Sec. 13a.14.06.11. Payments for Child Care Services

A. Basis of Payment.

(1) A sufficient number of invoice forms will be sent to the provider to cover the necessary service periods of a voucher after the voucher has been returned to the local department.

(2) A child care provider is paid:

(a) According to the weekly service unit rates as set out in §§B-D of this regulation for subsidies and Regulation .10B of this chapter for copayments;

(b) Based on 21.69 days in each month; and

(c) For authorized service units only.

(3) A separate payment rate is established for each of the following seven CCS service regions within the State for family homes and child care centers:

(a) Region U, which comprises Cecil, Queen Anne's, St. Mary's, Talbot, and Washington counties;

(b) Region V, which comprises Caroline, Dorchester, Kent, Somerset, and Wicomico counties;

(c) Region W, which comprises Anne Arundel, Calvert, Carroll, Charles, and Prince George's counties;

(d) Region X, which comprises Howard and Montgomery counties;

(e) Region Y, which comprises Baltimore, Frederick, and Harford counties;

(f) Region Z, which comprises Allegany, Garrett, and Worcester counties; and

(g) Region BC, which is Baltimore City.

B. Rate of Payment and Cost Guidelines - Family Child Care Home.

(1) This section shall apply only to a family child care home that is registered to operate pursuant to COMAR 13A.15.

(2) The amount paid to a family child care provider who cares for a child in the provider's home is the lowest of the:

(a) Regional weekly service unit rates established by this regulation;

(b) Weekly rate charged to the general public by the provider if that rate is comparable and competitive with the going rate in the community; or

(c) Actual cost of care.

(3) The regional weekly service unit rates specified in this subsection are based on three units of service per day. For two-unit and one-unit regional weekly rates, multiply by 2/3 and 1/3, respectively, the following regional weekly rates:

(a) Rate for a child 24 months old or older:

(i) Region U - $93.63;

(ii) Region V - $83.11;

(iii) Region W - $115.97;

(iv) Region X - $147.43;

(v) Region Y - $115.91;

(vi) Region Z - $85.46; and

(vii) Region BC - $106.35; or

(b) Rate for a child younger than 24 months old:

(i) Region U - $123.00;

(ii) Region V - $100.34;

(iii) Region W - $156.71;

(iv) Region X - $184.50;

(v) Region Y - $148.63;

(vi) Region Z - $97.38; and

(vii) Region BC - $141.08.

C. Rate of Payment and Cost Guidelines - Child Care Center and Large Family Child Care Home.

(1) The amount paid to a child care center is the lowest of the:

(a) Regional weekly service unit rates established by this regulation;

(b) Weekly rate charged to the general public by the child care center if that rate is comparable and competitive with the going rate in the community; or

(c) Actual cost of care.

(2) The regional weekly service unit rates specified in this subsection are based on three units of service per day. For two-unit and one-unit regional weekly rates, multiply by 2/3 and 1/3, respectively, the following regional weekly rates:

(a) Rate for a child 24 months old or older:

(i) Region U - $108.24;

(ii) Region V - $91.25;

(iii) Region W - $126.00;

(iv) Region X - $166.95;

(v) Region Y - $128.18;

(vi) Region Z - $87.79; and

(vii) Region BC - $112.16; or

(b) Rate for a child younger than 24 months old:

(i) Region U - $172.42;

(ii) Region V - $146.79;

(iii) Region W - $199.88;

(iv) Region X - $261.38;

(v) Region Y - $208.29;

(vi) Region Z - $112.75; and

(vii) Region BC - $187.79.

D. The informal child care weekly service unit rates specified in this section are based on three units of service per day. For two-unit and one-unit regional weekly rates, multiply by 2/3 and 1/3, respectively, the following jurisdictional weekly rates:

(1) Rate for a child 24 months old or older:

(a) Allegany County - $53.76;

(b) Anne Arundel County - $56.81;

(c) Baltimore County - $60.38;

(d) Calvert County - $56.81;

(e) Caroline County - $41.53;

(f) Carroll County - $56.81;

(g) Cecil County - $53.76;

(h) Charles County - $56.81;

(i) Dorchester County - $41.53;

(j) Frederick County - $60.38;

(k) Garrett County - $54.01;

(l) Harford County - $60.38;

(m) Howard County - $75.92;

(n) Kent County - $41.53;

(o) Montgomery County - $75.92;

(p) Prince George's County - $56.81;

(q) Queen Anne's County - $46.88;

(r) St. Mary's County - $53.76;

(s) Somerset County - $41.53;

(t) Talbot County - $46.88;

(u) Washington County - $54.01;

(v) Wicomico County - $41.53;

(w) Worcester County - $44.07; and

(x) Baltimore City - $54.77; or

(2) Rate for a child younger than 24 months old:

(a) Allegany County - $62.93;

(b) Anne Arundel County - $71.84;

(c) Baltimore County - $71.84;

(d) Calvert County - $71.84;

(e) Caroline County - $46.88;

(f) Carroll County - $73.12;

(g) Cecil County - $55.28;

(h) Charles County - $71.84;

(i) Dorchester County - $46.88;

(j) Frederick County - $71.84;

(k) Garrett County - $62.93;

(l) Harford County - $71.84;

(m) Howard County - $90.95;

(n) Kent County - $46.88;

(o) Montgomery County - $90.95;

(p) Prince George's County - $71.84;

(q) Queen Anne's County - $55.28;

(r) St. Mary's County - $62.93;

(s) Somerset County - $46.88;

(t) Talbot County - $55.28;

(u) Washington County - $55.28;

(v) Wicomico County - $46.88;

(w) Worcester County - $46.88; and

(x) Baltimore City - $69.04.

E. Additional Costs.

(1) A payment rate schedule is established for children attending public or nonpublic elementary or middle schools for the full school day who receive child care services. The payment rate schedule is:

(a) Paid pursuant to the maximum payment rates listed in §§B-D of this regulation;

(b) Valid when authorized child care services are provided:

(i) On a regular basis beyond school hours; and

(ii) When schools are closed during the school year;

(c) Based on a 42-week payment schedule that is calculated by averaging the child's rate for:

(i) 36 weeks of one or two authorized service units per day when school is scheduled to be in session; and

(ii) 6 weeks of three authorized service units per day when school is scheduled to be closed; and

(d) Applied to an uninterrupted 10-week school vacation when:

(i) The vacation period is not included in §F(1)(b)(ii) of this regulation; and

(ii) The care is authorized by the contractor for three units of service a day.

(2) The 52-week payment schedule is established for children attending public or nonpublic elementary or middle schools for the full school day that are open year-round and is calculated by averaging the child's rate for:

(a) 36 weeks of one or two authorized service units per day when school is scheduled to be in session;

(b) 6 weeks of three authorized service units per day when school is scheduled to be closed; and

(c) 10 designated school vacation weeks of three authorized service units per day.

(3) The contractor shall approve additional costs that exceed the payment rates specified in §§B-D of this regulation when child care is provided during nontraditional hours. Nontraditional hours are:

(a) 1 hour or more between 7 p.m. and 6 a.m. on Monday through Friday; and

(b) Any period of 1 hour or more on Saturday or Sunday.

(4) Additional costs above the rates shall be authorized for care provided weekly during nontraditional hours up to:

(a) 5 percent for one unit of care;

(b) 10 percent for two units of care; or

(c) 15 percent for three units of care.

(5) For a child with a disability, the payment rates specified in §§B and C of this regulation apply, except if the service provider offers documentation to the contractor that the cost of caring for the child with a disability exceeds the reasonable accommodation definition.

(6) The State may assist with one-time only or ongoing accommodation costs for materials or personnel if:

(a) The provider submits to the contractor a completed special disability rate request form, supplied by the contractor, that describes the need for the special accommodation; and

(b) The accommodation does not create a significant difficulty or expense.

(7) Upon receipt of a special disability rate request form that meets the requirements of §E(6)(a) of this regulation, the contractor shall:

(a) Approve the additional cost not to exceed the annual allocated amount up to 15 percent above the rates set out in §§B and C of this regulation; or

(b) If the requested cost exceeds 15 percent, submit a recommendation to the CCS Branch for approval of a higher payment not to exceed the annual allocated amount.

F. Payment Policy.

(1) The contractor shall process payment for the provider for CCS Program services through a completed invoice or other means approved by the CCS Branch.

(2) The rate paid to the provider is based on the region in which the:

(a) Child care is given if the provider is a:

(i) Family child care provider; or

(ii) Center child care provider; or

(b) Child resides, if the provider is an informal child care provider.

(3) The subsidy to be paid to a provider by the contractor is computed by subtracting the applicable weekly copayment for each child in the family receiving child care subsidy services, as set forth in Regulation .10B-C of this chapter, from the lowest of the:

(a) Weekly actual cost of care;

(b) Weekly local market rate; or

(c) Weekly applicable maximum provider payment rate set forth in Regulation .09B-D of this chapter.

(4) A provider is paid only for the time authorized by the voucher and may not be paid in excess of that time.

(5) A provider may not be paid for more than:

(a) The maximum full-time equivalent slots authorized for care by the Office of Child Care, Licensing Branch for care that is licensed or registered; or

(b) In accordance with Regulation .11D of this chapter, the amount allowed for informal child care.

(6) Except for vouchers written for less than 5 calendar days in accordance with Regulation .07B(2) of this chapter, and subject to §F(12)(a)(vi) of this regulation, the contractor shall pay for a 5 calendar day termination notification period to a provider of:

(a) Family child care; or

(b) Center child care.

(7) If a voucher signed by the parent and the provider is not received by the contractor within 60 calendar days of issuance, the provider may not be paid:

(a) Without attendance records signed by the provider and parent; or

(b) For the first 60 calendar days of the voucher.

(8) Except that holidays are included in the payment schedule pursuant to §E(1) and (2) of this regulation and not paid separately, family child care providers and center child care providers are paid for six holidays including Christmas, New Year's Day, Memorial Day, Independence Day, Labor Day, and Thanksgiving Day, according to the:

(a) Number of children enrolled in care the day before the holiday; and

(b) Enrollment status of the child during the period in which the holiday falls.

(9) Family child care and center child care providers shall be paid for those days when the services are closed for:

(a) An official emergency that is declared by the State or local government; and

(b) Voluntary closure days, as defined at Regulation .02B of this chapter, when:

(i) Child care services are not provided;

(ii) The period of voluntary closure does not include more than 2 consecutive weeks annually; and

(iii) Except in cases of provider or family illness or death, the provider gives 2 weeks written notice of closure to the parent and the contractor.

(10) Family child care and center child care providers are paid for the time a child is absent up to 60 calendar days per calendar year, except that in the case of illness or injury of the child, documented by a health practitioner, the contractor may authorize additional absences.

(11) Payment may not be made to an informal child care provider for any holiday or for any child absence, except that for eligible customers, payments shall be made fora Christmas Day, New Year’s Day, Memorial Day, Independence Day, Labor Day, or Thanksgiving Day if the provider submits verification of child attendance in care.

(12) Payment, including that for the termination notification period, may not be made to a provider if:

(a) The provider:

(i) Denies parental access to the child;

(ii) Has been identified as responsible for child abuse or neglect, as defined in COMAR 13A.15.01.02B;

(iii) Is the child's parent, stepparent, or legal guardian, or is a member of the child's CCS or TCA assistance unit;

(iv) Fails to give 5 calendar days written notice of service termination to the parent;

(v) Has been disqualified pursuant to Regulation .14M of this chapter and the disqualification period has not ended;

(vi) Has committed an intentional program violation;

(vii) If required to be licensed or registered, is not licensed or registered;

(viii) Has had a child care license or registration suspended or revoked;

(ix) If required to submit an affirmation of compliance with health and safety standards, has not submitted the affirmation;

(x) Has not submitted a signed release of information form consenting to a review of child abuse and neglect records;

(xi) Has not applied for a criminal background check;

(xii) Has a criminal history that includes a conviction, a probation before judgment disposition, a not criminally responsible disposition, or a pending charge for the commission or attempted commission of a crime listed at Regulation .06D(6) of this chapter; or

(b) The contractor has documented information indicating that the provider, a resident in the informal child care home, or the informal child care home itself presents a risk to the health or safety of a child in care.

(13) Stoppage of payment to a provider whose child care license or registration has been suspended or revoked is based on the date of the suspension or revocation notice.

(14) Effective June 29, 2015, payment may not be made to a family child care home or a child care center unless the home or center is participating, or has applied for participation in, Maryland EXCELS and a quality rating has been assigned and published by Maryland EXCELS.

(15) An informal child care provider may not require or request a parent to pay a fee that is in addition to the copayment required by the State.

G. Method of Payment.

(1) State Payment.

(a) The contractor shall pay a provider upon approval of an invoice submitted within 60 calendar days of the end date of the last service period.

(b) The amount of the invoice shall match the authorized service units listed on the voucher.

(c) Payment may not be made for any units in excess of those authorized by the voucher.

(2) Parental Payment.

(a) Parental payment for child care services shall be made directly to the provider at times set by the provider and shall follow the payment policy of the provider.

(b) The parent shall pay the provider the copayment listed on the voucher.

(c) The provider shall give the parent a receipt for the full amount of the parent's payment.

(3) An invoice adjustment may be made within 12 months after the end of the month in which services were provided.

H. Payment Irregularities.

(1) Overpayments are collected from:

(a) Customers when they fail to report a timely change;

(b) Providers when they fail to correctly report information;

(c) A customer or provider who benefits from an erroneous service reimbursement made by the contractor.

(2) Calculation of Overpayments. A provider or a customer overpayment, whether it occurs due to incorrect or incomplete information at application, or to a change in the customer’s or provider’s circumstances that was unreported or reported late, shall:

(a) Be counted from the beginning of the service period; and

(b) Include each subsequent service period in which the incorrect subsidy reimbursement is identified.

(3) The contractor shall calculate the amount of an overpayment to a customer or a provider by determining the:

(a) Correct amount to be paid;

(b) Amount of the incorrect payment; and

(c) Difference between the correct and incorrect payment amounts.

(4) Notification.

(a) In the event of an overpayment to a customer or a provider, the contractor shall notify the recipient of the overpayment within 30 calendar days after the discovery of the overpayment.

(b) If, 30 calendar days after the overpayment notification specified at §H(4)(a) of this regulation was sent, there is no response from the overpayment recipient, the contractor shall promptly send a second overpayment notification to the recipient.

(c) If, 30 calendar days after the second overpayment notification specified at §H(4)(b) of this regulation was sent, there is no response from the overpayment recipient, the contractor shall promptly send a third overpayment notification to the recipient.

(5) Recovery from a customer or a provider of an overpayment amount shall be made by:

(a) Repayment of the full amount by the customer or the provider, as applicable; or

(b) If the overpayment amount was paid to the provider, reduction of continuing child care payments.

(6) If a customer or a provider does not pay the repayment of an overpayment amount as directed by the contractor, the contractor shall request that the State take action to collect that amount.

(7) If an overpayment is recovered incrementally, it shall be recovered at a monthly rate of:

(a) 10 percent of the overpayment for cases not involving fraud; or

(b) 20 percent of the overpayment for cases involving fraud.

(8) The contractor shall promptly correct any underpayment to a recipient or a service provider.