
18 year old dependent children must be attending school to be counted in
the household. Incidental money earned
by dependent children is not to be counted as household income.]
[(4)] (3) Household
income: [Income eligibility for
benefits is determined by the number of members in the household and the total
countable gross earned and unearned income.
Eligibility determinations will take into account irregular fluctuations
of earnings to income based on the client’s individual circumstances.] The
household’s gross monthly or annual average countable earned and unearned income,
taking into account any fluctuation(s) of earnings, and will always be
calculated in favor of eligibility. Household
income does not include any earned and unearned income received by grandparents
who are not legal guardians, and any legal dependents of the biological
parents, stepparents, or legal guardians of the child(ren) for whom child care
assistance is sought, living in the household.
[(5)] (4) Family assets: A
family’s assets may not exceed one million dollars.
[(6)] (5) Countable earned
and unearned income: The following
sources of income are counted when computing a family’s eligibility for
assistance and for determining the co-payment (if applicable): income from employment by working for others
or from self-employment; [child support payments;] alimony payments;
veterans administration (VA) payments except VA payments [for educational
purposes and disability] that are specifically exempted in Paragraph (6)
of Subsection C of 8.15.2.11 NMAC; [union payments; unemployment or]
workman’s compensation; railroad retirement benefits; pensions; [TANF
benefits, including diversion payments;] royalties; income from rental
property; social security benefits (except social security payments that are
specifically exempted in Paragraph (6) of Subsection C of 8.15.2.11 NMAC; [work
study income;] overtime shall be counted at CYFD’s discretion if CYFD
determines that the applicant is paid overtime on a regular basis.
[(7)] (6) Exempt
income: The types of income not counted
when computing eligibility or co-payments include but are not limited to: earnings of [a] household
dependents [child who is under 18 and in school]; earnings of
household grandparents who are not the legal guardians of the child(ren) for
whom child care assistance is sought; SNAP; TANF benefits, including
diversion payments; supplemental security income (SSI); social security
disability insurance (SSDI); social security benefits received by household
children; any VA payments made on behalf of the child(ren); VA benefits
for educational purposes or for disability; unemployment benefits; work study
income; child support payments; military food and housing allowances; an
increase in military salary or allowances due to “temporary national emergency
status beginning September 11, 2001”; third party payments; energy assistance
benefits; foster care payments; adoption subsidies; [VA payments for
educational purposes and disability;] loans; child or adult nutrition
programs; income tax refunds; payments for educational purposes; compensation
under the Domestic Volunteer Services Act and the volunteers in service to
America (VISTA) program or [Americorp] AmeriCorps; Work
Investment Act (WIA) payments made to dependent children; relocation payments;
department of vocational rehabilitation (DVR) training payments; in-kind gifts;
cash gifts; employer reimbursements; overtime, unless CYFD determines that the
applicant is paid overtime on a regular basis; payments from special funds such
as the agent orange settlement fund or radiation exposure compensation
settlement fund; lump sum payments such as those resulting from insurance
settlements and court judgments; or other resources such as savings, individual
retirement accounts (IRAs), vehicles, certificates of deposits (CDs) or
checking accounts. In the case of an
emergency, or under extenuating circumstances, the department secretary may
disregard certain temporary income, such as federal stimulus payments or hazard
pay.
[(8)] (7) Verification of household
countable earned and unearned income:
Clients applying for child care assistance benefits are required to
verify household countable earned and unearned income by providing
current [proof] documentation of income for [all members of
the household] biological parents, stepparents, and legal guardians of
the child(ren) for whom child care assistance is sought, living in the
household, who receive such income.
[Self-employed clients must show proof of business expenses in order
for the countable self-employment income to be determined.] A self-employed individual who does not show
a profit that is equal to federal minimum wage times the amount of hours needed per week within 24 months from the
start date of receiving child care assistance will be evaluated by the child
care assistance supervisor, at which point services may be reduced or
discontinued.
D. Residency
requirement: An applicant of child care assistance and a child care provider must
be a resident of the state of New Mexico.
Proof of residency is required.
E. Citizenship: Any child receiving child care assistance
must be a citizen or legal resident of the United States; or a qualified
[alien] immigrant as [determined by applicable federal laws]
defined by the United States Department of Health and Human Services,
Administration for Children & Families, Office of Child Care. [If a
child is determined to be a citizen of the United States or a qualified alien,
as approved by the New Mexico human services department, the child will be
eligible provided all other eligibility requirements are met regardless of the
citizenship or alien status of the child’s parent or parents.]
F. Age
requirement: Child care benefits are
paid for children between the ages of six weeks up to the day in which the
child turns 13 years old. Eligibility determinations made prior to a
child turning 13 years old may be granted a 12-month eligibility period or a
lesser period of time as determined by the department for [CPS or]
at-risk child care.
G. Special
supervision: Children between the ages
of 13 and 18 who are under the supervision of a court of law, or who are
determined by a medical or treatment professional to require supervision.
H. Children enrolled in head start,
kindergarten, school or other programs:
Child care benefits are not paid during the hours that children are
attending head start, kindergarten, New Mexico pre-K, school or other programs.
[G. Failure
to use authorized child care: If
authorized child care has not been used for five consecutive scheduled days
without a reason such as illness, sudden death, or family medical emergency,
payment may discontinue to the provider and the client will remain eligible for
the remainder of their eligibility period.
The provider or the client shall notify the department within three
business days after the fifth day of non-attendance. Upon receiving notice from the provider or
the client within the prescribed timeframe, the department shall issue a notice
to the client stating when the client’s placement will be closed and shall
simultaneously issue a notice to the provider stating when the last date of
payment will be made. Providers shall be
paid through the 14th day following the first day of nonattendance provided
that the department was notified within the timeframe prescribed above. If the department is not notified within the
prescribed timeframe, the provider shall be paid through the last date of
attendance.]
[H. Change
in Provider: If the parent or guardian
changes providers, the provider shall be paid through the 14th day following
the first day of nonattendance provided that the department was notified within
the timeframe prescribed. If the
department is not notified within the prescribed timeframe, the provider shall
be paid through the last date of attendance.]
I. Work/education
requirement: Child care benefits are
paid only for families who are working, attending school or participating in a
job training or educational program and who demonstrate a need for care during
one or more of these activities. Clients
who are receiving TANF are required to participate in a TANF-approved activity
unless they are exempt by TANF. Clients
and caseworkers shall negotiate a reasonable amount of study and travel time
during the application or recertification process. [Child care will not be paid during the
hours in which a parent or guardian is attending graduate or post-graduate
courses. Child care benefits for clients
who are preparing for the acquisition of a GED shall be limited to one year.] The department may, in its discretion,
exempt a client or applicant from any eligibility requirement upon submission
of a demonstration of incapacity.
[J. Periods
of absences: A household member may be
absent from the home and will be considered as living in the home and be
counted in the household composition as long as the absent household member
plans to return to the home. Any parent
or guardian who remains in the home must be working, attending school, or
participating in a job training or educational program. Temporary absence may include, but are not
limited to, attending school, working, training, or military service.]
[K. Special supervision:
Child care benefits may be provided to children between the ages of 13
and 18 who are under the supervision of a court of law, or who are determined
by a medical professional to require supervision because of a diagnosis of a
physical, emotional, or neurobiological impairment, under
an IEP or who are physically or mentally
incapable of caring for themselves.
Children with special needs are prioritized relative to budget
availability.]
[L. Children
enrolled in head start, kindergarten, school or other programs: Child care benefits are not paid during the
hours that children are attending head start, kindergarten, New Mexico pre-K,
school or other programs.]
[8.15.2.11
NMAC - Rp, 8.15.2.11 NMAC, 10/1/2016, A/E, 9/18/2020]
8.15.2.12 RECERTIFICATION: Clients must
recertify for services at the end of their eligibility period by complying with
all requirements of initial certification.
Clients who recertify will qualify at or below two hundred fifty percent
of the federal poverty level. If
recertification is not completed in a timely manner, the case may be closed on
the last day of the month for which assistance is provided under the previous child
care placement agreement. At time of
recertification, clients must provide [proof] documentation of
income, or proof of school enrollment.
Changes in income, household size, employment, training or educational
status are noted in the client’s record.
Co-payment, if applicable, is re-determined at the time of
recertification. A 12-month
certification period will be granted in accordance with eligibility
requirements outlined in Subsection B. of 8.15.2.11 NMAC.
[8.15.2.12
NMAC - Rp, 8.15.2.12 NMAC, 10/1/2016; A, 10/1/2019, A/E, 9/18/2020]
8.15.2.13 CLIENT RESPONSIBILITIES:
Clients must abide by the regulations set forth by the department and
utilize child care assistance benefits only while they are working, attending
school or participating in a training or educational program.
A. Co-payments: Co-payments are paid by all clients receiving
child care assistance benefits, except for [CPS child care,] at-risk
child care[,] and qualified grandparents or legal guardians. [as
defined in Paragraph (2) of Subsection
C of 8.15.2.11 NMAC]. [In the
case of a public health emergency, the department secretary may waive
co-payments for families receiving child care.
The department will pay providers the client’s approved rate, to include
required co-payments, during the time of the public health emergency.] Co-payments are determined by income and
household size. The co-payment schedule
is published yearly at [https://cyfd.org/child-care-services] https://www.nmececd.org/child-care-assistance/.
In the case of an emergency, or under extenuating circumstances, the
department secretary may waive co-payments for families receiving child care,
during which period, the department will pay providers the client’s approved
rate, including required co-payments.
B. Co-payments
described in Subsection A of 8.15.2.13 NMAC, are used for determining the base
co-payment for the first eligible child.
The formula for [calculating] determining the co-payment amount
based on the co-payment schedule for the first full time child is (low end
of the monthly income bracket on the co-payment schedule ÷ 200 percent of
annual federal poverty level for household size) X (low end of the monthly
income bracket on the co-payment schedule) X 1.1 = monthly copayment for first
full time child. Base co-payments for
each additional child are determined at one half of the co-payment for the
previous child.
(1) The
first child is identified as the child requiring the most hours of child care.
(2) Each
additional child will be ranked based on the most number of hours needed for
child care to the least number of hours needed for child care.
C. Each child’s
co-payment will be adjusted based on the units of services described in
Subsection E of 8.15.2.17 NMAC, as follows:
(1) full
time care will be based on one hundred percent of the base co-payment;
(2) part
time 1 care will be based on seventy-five percent of the base co-payment;
(3) part
time 2 care will be based on fifty percent of the base co-payment; and
(4) part
time 3 care will be based on twenty-five percent of the base co-payment.
D. Clients pay
co-payments directly to their child care provider and must remain current in
their payments. A client who does not
pay co-payments may be subject to sanctions.
E. The co-payment
for a child shall not exceed the monthly provider reimbursement rate. If this situation arises, the co-payment may
be reduced in the amount by which it exceeds the monthly provider reimbursement
rate.
F. In-home
providers: Parents or legal guardians who choose to use an in-home provider become the
employer of the child care provider and must comply with all federal and state
requirements related to employers, such as the payment of all federal and state
employment taxes and the provision of wage information. Any parent or
legal guardian who
chooses to employ an in-home provider releases and holds the department
harmless from any and all actions resulting from their status as an
employer. Payments for in-home provider
care are made directly to the parent or legal guardian.
G. Notification of
changes: [Clients must notify the
department of changes that affect the need for care, which include but are not
limited to any non-temporary change in activity, or household members moving in
or out, within five business days of the change. Clients who do not comply with this
requirement may be sanctioned.] Clients must provide notification of
changes via fax, e-mail, or telephone that affect the need for care to their
local child care assistance office.
(1) A client must notify the
department of any non-temporary change in activity or changes to household
composition. Notifications must be
provided within 14 calendar days of the change.
(2) A client who changes a provider
must notify the department and the current provider 14 calendar
days prior to the expected last day of enrollment. If this requirement for notification is met
by the client, the current provider will be paid through the 14th
calendar day. If this notification
requirement is not met, the current provider will be paid 14 calendar days from
the last date of nonattendance. The
child care placement agreement with the new provider shall become effective
when payment to the previous provider ceases.
The client will be responsible for payment to the new provider beginning
on the start date at the new provider and until the final date of payment to
the former provider.
(3)
If the client has not used
the authorized provider for 14 consecutive calendar days, the child will be
disenrolled from that provider and the client will remain eligible for the
remainder of their eligibility period.
(4) Clients who do not comply with
this requirement may be sanctioned.
[H. Required
application with New Mexico human services department’s child support
enforcement division (CSED):
(1) When
one or both of the child’s parents are absent from the home, the client shall
apply for child support though CSED within 12 months of initial application with the child care assistance
program.
(2) The
following exceptions include but are not limited to: the client is receiving TANF; the client is
already receiving child support; the client is receiving financial support,
including but not limited to housing, clothing, food, transportation and funds,
from the non-resident parent; there is a joint custody agreement and neither
parent is ordered to pay support; parental rights have been terminated; the
parent is a foster parent to the child; the parent is an adoptive parent and provides proof of a
single parent adoption; at-risk child care; a parent is temporarily out of the
home and is still considered part of the household; the client is a teen
parent; the client is a grandparent; guardian; parent is deceased or when good cause exists.
(3) Good
cause for refusal to apply may be granted when such application is not in the
best interest of the child or parent, including but not limited to the
following circumstances:
(a) there
is possible physical or emotional harm to the child, parent or guardian;
(b) the
child was conceived as a result of incest or rape;
(c) legal
proceedings for adoption of the child are pending before a court; or
(d) the
client is currently being assisted by a public or licensed private social
agency to resolve the issue of whether to keep the child or relinquish the
child for adoption.
(4) The
applicant or recipient who makes a claim for good cause shall supply written
documentation to establish the claim.
The caseworker shall not deny, delay, or discontinue subsidized child
care benefits pending a determination of good cause if the applicant or
recipient has complied with the requirements to furnish information.
(5) If
the client is not exempted from applying with CSED and has not applied within
the required timeframe, the client’s case will be closed.]
[8.15.2.13
NMAC - Rp, 8.15.2.13 NMAC, 10/1/2016; A, 10/1/2019; A/E, 03/16/2020; A,
8/11/2020, A/E, 9/18/2020]
8.15.2.14 CASE SUSPENSIONS AND CLOSURES:
A. A case may be suspended by the client if child care benefits
are not being utilized for a period not to exceed three months with payment
being discontinued to the provider. The
client will remain eligible for child care assistance through the remainder of
their eligibility period.
B. If the client
experiences a non-temporary change of activity including the loss of
employment, no longer attending school, or no longer participating in a job
training or education program, the client will be granted a three-month grace
period in which the client will remain eligible. This three-month grace period is for the
purpose of giving the client an opportunity to secure new employment or another
approved activity. The three-month grace
period will start on the date of required notification for the non-temporary
change of activity pursuant to section 8.15.2.13 G NMAC.
C. A case will be
closed if the following conditions apply:
(1) any
non-temporary change in activity and failure to obtain an activity after the
three-month grace period;
(2) income in excess
of two hundred and fifty percent federal poverty level [or
eighty-five percent state median income, whichever is greater];
(3) moving out of
state;
(4) failing to
recertify at the end of approved eligibility period;
(5) at the option of
the client;
(6) being disqualified from participation in the program; or
(7) failure to use
authorized child care.
[8.15.2.14
NMAC - Rp, 8.15.2.14 NMAC, 10/1/2016]
8.15.2.15 PROVIDER REQUIREMENTS:
Child care providers must abide
by all department regulations. Child
care provided for recreational or other purposes, or at times other than those
outlined in the child care placement agreement, are paid for by the
client.
A. All child care
providers who receive child care assistance reimbursements are required to be
licensed or registered by the department and meet and maintain compliance with
the appropriate licensing and registration regulations in order to receive
payment for child care services.
Beginning July 1, 2012, child care programs holding a 1-star license are
not eligible for child care assistance subsidies. The department honors properly issued military
child care licenses to providers located on military bases and tribal child
care licenses properly issued to providers located on tribal lands.
B. Signed child care placement
agreements (including electronically signed child care placement agreements)
must be returned by hand delivery, mail, email, fax, or electronic submission
to the local child care office within 30 calendar days of issuance. Failure to comply may affect payment for
services and the child care placement agreement will be closed. The department will provide reasonable
accommodations to allow a client or provider to meet this requirement.
[B.] C. Child care providers collect required
co-payments from clients and provide child care according to the terms outlined
in the child care placement agreement.
[C.] D. [Child care providers must notify the
department within three business days after the fifth day of non-attendance if
the child is disenrolled or is absent for five consecutive scheduled days. Providers who do not comply with this
requirement are sanctioned and may be subject to recoupment or disallowance of
payments as provided by Subsection G of 8.15.2.11 NMAC] Notification of
changes: Child care providers must
notify the department if a child is disenrolled or child care has not been used
for 14 consecutive calendar days without notice from the client.
(1) If the above notification was met,
the provider will be paid through the 14th calendar day
following
the first date of nonattendance.
(2) If a provider does not notify the
department of disenrollment or of non-use for 14 consecutive
calendar days, the provider will be paid through the last date of attendance.
(3) If a child was withdrawn from a
provider because the health, safety, or welfare of the child was at risk, as
determined by a substantiated compliant against the child care provider,
payment to the former provider will be made through the last day that care was
provided.
(4) Providers who do not comply with this
requirement are sanctioned and may be subject to recoupment or disallowance of
payments as provided in 8.15.2.21 NMAC.
[D.] E. Child care providers accept the rate the
department pays for child care and are not allowed to charge families receiving
child care assistance above the department rate for the hours listed on the child
care placement agreement. Failure to
comply with this requirement may result in sanctions [or suspension of the
child care assistance agreement].
(1) Providers
are not allowed to charge clients a registration/educational fee for any child
who is receiving child care assistance benefits as listed under 8.15.2 NMAC. The department shall pay a five dollar
monthly, not to exceed sixty dollars per year, registration/educational fee per
child in full time care, on behalf of department clients under 8.15.2 NMAC. Adjustments to the five dollar
registration/educational fee will be made based on units of care.
(2) In
situations where an incidental cost may occur such as field trips, special
lunches or other similar situations, the child care provider is allowed to
charge the child care assistance family the additional cost, provided the cost
does not exceed that charged to private pay families.
(3) Child
care providers are allowed to charge child care assistance families the
applicable gross receipts tax for the sum of the child care assistance benefit
and co-payment.
[E.] F. Under emergency circumstances, when CYFD
has reason to believe that the health, safety or welfare of a child is at risk,
the department may immediately suspend or terminate assistance payments to a
licensed or registered provider. The child care resource and referral will assists clients
with choosing another CYFD approved provider.
[F.] G. Providers who are found to have engaged in
fraud relating to any state or federal programs, or who have pending charges
for or convictions of any criminal charge related to financial practices will
not be eligible to participate in the subsidy program.
[8.15.2.15
NMAC - Rp, 8.15.2.15 NMAC, 10/1/2016; A, 10/1/2019]
8.15.2.16 DEPARTMENT RESPONSIBILITIES:
[A. The
department will initiate mid-certification communication with the client to
provide outreach and consumer education with a case management approach and
coordination of services to support families.]
[B.] A. The
department pays child care providers who provide child care services to
department clients in a timely manner.
[C.] B. Child care assistance workers perform all
casework functions in a timely manner, including the processing of payments and
notifications of case actions.
[D.] C. Child care assistance workers will perform
all eligibility and recertification determinations within 10 working days upon
receipt of all required documentation from the client.
[E.] D. Child care assistance workers notify clients
and providers in writing of all actions, which affect services, benefits, or
provider payments or status, citing the applicable policy.
[F.] E. Child care assistance workers determine
eligibility for all child care assistance programs except for TANF. Eligibility for TANF is determined by the New
Mexico human services department.
[G.] F. Child care assistance workers must inform
parents or legal guardians of their right to choose their child
care providers and provide information on how to look for quality child care in
a provider.
[H.] G. The
department and other organizations approved by the department provide
information and orientation programs regarding child care assistance benefits,
quality child care issues, and the impact of child care on the child’s
physical, mental, social and emotional development to parents or legal guardians and providers.
[I.] H. The department and other organizations
approved by the department offers provider education programs consisting of
training on program participation requirements, parent or legal guardian and provider responsibilities, licensing and
registration requirements, payment issuance and background check processing,
the competency areas for child care providers as outlined by the office of
child development, or the department, the importance of providing quality child
care, and other topics of interest to parents or
legal guardians and
providers. These education programs
count toward the continuing education hours required of providers by
registration and licensing regulations.
[8.15.2.16
NMAC - Rp, 8.15.2.16 NMAC, 10/1/2016, A/E, 9/18/2020]
8.15.2.17 PAYMENT FOR SERVICES:
The department pays child care providers on a monthly basis, according
to standard practice for the child care industry. Payment is based upon the child’s enrollment
with the provider as reflected in the child care placement agreement, rather
than daily attendance. As a result, most
placements reflect a month of service provision and are paid on this
basis. However, placements may be closed
at any time during the month. A
signed child care placement agreement must be returned to the department for
payment to be issued to the provider.
The following [describes] circumstances under which the
department may close placements or discontinue payment [when
placements may be closed and payment discontinued] at a time other than the
end of the month:
A. When the child
care placement agreement expires during the month, or when the provider
requests that the client change providers or the provider discontinues
services; payment will be made through the last day that care is provided.
B. [Upon a
change of provider the client and former provider have three days after the
fifth day of nonattendance to notify the department. If this requirement for notification was met,
the provider will be paid through the 14th day following the first date of
nonattendance. If notification
requirement is not met, the provider will be paid through the last date of
attendance. The agreement with the new
provider shall become effective when payment to the previous provider ceases.
If the client notifies the department of the change in providers fewer than 14
days before the change will take place or after the change has taken place, the
client is responsible for payment to the new provider beginning on the start
date at the new provider and continuing up until the final date of payment to
the former provider, as described above.
Payment to the former provider will be made through the last day that
care is provided if the child is withdrawn from the provider because the
health, safety or welfare of the child is at risk, as determined by a
substantiated complaint against the child care facility.] Payment for notification of changes:
(1) If a client fails to notify the
department within 14 calendar days of their expected last day
of enrollment,
the department will pay the provider 14 calendar days from the last day of
nonattendance. The child care placement
agreement with the new provider shall become effective when payment to the
previous provider ceases.
(2) If the provider notifies the
department of a child who is disenrolled or child care has
not
been used for 14 consecutive calendar days, the provider will be paid through
the 14th calendar day following the last day of attendance.
(3) If a provider does not notify the
department of disenrollment or of nonattendance
for
14 consecutive calendar days, the provider will be paid through the last date
of attendance.
(4) If a child was withdrawn from a
provider because the health, safety, or welfare of the
child
was at risk, as determined by a substantiated compliant against the child care
provider, payment to the former provider will be made through the last day that
care was provided.
C. The department
shall pay a five dollar monthly, not to exceed sixty dollars per year,
registration/educational fee per child in full time care, on behalf of
department clients under 8.15.2 NMAC. Adjustments
to the five dollar registration/educational fee will be made based on units of
care. The registration/educational fee
will discontinue when a placement closes as a result of a client changing providers,
a provider discontinuing services, a child care placement agreement expiring,
or a provider’s license being suspended or expiring.
D. The amount of
the payment is based upon the age of the child and average number of hours per week needed per child during the
certification period. The number of
hours of care needed is determined with the parent or legal guardian at
the time of certification and is reflected in the provider agreement. Providers are paid according to the units of
service needed which are reflected in the child care placement agreement
covering the certification period.
E. The department
pays for care based upon the following units of service:
|
Full time |
Part time 1 |
Part time 2
(only for split custody or in cases where a child may have two providers) |
Part time 3 |
|
Care
provided for an average of 30 or more hours per week per month |
Care
provided for an average of 8-29 hours
per week per month |
Care
provided for an average of 8-19 hours per week per month |
Care
provided for an average of 7 or less hours per week per month |
|
Pay at 100%
of full time rate |
Pay at 75 %
of full time rate |
Pay at 50 %
of full time rate |
Pay at 25%
of full time rate |
F. Hours of care
shall be rounded to the nearest whole number.
G. Monthly
reimbursement rates:
|
Licensed
child care centers |
|||
|
Infant |
Toddler |
Pre-school |
School-age |
|
$720.64 |
$589.55 |
$490.61 |
$436.27 |
|
Licensed
group homes (capacity: 7-12) |
|||
|
Infant |
Toddler |
Pre-school |
School-age |
|
$586.07 |
$487.11 |
$427.13 |
$422.74 |
|
Licensed
family homes (capacity: 6 or less) |
|||
|
Infant |
Toddler |
Pre-school |
School-age |
|
$566.98 |
$463.50 |
$411.62 |
$406.83 |
|
Registered
homes, [ |
|||
|
Infant |
Toddler |
Pre-school |
School-age |
|
$289.89 |
$274.56 |
$251.68 |
$251.68 |
H. The department
pays a differential rate according to the license or registration status of the
provider, national accreditation status of the provider if applicable, and star
level status of the provider if applicable.
In
the case of a public health emergency, the department secretary may approve a
differential rate be paid to licensed providers.
I. Providers
holding and maintaining CYFD approved national accreditation status will
receive the differential rate listed in Subsection I below, per child per month
for full time care above the base rate for type of child care (licensed center,
group home or family home) and age of child.
All providers who maintain CYFD approved national accreditation status
will be paid at the accredited rates for the appropriate age group and type of
care. In order to continue at this
accredited reimbursement rate, a provider holding national accreditation status
must meet and maintain licensing standards and maintain national accreditation
status without a lapse. If a provider
holding national accreditation status fails to maintain these requirements,
this will result in the provider reimbursement reverting to a lower level of
reimbursement.
(1) Providers
who receive national accreditation on or before December 31, 2014 from an
accrediting body that is no longer approved by CYFD will no longer have
national accreditation status, but will remain eligible to receive an
additional $150 per child per month for full time care above the base rate for
type of child care (licensed center, group home or family home) and age of
child until December 31, 2017.
(a) In
order to continue at this reimbursement rate until December 31, 2017 a provider
holding accreditation from accrediting bodies no longer approved by CYFD must
maintain licensing standards and maintain accreditation without a lapse.
(b) If
the provider fails to maintain their accreditation, the provider reimbursement
will revert to the base reimbursement rate unless they have achieved a FOCUS
star level or regain national accreditation status approved by CYFD.
(2) The
licensee shall notify the licensing authority within 48 hours of any adverse
action by the national accreditation body against the licensee’s national
accreditation status, including but not limited to expiration, suspension,
termination, revocation, denial, nonrenewal, lapse or other action that could
affect its national accreditation status. All providers are required to notify the
department immediately when a change in accreditation status occurs.
J. The department
will pay a differential rate per child per month for full time care above the
base reimbursement rate to providers achieving higher Star levels by meeting
FOCUS essential elements of quality as follows:
|
2+ Star
FOCUS Child Care Centers, Licensed
Family and Group Homes |
|||||
|
Infant |
Toddler |
Pre-school |
School-age |
||
|
$88.00 |
$88.00 |
$88.00 |
$88.00 |
||
|
3 Star FOCUS
Child Care Centers, Licensed
Family and Group Homes |
|||||
|
Infant |
Toddler |
Pre-school |
School-age |
||
|
$100.00 |
$100.00 |
$100.00 |
$100.00 |
||
|
4 Star FOCUS Licensed Family and
Group Homes |
|||||
|
Infant |
Toddler |
Pre-school |
School-age |
||
|
$180.00 |
$180.00 |
$180.00 |
$180.00 |
||
|
5 Star FOCUS or CYFD approved
national accreditation Licensed Family and Group Homes |
|||||
|
Infant |
Toddler |
Pre-school |
School-age |
||
|
$250.00 |
$250.00 |
$250.00 |
$250.00 |
||
|
4 Star FOCUS Child Care Centers |
|||||
|
Infant |
Toddler |
Pre-school |
School-age |
||
|
$280.00 |
$280.00 |
$250.00 |
$180.00 |
||
|
5 Star FOCUS
or CYFD approved national accreditation Child Care Centers |
|||||
|
Infant |
Toddler |
Pre-school |
School-age |
||
|
$550.00 |
$550.00 |
$350.00 |
$250.00 |
||
K. In order to
continue at the FOCUS reimbursement rates, a provider must meet and maintain
the most recent FOCUS eligibility requirements and star level criteria. If the provider fails to meet the FOCUS
eligibility requirements and star level criteria the provider reimbursement
will revert to the FOCUS criteria level demonstrated.
L. Differential
rates determined by achieving higher star levels determined by AIM HIGH
essential elements of quality will be discontinued effective December 31,
2017. The department will pay a
differential rate to providers achieving higher star levels determined by the
AIM HIGH essential elements of quality until December 31, 2017 as follows: 3-Star at $88.00 per month per child for full
time care above the base reimbursement rate; 4-Star at $122.50 per month per
child for full time care above the base reimbursement rate, and 5-Star at
$150.00 per child per month for full time care above the base reimbursement
rate. In order to continue at these
reimbursement rates, a provider must maintain and meet most recent AIM HIGH
star criteria and basic licensing requirements. If the provider fails to meet the
requirements, this will result in the provider reimbursement reverting to the
base reimbursement rate.
M. The department
pays a differential rate equivalent to five percent, ten percent or fifteen
percent of the applicable full-time/part-time rate to providers who provide
care during non-traditional hours. Non-traditional
care will be paid according to the following charts:
|
|
1-10 hrs/wk |
11-20 hrs/wk |
21 or more hrs/wk |
|
After hours |
5% |
10% |
15% |
|
|
1-10 hrs/wk |
11-20 hrs/wk |
21 or more hrs/wk |
|
Weekend
hours |
5% |
10% |
15% |
N. If a significant
change occurs in the client’s circumstances, (see Subsection G of 8.15.2.13
NMAC) the child care placement agreement may be modified and the rate of
payment is adjusted. The department
monitors attendance and reviews the placement at the end of the certification
period when the child is re-certified.
O. The department
may conduct provider, [or] parent, or legal guardian,
audits to assess that the approved service units are consistent with
usage. Providers found to be defrauding
the department are sanctioned. Providers
must provide all relevant information requested by the department during an
audit.
P. Payments are
made to the provider for the period covered in the child care placement
agreement or based on the availability of funds.
[8.15.2.17 NMAC - Rp, 8.15.2.17
NMAC, 10/1/2016; A, 10/1/2019, A/E, 03/16/2020; A, 8/11/2020]
8.15.2.18 UNDER PAYMENTS:
If a client or provider is underpaid for child care services, the
department may issue a one-time payment within 15 calendar days of the
department’s knowledge or receipt of notification. Notification of the department by the client
or provider must occur within [90 calendar days] three months of
the occurrence of alleged underpayment.
[8.15.2.18 NMAC - Rp, 8.15.2.18 NMAC, 10/1/2016]
8.15.2.19 OVER PAYMENT AND RECOUPMENT:
If a provider receives payment for services for which he/she is not entitled,
or a client receives benefits on behalf of their child for which he/she is not
entitled, and this results in an overpayment, the child care worker will
initiate recoupment procedures unless the early childhood services director
deems otherwise in exceptional circumstances.
Recoupments will only be sought from providers. The department will
not seek a recoupment from a client unless substantiated fraud by that client
has been determined. The client or
provider must repay the amount of the overpayment to the department within 30
calendar days of notification, unless the department determines that the amount
is so large that it cannot be paid in one lump sum. In this case, the department may allow the
client or provider to repay the amount over a payment period, negotiated
between the client and the department, usually not to exceed four months. Failure to pay the overpayment within 30 days
of the notice or failure to make regular payments under an agreed upon payment
schedule may result in sanctions including termination of benefits or referral
of the account to a collection agency or legal action.
[8.15.2.19
NMAC - Rp, 8.15.2.19 NMAC, 10/1/2016, A/E, 9/18/2020]
8.15.2.20 FRAUD: The purposeful
misrepresentation of facts relating to eligibility for benefits, or knowingly
omitting information that affects eligibility is fraud and appropriate
sanctions, including recoupment, termination of benefits, and referral to law
enforcement, are initiated by the department.
Fraudulent cases are reported to the department, which will take such
action as is deemed necessary. The case
remains open at the same rate of benefits until the investigation is concluded
and disposition is determined. In
cases where substantiated fraud has been determined, the department may
disqualify a client or provider until their debt has been paid in full.
[8.15.2.20
NMAC - Rp, 8.15.2.20 NMAC, 10/1/2016]
8.15.2.21 SANCTIONS: [If a client
or provider fails to meet programmatic requirements that affect benefits and
result in an overpayment, sanctions] Sanctions may be imposed
according to the severity of the infraction as determined by the department [and]
as detailed below.
A. Providers or
clients who fail to make timely payments in the case of recoupment of
overpayments may be referred to a collection agency.
B. [Providers]
The department may initiate the recoupment process against any provider
who fail to report in a timely manner that a child [is not] has not
been in attendance for [five] 14 consecutive calendar days
[, scheduled days will have the payment recoupment process initiated].
C. Providers who
allow their registration or license to lapse without renewal will not be paid
during the periods for which the license or registration is not current. Providers who lose national accreditation
status or lose eligibility for payment at any level of reimbursement for
failure to maintain the standards required to be paid at that level of
reimbursement, will not be paid at that level of reimbursement beginning with
the first day of the month during which the loss of accreditation or
eligibility occurred. Payment recoupment
will be sought for any period for which excessive benefits have been paid.
D. Clients who fail
to notify the department of any non-temporary change of activity may be placed
on conditional eligibility status up to one year on the following eligibility
period. Any further violations within
the conditional eligibility period may result in termination.
E. Clients who fail
to pay co-payments may be disqualified until the co-payment is paid or until an
agreement is made between the client and the provider to bring the co-payment
current. [The department assists the
provider in collecting the co-payment only if the co-payment has been in
arrears 30 calendar days or less.]
[8.15.2.21
NMAC - Rp, 8.15.2.21 NMAC, 10/01/2016]