Section He-C 6910.09 - Verification Requirements(a) The name of each member of the assistance group shall be verified by one or more of the following documents: (1) The individual's birth certificate;(2) The individual's marriage certificate;(3) The individual's divorce decree, if the name to be used subsequent to a divorce is changed;(4) The individual's driver's license or other identification which contains a picture of the individual; or(5) If the individual has had a legal name change, the court documentation showing the legal name of the individual and the date the name change took effect.(b) The date and place of birth of each child in the assistance group for which the parent is requesting child care scholarship shall be verified by one or more of the following documents: (1) The child's birth certificate;(2) The child's baptismal certificate; or (3) The child's US passport.(c) When a child was not born in the US but has either become a US citizen or been lawfully admitted to the US, the child's birth record and one or more of the following documents shall be submitted to verify date and place of birth and citizenship status: (1) The child's certificate of citizenship or naturalization; or(2) The following US Citizenship and Immigration Services (USCIS) forms or documentation: a. USCIS Form I-551, Permanent Resident card; b. USCIS Form I-327, Re-entry Permit;c. USCIS Form I-94, Arrival Departure Record, stating that the child has been admitted to the US as a refugee under Section 207(c) of the Immigration and Nationality Act;d. USCIS Form I-94, Arrival Departure Record, stating that the child has been admitted to the US as an asylee under Section 208 of the Immigration and Nationality Act; ore. Documentation from USCIS that the child has lawful temporary or permanent resident status under Section 201 or 302 of the Immigration Reform and Control Act.(d) The relationship of any adult in the assistance group to the child(ren) in the assistance group shall be verified by one or more of the following: (1) The child's birth record containing the name(s) of his or her parent(s);(2) The adult's birth record;(3) A marriage certificate containing the names of the parties who were married, including any maiden or previous names used;(4) Any additional birth or marriage records necessary to show the relationship of the child(ren) to the adult(s) in the assistance group;(5) For a legal guardian, the court documentation indicating the relationship of the adult to the child as that of a legal guardian; or(6) For a caretaker relative, one or more of the following documents: a. A court order giving the caretaker relative the duty of care, custody, and supervision of the child;b. A document showing power of attorney for the child(ren) by the caretaker relative with whom the child(ren) lives; orc. A statement from the child's parent(s) that the caretaker relative is the individual who shall provide care and supervision for the child on his or her behalf.(e) To verify a current address, any of the following verifications which show the address of the family shall be acceptable:(2) If the home is owned, the deed or mortgage receipts;(3) Utility or telephone bills; or(4) A statement from the current landlord.(f) Self-attestation shall be an acceptable form of verification for children of migrant workers who qualify as homeless because they are living in circumstances described in He-C 6910.03(ag).(g) Monthly gross income of each member of the assistance group shall be verified in accordance with He-W 744.01 or He-W 744.03 or as follows: (1) For self-employment, a parent's current profit and loss statement or the entire IRS tax filing from the previous year, as described in He-C 6910.06(d);(2) Any contributions of monies to the assistance group from any source, verified by a statement from the contributor which indicates the amount, frequency, and expected end date of the contribution;(3) For earned income that fluctuates month to month according to He-C 6910.06(g)(1), a pay stub or a written statement from the employer stating the monthly amount earned;(4) For unearned income that fluctuates according to He-C 6910.06(g)(2), a pay stub, a written statement from the contributor, physical documentation, or a collateral contract;(5) For earned income that fluctuates season to season according to He-C 6910.06(g)(3)b, either the previous year's tax return or a statement from the employer; or(6) For income that cannot be verified according to (1)-(5) above, and which is anticipated to fluctuate over the next 12-month period, verification shall consist of a statement from the employer identifying an estimate of future earnings during the upcoming 12-months. (h) The applicant shall attest that the assistance group's resources, including both personal and real property, do not exceed $1,000,000.00 in assets. No member of the assistance group shall have, nor shall the combined assets of the assistance group be, equal to or greater than $1,000,000.00.(i) To establish a link between the child and the child care provider, the parent and the child care provider shall complete and submit to the department Form 1863 "Child Care Provider Verification," (May 2020) with the understanding that: "A license is required when care is given in a private home for more than 3 children, unrelated to the provider at any given time, in addition to my own children;
I cannot be reimbursed for child care scholarship if I reside in the same home as the child that I am caring for and/or if the child has a biological, step, or adoptive relationship to me; and
The department may release child care information to the above-named provider by the Department of Health and Human Services."
(j) The following verification requirements shall apply for a child experiencing a disability or significant special needs requiring additional funds for accommodations or classroom adaption in the child care setting:(1) The parent shall authorize the release of information to DHHS by completing section III of Form 2690 "Verification for a Child Experiencing a Disability or Significant Special Needs," (May 2020), and by signing and dating the form, affirming the following: "By signing below, I authorize this verification to be released to the Department of Health and Human Services. I understand that the information will be held in the strictest confidence and that it will be reviewed by, or shared with, authorized Department of Health and Human Services' staff involved in the authorization of Child Care and Development Fund Scholarships";
(2) The child care provider shall complete section I of Form 2690, "Verification for a Child Experiencing a Disability or Significant Special Needs" (May 2020), including signing and dating the form, certifying the following: a. I certify that the child's disability or special need(s) is significant enough that the child requires additional funds for accommodation or classroom adaptation in the child care setting."; andb. "I agree to submit an annual report to DHHS specifying how the monies were spent which include all DHHS requested information necessary for program monitoring";(3) A licensed professional shall complete section II of Form 2690, "Verification for a Child Experiencing a Disability or Significant Special Needs," (May 2020), including signing and dating the form, certifying that one of the following, is applicable: a. "I certify that: I am the child's attending physician, physician's assistant, advance practice registered nurse, or licensed mental health professional and am providing ongoing treatment; the child's disability or special need(s) is significant enough that the child requires additional support and/or accommodation in a child care setting; and, if the child is 13 through 17 years of age, the child's condition limits the child's ability to care for himself/herself or he/she would cause harm to himself/herself or others without supervision."; orb. "I certify that I am a SAU Special Education Director or Area Agency Director and I believe that the child's disability or special need(s) is significant enough that the child requires additional support and/or accommodation in a child care setting."(k) When a parent in a 2-parent household claims that he or she has a disability, acceptable verification shall be a signed and dated statement from an attending physician, physician assistant, advance practice registered nurse, or licensed mental health professional indicating: (1) The medical condition, disease, or disability of the adult;(2) The expected duration of the condition, disease, or disability; and(3) That the adult is unable to work and to care for and supervise his or her child(ren) because of the condition, disease, or disability.(l) For those parents who are NHEP participants but who are in an approved training or educational program, including any internet training or education programs, the acceptable verification shall be a signed and dated statement from the school or training organization indicating: (1) The parent is enrolled in the program;(2) The duration of the program;(3) The class schedule, including hours of class attendance; and(4) The program shall lead to a degree, license, or certificate at the associate's level or less in a specific field of employment.(m) For parents who are not receiving TANF financial assistance, but who are in an approved training or educational program, including any internet training, or education program the acceptable verification shall be a signed and dated statement from the school or training organization indicating: (1) The parent is enrolled in the program; (2) The program shall lead to a degree, license or certificate at the associate's level or less in a specific field of employment;(3) The duration of the program; and(4) The class schedule, including hours of class attendance.(n) For the parents receiving TANF financial assistance and not participating in the NHEP work program, acceptable verification of the training program or course of study, including any internet training or education program, shall be a signed and dated statement from the school or training organization indicating: (1) The requirements in (m)(1), (3) and (4) above; and(2) That the program shall lead to a degree or certificate at the associate or bachelor's level or less in a specific field of employment.(o) When a parent works at least 4 hours on a night shift between 10:00 p.m. and 6:00 a.m., acceptable verification shall be a signed and dated statement from the parent's employer, or, if self-employed, the parent's customer, stating the hours of the shift that the individual works each week.(p) If at redetermination a parent is experiencing one of the circumstances in He-C 6910.10(o), the following verification shall be required: (1) A signed and dated statement from the employer that the parent is still employed and will be able to return to work following the medical leave or seasonal break in employment; or(2) Proof of registration for the following semester, or a signed and dated statement from the institution where the parent attends the training or educational program, stating that the parent is still enrolled.(q) When a parent is participating in a job search at initial application or at redetermination, acceptable verification shall be: (1) Proof of receipt of unemployment compensation benefits;(2) A personal summary page from the NH department of employment security's job match; or(3) The verifications described in He-W 637.03(g).(r) When a parent has a permanent job loss acceptable verification shall be a signed and dated: (1) Notice of termination from the employer; and(2) Other verification from the employer that the person is no longer employed.(s) When a parent applying for expedited child care scholarship is homeless as defined in the McKinney-Vento Homeless Assistance Act, section 725(2) of 42 USC 11434a(2) (2011), acceptable verification shall be a self-declaration from the parent that the family is homeless.(t) When a parent is homeless and in an employment related activity and is seeking housing in the same week, acceptable verification shall be a self-declaration stating that the parent is homeless and seeking housing while in an employment related activity. (u) For individuals who are providing care as a license-exempt child care provider in the child's home but whose employment is based on the condition described in He-C 6910.07(l), the individual shall provide a document signed by his or her employer verifying that the provider is prohibited from caring for his or her own children while caring for the employer's children as a condition of the individual's employment and that the employer is not a license-exempt child care provider. (v) For individuals who did not find a child care provider within 30 days when seeking child care through a child care resource and referral agency pursuant to He-C 6910.10(s)(1), acceptable verification shall be a letter from the child care resource and referral agency stating that the parent has been working with its staff and child care has not been identified for a specific child.(w) When a child or parent has had an in-patient hospital stay within the past 30 days as described in He-C 6910.10(s)(2), acceptable verification shall be the discharge statement, hospital record, or a statement from the attending physician.(x) When a parent is engaged in an employment related training or educational activity, as described in He-C 6910.07(f)(3), acceptable verification of satisfactory progress shall be a report card or signed and dated statement from an organization or agency, or the educational or training facility, indicating that the parent is making satisfactory progress as defined in He-C 6910.03(as).(y) The following verifications requirements shall apply to an individual participating in a mental health or substance misuse treatment program: (1) The parent shall certify participation in an approved mental health treatment program or substance misuse treatment program and authorize the release of information to DHHS by completing, signing, and dating section I of Form 2691 "Verification for an Individual Participating in a Mental Health or Substance Misuse Treatment Program," (May 2020) affirming the following: a. "By signing this form, I authorize the release of this information to the Department of Health and Human Services (DHHS). I understand that information will be held in the strictest confidence and will be reviewed by, or shared with, authorized DHHS staff involved in the administration of the NH Child Care Scholarship Program"; and(2) A licensed professional shall certify ongoing treatment is being provided by completing, signing, and dating section II of Form 2691 "Verification for an Individual Participating in a Mental Health or Substance Misuse Treatment Program," (May 2020) certifying the following: a. "I am the individual's attending physician, physician's assistant, advance practice registered nurse, licensed mental health professional, licensed behavioral health professional, licensed alcohol and drug counselor, certified recovery support worker or board certified psychologist and am providing ongoing treatment".N.H. Admin. Code § He-C 6910.09
#7357, eff 9-1-00; amd by #7484, eff 4-28-01; ss and moved by #7723, eff 7-1-02 (from He-C 6910.08 ); amd by #8377, eff 6-21-05; ss by #9209, INTERIM, eff 7-19-08, EXPIRED: 1-15-09
New. #9363, eff 1-17-09; (See Revision Note at part heading for He-C 6910) #9474, eff 6-29-09; ss by #10120, eff 5-7-12
Amended by Volume XXXV Number 36, Filed September 10, 2015, Proposed by #10917, Effective 9/1/2015, Expires9/1/2025.Amended by Volume XXXVII Number 28, Filed July 13, 2017, Proposed by #12221, Effective 7/10/2017, 7/10/2027.Amended by Volume XL Number 27, Filed July 9, 2020, Proposed by #13063, Effective 7/1/2020, Expires 7/1/2030