18 Miss. Code. R. 5-1-2.7

Current through December 10, 2024

Section 18-5-1-2.7 - Payment Rates for Child Care Services

The statute at 658E(c)(4) and the regulations at § 98.43(b)(1) require the Lead Agency to establish adequate payment rates for child care services that ensure eligible children equal access to comparable care.

2.7.1 Attach a copy of your payment rates as Attachment 2.7.1.

Will the attached payment rates be used in all parts of the State/Territory?

* Yes. Effective Date: October 2007

[] No. If no, attach other payment rates and their effective date(s) as Attachment 2.7.1a, 2.7.1b, etc.

2.7.2. Which strategies, if any, will the Lead Agency use to ensure the timeliness of payments?

[] Policy on length of time for making payments. Describe length of time___

* Track and monitor the payment process

[] Other. Describe______

[] None

2.7.3. Market Rate Survey

Lead Agencies must complete a local Market Rate Survey (MRS) no earlier than two years prior to the effective date of the Plan (no earlier than October 1, 2011). The MRS must be completed prior to the submission of the CCDF Plan (see Program Instruction CCDF-ACF-PI-2009-02 for more information on the MRS deadline).

a) Provide the month and year when the local Market Rate Survey(s) was completed (§ 98.43(b)(2)): March 2013.

b) Provide a summary of the results of the survey. The summary should include a description of the sample population, data source, the type of methodology used, response rate, description of analyses, and key findings.

The Mississippi State Department of Health (MSDH), Bureau of Licensure and Regulations, periodically provided a list of licensed child care facilities in Mississippi. The most recent populated list indicated 1,640 facilities. A list of family/in-home providers was developed using records from the Nurturing Homes Initiative (NHI) project and other MSU School of Human Sciences resources. A total of 419 family/in-home providers were identified. All 1,640 licensed centers and 419 family/in-home providers were selected for inclusion in the survey. Selected findings are provided below using frequencies, percentages, means and standard deviations. Where appropriate, comparisons are made between licensed centers and family/in-home providers.

CCDF Certificates

Overall, 3,739 licensed and family/in-home centers accept CCDF certificates. Of these 3,739 centers, 1,236 are licensed centers and 2,504 are family/in-home providers. Of the licensed centers, 747 (60.4%) are in Tier 1, 482 (39.0%) are in Tier 2, and seven (0.01%) are Tier 3. Of the family/in-home providers, 2,461 (98.2%) are in Tier 3, and 20 (0.01%) are in each Tiers 1 and 2.

Vacancies

The current MSDH licensed center list indicates there are 35,762 total vacancies of a total maximum capacity of 132,512. The NACCRRAware database shows there are 255 vacancies in family/in-home care facilities.

Weekly and Monthly Childcare Rates

Child care rates reported by licensed centers were generally higher than those reported by family/in-home providers. However, these differences were minimal across all categories of time and age. Rates reported for weekly part-time for children age five to 12 and monthly part-time for two-, three- and four-year-old children were the same for licensed centers and family/in-home providers. The 75^th percentile by center type, time, and age are provided in Table 2.

2.7.4. Describe the payment rate ceilings in relation to the current MRS using the tables below.

Because of the flexibility that Lead Agencies have in setting payment rate ceilings, the following tables have been developed to simplify Lead Agency reporting on how their payment rate ceilings compare to their most recent MRS. These tables are not meant to collect comprehensive payment rate ceilings within a State/Territory and ACF recognizes that Lead Agencies are not required to set their payment rate ceilings at the 75^th percentile. These tables allow Lead Agencies to use a common metric the 75^th percentile as a reference point against which the Lead Agency can report their percentiles for three selected age groups in two geographic areas for licensed child care centers and licensed family child care homes.

In table 2.7.4^a and 2.7.4^b, highest rate area refers to the State or Territory's area or geographic region with the highest maximum payment rate ceiling for child care centers (2.7.4a) and the lowest maximum payment rate ceiling for child care centers (2.7.4b). Identify the highest rate area in the box provided. In column (a), provide the full-time monthly rate at the 75^th percentile from the most recent MRS, even if the most recent MRS is not used to set rates. In column (b), provide the maximum monthly payment rate ceiling from your CCDF payment rate table. Complete column (c) ONLY IF the percentile for the monthly maximum payment rate ceiling is lower than the 75^th percentile of the most recent MRS.

Note - Report the "base" maximum reimbursement rate ceiling, not including any rate add-ons or tiered reimbursements. For example, if maximum reimbursement rate ceilings are tiered based on level of quality (e.g., accreditation, or rating within a quality rating system such as gold, silver and bronze), report the rates for the lowest level in the tables below (e.g., bronze), only if there is no lower "base" rate paid for child care services by providers not participating in the quality rating system.

If your State/Territory has hourly, daily and/or weekly maximum payment rate ceiling, Lead Agencies can use the following assumptions to calculate monthly maximum payment rate ceiling for column (b) 9 hours a day, 5 days per week, 4.33 weeks per month.

OCC recognizes that States and Territories use a wide variety of age ranges and categories in setting payment rate ceilings. In these charts, report rates for the following ages only 11 months, 59 months, and 84 months of age regardless of what that age category may be called in your State/Territory.

2.7.4a Highest Rate Area (Centers)	(a)MonthlyPayment Rateat the 75^thpercentile fromthe most recentMRS	(b)MonthlyMaximumPayment RateCeiling	(c)Percentile iflower than 75^thpercentile ofmost recentsurvey
Full-Time Licensed Center Infants (11 months)	$563	$346	70%
Full-Time Licensed Center Preschool (59 months)	$476	$313	66%
Full-Time Licensed Center School-Age (84 months)	$433	$304	70%

2.7.4b Lowest Rate Area (Centers)	(a)MonthlyPayment Rate atthe 75^thpercentile of themost recentMRS	(b)MonthlyMaximumPayment RateCeiling	(c)Percentile iflower than 75^thpercentile ofmost recentsurvey
Full-Time Licensed Center Infants (11 months)	$368	$346	94%
Full-Time Licensed Center Preschool (59 months)	$325	$313	96%
Full-Time Licensed Center School-Age (84 months)	$217	$304	140%

In table 2.7.4c and 2.7.4d, highest rate area refers to the State or Territory's area or geographic region with the highest maximum payment rate ceiling for family child care homes (2.7.4c) and the lowest maximum payment rate ceiling for family child care homes (2.7.4d). Identify the lowest rate area in the box provided. In column (a), provide the full-time monthly rate at the 75^th percentile from the most recent MRS, even if the most recent MRS is not used to set rates. In column (b), provide the maximum monthly payment rate ceiling from your CCDF payment rate table. Complete column (c) ONLY IF the percentile for the monthly maximum payment rate ceiling is lower than the 75^th percentile of the most recent MRS.

Note - Report the "base" maximum reimbursement rate ceilings, not including any rate add-ons or tiered reimbursement. For example, if maximum reimbursement rate ceilings are tiered based on level of quality (e.g., accreditation, or rating within a quality rating system such as gold, silver and bronze), report the rates for the lowest level in the tables below (e.g., bronze), only if there is no lower "base" rate paid for child care services by providers not participating in the quality rating system.

2.7.4c Highest Rate Area (FCC)	(a)Monthly PaymentRate at the 75^thpercentile of themost recent MRS	(b)MonthlyMaximumPaymentRate Ceiling	(c)Percentile iflower than 75^thpercentile of mostrecent survey
Full-Time Licensed FCC Infants (11 months)	$476	$251	53%
Full-Time Licensed FCC Preschool (59 months)	$325	$227	70%
Full-Time Licensed FCC School-Age (84 months)	$368	$222	60%

2.7.4d Lowest Rate Area (FCC)	(a)Monthly PaymentRate at the 75^thpercentile of themost recent MRS	(b)MonthlyMaximumPaymentRate Ceiling	(c)Percentile iflower than 75^thpercentile ofmost recentsurvey
Full-Time Licensed FCC Infants (11 months)	$238	$251	105%
Full-Time Licensed FCC Preschool (59 months)	$173	$227	131%
Full-Time Licensed FCC School-Age (84 months)	$195	$222	114%

2.7.5. How are payment rate ceilings for license-exempt providers set?

a) Describe how license-exempt center payment rates are set: The Lead Agency makes no distinction between license-exempt centers and those centers that are required to have a license.

b) Describe how license-exempt family child care home payment rates are set: Payment rates for all providers are set based on availability of funding. Consideration is given to raising rates vs. fewer certificates.

c) Describe how license-exempt group family child care home payment rates are set: Payment rates for all providers are set based on availability of funding. Consideration is given to raising rates vs. fewer certificates.

d) Describe how in-home care payment rates are set: Payment rates for all providers are set based on availability of funding. Consideration is given to raising rates vs. fewer certificates.

2.7.6 Will the Lead Agency provide any type of tiered reimbursement or differential rates on top of its base reimbursement rates for providing care for children receiving CCDF subsidies?

Check which types of tiered reimbursement, if any, the Lead Agency has chosen to implement. In the description of any tiered rates or add-ons, indicate the process and basis used for determining the tiered rates and amount and also indicate if the rates were set based on the MRS or another process.

[] Differential rate for nontraditional hours. Describe______

* Differential rate for children with special needs as defined by the State/Territory. Describe Providers are paid higher rates for children with special needs, if a higher rate for care of these children in charged to non-CCDF clients.

[] Differential rate for infants and toddlers. Describe______

[] Differential rate for school-age programs. Describe______

[] Differential rate for higher quality as defined by the State/Territory.

Describe______

[] Other differential rate. Describe______

[] None.

Reminder - CCDF regulations require the Lead Agency to certify that the payment rates for the provision of child care services are sufficient to ensure equal access for eligible families to child care services comparable to those provided to families not eligible to receive CCDF assistance. In the next three questions, Lead Agencies are asked to describe how their payment policies reflect the affordable copayments for families' provision of equal access (i.e., minimizing additional fees to parents), how payment practices are implemented consistent with the general child care market to be fair to providers (see Information Memorandum on Continuity of Care for examples), and the summary of facts describing how payment rates are adequate to ensure equal access to the full range of providers.

2.7.7. What policies does the Lead Agency have regarding any additional fees that providers may charge CCDF parents? The Lead Agency&

* Allows providers to charge the difference between the maximum reimbursement rate and their private pay rate

[] Pays for provider fees (e.g., registration, meals, and supplies). Describe_____

[] Policies vary across region, counties and or geographic areas. Describe_______

[] Other. Describe______

2.7.8 What specific policies and practices does the Lead Agency have regarding the following:

a) Number of absent days allowed. Describe The Lead Agency pays for 15 absence days per program year, per child. Absence days can be used for any reason deemed necessary by the family. The Lead Agency has no policy regarding the maximum number of allowable absences within a program year.

b) Paying based on enrollment. Describe The Lead Agency pays for the care type (full time vs part time) that is assigned to the certificate, even if the child attends fewer hours than is required to determine care type on a given day. School-aged children and children attending Head Start programs are paid full time rates when full time care is needed during holidays, school breaks, and school closings.

c) Paying on the same schedule that providers charge private pay families (e.g., hourly, weekly, monthly). Describe The Lead Agency pays all providers a daily rate, regardless of their established private pay schedule.

d) Using electronic tools (automated billing, direct deposit, EBT cards, etc.) to make provider payments. Describe The Lead agency makes payments twice monthly to providers using a direct deposit system. Providers can elect to have their payments deposited to a pre-paid card instead of a traditional bank account.

2.7.9. Describe how payment rates are adequate to ensure equal access to the full range of providers based on the Market Rate Survey.

CCDF regulations require the Lead Agency to certify that the payment rates for the provision of child care services are sufficient to ensure equal access for eligible families to child care services comparable to those provided to families not eligible to receive CCDF assistance. To demonstrate equal access, the Lead Agency shall provide at a minimum a summary of facts describing: (§ 98.43(a))

a) How a choice of the full range of providers, e.g., child care centers, family child care homes, group child care homes and in-home care, is made available (§ 98.43(a)(1))

The Lead Agency approves a range of care environments including licensed/unlicensed and home/center-based. The approval of the range of care environments allows for parental choice. Parents are provided with a list of providers participating in the subsidy program in a given area upon request.

b) How payment rates are adequate based on the most recent local MRS (§ 98.43(a)(2))

Based on the Mississippi Child Care Market Rate Survey, which supplies information about tuition rates at licensed child care facilities in the state, MDHS DECCD adjusts payment of tier rates accordingly. The Lead Agency makes every effort to balance reimbursement rates with the number of applicants for assistance. Tier rates are evaluated every two years as a result of the Mississippi Child Care Market Rate Survey. In addition, the Mississippi Child Care Quality Step System (MCCQSS) facilitates an increase in the provider's current tier rate based upon steps attained in the MCCQSS. The increase in the tiered reimbursement is referred to as an "On-Going Quality Bonus" and the increase in tiered reimbursement does not have to be passed on to the general public.

c) How family co-payments based on a sliding fee scale are affordable (§ 98.43(a)(3)) Co-payments for families whose income is at or below 50% of the SMI does not exceed 6.5% of the total family income per child. Co-payments for families whose income is between 50 and below 85% of the SMI does not exceed 8% of the total family income per child.

d) Any additional facts the Lead Agency considered to determine that its payment rates ensure equal access, including how the quality of child care providers is taken into account when setting rates and whether any other methodologies (e.g., cost estimation models) are used in setting payment rates

No additional facts.

18 Miss. Code. R. 5-1-2.7