Child Care Chapter 16: Child Care Eligibility, Fraud & Overpayments
5101:2-16-44 Provider Agreement for Payment of Publicly Funded Child Care
Effective Date: December 16, 2018
Most Current Prior Effective Date: July 9, 2017

(A)The Ohio department of job and family services (ODJFS) shall pay eligible child care providers for publicly funded child care services provided to eligible caretakers.

(B)Providers are eligible for payment after they complete the provider agreement with ODJFS and have entered all required information in the provider portal. These required documents are located at: http://jfs.ohio.gov/cdc/CCIDS.stm.

(C)An eligible child care provider who provides child care services for a caretaker who is potentially eligible for publicly funded child care benefits shall be paid for child care services provided during the authorization period created by the county agency.

(D)A child care provider shall collect an identified copayment pursuant to paragraphs (G) and (H) of rule 5101:2-16-39 of the Administrative Code. If a provider fails to inform the county agency of the delinquent copayment in accordance with paragraph (H) of rule 5101:2-16-39 of the Administrative Code, the caretaker shall be responsible for any delinquent copayments reported by the provider for the previous three weeks from the date the county agency was notified.

(E)For caretakers who have applied or have been determined eligible for publicly funded child care, child care providers shall utilize the automated child care system to track attendance data in accordance with procedures outlined by ODJFS.

(E)(F)  A child care provider shall submit all data for the calculation of payments in accordance with instructions provided in the provider portal by ODJFS.

(1)Attendance data shall be submitted for payment after the close of the service week and no later than four weeks from the last day of the service week or four weeks from the last day of the week the authorization is provided to the automated system, whichever is later.

(2)Only complete data (days with both an in and out time for the child receiving care) may be submitted.

(3)Changes to attendance data shall be submitted with caretaker approval.

(4)The provider may track attendance or make changes to attendance data in the automated child care system without caretaker approval if all of the following apply:

(a)There has been a loss of contact with the caretaker for five consecutive calendar days from the last day of attendance;

(b)The provider has notified the county agency of the loss of contact; and

(c)The authorization to the provider has been ended.

(d)The new or changed attendance is limited to no more than five consecutive days.

(5)Once attendance has been submitted, the provider has until the following Saturday to recall the submitted attendance in order to make a change to the attendance data. Any changes made shall require caretaker approval pursuant to paragraphs (F)(3) and (F)(4) of this rule prior to resubmitting the attendance.

(6)ODJFS will begin processing the payment on the Sunday following the submission of the attendance data.

(7)If the attendance has not been submitted pursuant to the timelines in paragraph (F)(1) of this rule, ODJFS shall automatically process any complete attendance data for payment. No new attendance data may be submitted after this date.

(8)ODJFS shall not pay for a child's attendance submitted by more than one provider for the same date and time.

(G)Child care providers shall submit attendance data pursuant to paragraphs (E) and (F) of this rule when notification has been received that a caretaker's application for child care has been denied.

(1)The provider may appeal a denial notice of eligibility for payment after denial within fifteen days from the date of denial if either of the following apply:

(a)Payment was denied due to a caretaker's incomplete application.

(b)Payment was denied because the provider did not have a valid provider agreement when services were provided.

(2)The provider shall not request reimbursement for absent days or professional development days during the period after denial of a caretaker's application.

(H)Payment adjustments after payment has been issued:

(1)The provider shall submit a request for payment adjustment in the automated child care system within four weeks of the payment date. No new attendance may be submitted for payment adjustments.

(2)If the incorrect payment amount is because of a county agency data entry error, the caretaker shall contact the county agency to request correction of the error before the provider submits the request for payment adjustment. ODJFS shall not process the request for payment adjustment until the error is corrected by the county agency.

(F)Child care providers shall utilize the Ohio electronic child care (Ohio ECC) swipe card system in accordance with procedures outlined by ODJFS.

(G)(I)   Child care providers or a person acting in any capacity for the provider shall not possess or use the personal identification information created by the caretaker or a caretaker's designee/sponsor to track attendance in the automated child care system an Ohio child care swipe card.

(J)For services provided prior to the effective date of this rule:

(1)Child care providers shall submit to ODJFS the JFS 01261 "Publicly Funded Child Care Manual Claim for Attendance" (rev. 9/2014) for attendance not recorded in the Ohio electronic child care (Ohio ECC) system for the following reasons:

(a)Authorization made prior to the current back swipe period.

(b)A bureau of state hearings decision.

(c)The point of services (POS) device was not installed when services were provided.

(d)A caretaker is awaiting a swipe card.

(e)A caretaker withdraws without notice.

(2)The child care provider shall submit the JFS 01261 no later than seven weeks from the week of service being submitted unless otherwise determined by ODJFS.

(3)ODJFS shall reject the JFS 01261 for care provided during the back swipe period.

(4)Child care providers shall submit to ODJFS the JFS 01292 "Publicly Funded Child Care Request for Ohio ECC Payment Adjustment" (rev. 07/2017) when a payment has been issued and needs to be corrected no later than seven weeks from the week of service unless otherwise determined by the bureau of state hearings.

(5)Child care providers shall submit to ODJFS the JFS 01211 "Request for Payment of Publicly Funded Child Care Services Provided for a Denial of Application" (9/2014) when notification has been received that a caretaker's application for child care has been denied.

(a)The JFS 01211 shall be submitted by the provider no later than seven weeks from the date of denial of the caretaker's application.

(b)The provider may appeal a denial of the JFS 01211 within fifteen days from the date of denial when:

(i)Payment was denied due to a caretaker's incomplete application.

(ii)Payment was denied because the provider did not have a valid provider agreement when services were provided.

(c)The provider shall not request reimbursement for absent days during the reimbursement period after denial of a caretaker's application.

(H)Child care providers shall submit to the county agency the JFS 01261 "Publicly Funded Child Care Manual Claim for Attendance" (rev. 9/2014) for attendance not recorded in the Ohio ECC system for the following reasons:

(1)Authorization made prior to the current back swipe period.

(2)A bureau of state hearings decision.

(3)The point of services (POS) device is not installed.

(4)A caretaker is awaiting a swipe card.

(5)A caretaker withdraws without notice.

(I)The child care provider shall submit the JFS 01261 no later than seven weeks from the week of service being submitted unless otherwise determined by the ODJFS.

(J)The county agency shall reject the JFS 01261 for care provided during the current back swipe period.

(K)Child care providers shall submit to the county agency the JFS 01292 "Publicly Funded Child Care Request for Ohio ECC Payment Adjustment" (rev. 07/2017) when a payment has been issued and needs to be corrected no later than seven weeks from the week of service unless otherwise determined by the bureau of state hearings.

(L)Child care providers shall submit to the county agency the JFS 01211 "Request for Payment of Publicly Funded Child Care Services Provided for a Denial of Application" (9/2014) when notification has been received that a caretaker's application for child care has been denied.

(1)The JFS 01211 shall be submitted by the provider no later than seven weeks from the date of denial of the caretaker's application.

(2)The provider may appeal a denial of the JFS 01211 within fifteen days from the date of denial when:

(a)Payment was denied due to a caretaker's incomplete application.

(b)Payment was denied because the provider did not have a valid provider agreement when services were provided.

(3)The provider shall not request reimbursement for absent days during the reimbursement period after denial of a caretaker's application.

(M)(K) Payment for publicly funded child care services shall be contingent upon the availability and appropriation of state and federal funds.

(N)(L)  The provider agreement as entered into with ODJFS may be suspended and/or terminated if ODJFS determines misuse of publicly funded child care or Ohio ECCthe automated child care system.

(O)(M) The provider agreement as entered into with ODJFS, may be terminated in accordance with the terms contained in the agreement.

(P)(N) Providers of publicly funded child care with a valid provider agreement shall not be considered employees of ODJFS but shall be considered independent contractors who are responsible for the requirements of self-employment.

(O)The provider shall be responsible for the cost of replacement or repair of the hardware required for use of the automated child care system. Recoupment may occur through payment adjustments.

Effective: 12/16/2018

Five Year Review (FYR) Dates: 5/1/2019

Certification: CERTIFIED ELECTRONICALLY

Date: 12/06/2018

Promulgated Under: 119.03

Statutory Authority: 5104.30, 5104.38

Rule Amplifies: 5104.34, 5104.37, 5104.32

Prior Effective Dates: 07/01/1989 (Emer.), 09/28/1989, 07/01/1990 (Emer.), 09/30/1990, 05/01/1991 (Emer.), 07/29/1991, 11/01/1991 (Emer.), 01/20/1992, 07/06/1992 (Emer.), 10/01/1992, 09/01/1993, 10/01/1997 (Emer.), 12/30/1997, 06/10/2000, 05/12/2002, 07/01/2003, 02/01/2007, 02/01/2008, 07/01/2008, 10/21/2009, 03/28/2010, 06/01/2011, 05/04/2014, 09/14/2014, 08/10/2015, 07/09/2017