Payments

C.  DETERMINING UNITS OF CARE TO AUTHORIZE TO LICENSED CARE PROVIDERS

clarifying information

1. "Unit of Care" refers to the type of care authorized. This includes "half-day" or "full-day" licensed care.

2. We authorize licensed child care at the full-day or half-day rate based on the best estimate of the number of child care hours the consumer needs. Consider work, school, and training schedules and wage stubs when you estimate the hours.  See Payments - B. - Determining Monthly Hours of Care

3. WCCC allows child care for the actual hours the consumer is working and/or in an approved training course, study time, and travel to and from the work or school site. If a parent works the 'grave-yard' shift and there isn't another parent available to care for the children, allow child care for sleep time for the parent.

4. We require providers to maintain daily attendance records with arrival and departure time of each child in their care. The parent or an authorized person must sign the children in and out of care.

5. Determine the type of unit (half-days or full-days) to authorize, based on the number of hours the child needs care. The types of units are:

   1. 1 - 109 hours per month = half-day care;

   2. 110 - 220 hours per month = full-day care.

6. Half-Day Care:

   1. Authorize 22 half-day units for children who consistently need care five days per week, and the number of hours the child needs per month are below 110.

   2. Authorize a maximum of 30 half-days. Most school-age children in half-day care (before and after school) need 30 half-days to cover school closure days, when they may need full-day care.

   3. The provider may bill an additional half-day to cover one full-day of child care, such as on school closure days.
   4. The provider can bill up to five absent days per month only if you authorized 22 or more half-day units.
   5. Authorize less than 22 half-day units per month for children who consistently need less than 5 days per week and less than 110 hours of care per month.
   6. If a school age child needs less than 22 half-days per month, authorize one extra half-day per week, or up to five additional half-days per month, to allow for school closures/holidays. Authorize the extra half-days on a separate line with a "9" code. Use a separate line so the provider will bill the extra half-days only for days when the child is in care five or more hours. The extra half days cannot be used to claim absent days.

7. School-Age Care:

   School-age children who need care before and after school usually need an authorization for 30 half-days. Authorizing eight extra half-days (22+8=30) allows the provider to bill an extra half-day when the child is in their care for five or more hours per day. If the consumer needs more than 30 half-days each month, use a "9" code to authorize the additional days.

   Use the following guidelines when changing authorizations for school-age children.

   1. Before and after school: Authorize half-day care through the last day of the school year. If the child needs full-day care for the summer months, terminate the half-day authorization and reopen full days when the summer schedule begins.

   2. Summer: If needed, authorize full-day care until the first day of the school year. Once school begins, if the child no longer needs full-days, terminate the full-day authorization and reopen half-days.

   3. When needed, set a tickle as a reminder to change the authorization.

   4. Work expired service lists.

8. Full-Day Care:

   1. The maximum number of full-days you can authorize is 22. For authorizations which require more than 22 full-days of care or 230 monthly hours, see Payments F. - Rate Structure "Special Requirements".

   2. b. When the total monthly hours for licensed care are 110 or more (up to 220) authorize 22 full-days when the actual number of days per week the consumer needs is five or less. The provider can bill up to five absent days per month only if 22 full-days are authorized.

9. Consumers who need care more than 5 days per week:

   If the consumer uses two providers, determine the number of monthly hours for each child care provider separately and authorize following the full-day or half-day rule.

If a consumer uses one provider for all their approved activity days, look at the week as Sunday through Saturday then:

1. Add the hours for the first five days of each week together for one monthly hours total.

2. Add the remaining days of each week for a second monthly total.

3. Authorize each monthly total separately following the full-day or half-day rule.

10. Consumers who use more hours than their schedule allows:

    A consumer's scheduled hours may be less than the maximum WCCC allows under a half- or full-day authorization. Examples of these situations are:

    1. The parent needs child care from 7-11. They need four hours each day. Authorize half-day units. The half-day authorization can cover up to but less than five hours.

    2. The parent needs child care from 8-2. They need six hours of care per day. Authorize full-day units. The full-day authorization can cover up to 10 hours.

    The Department of Early Learning made the following administrative decision: The provider CANNOT charge extra for the hours outside of the actual hours the client needs as long as:

    • The consumer stays within the half- or full-day time frame; and

    • The hours used are within the providers normal operating hours.

    If the client needs care outside of the half or full-day authorization (and the care isn't covered by the State), the provider can charge the consumer for the extra care.