N.M. Admin. Code § 8.9.3.17
Current through Register Vol. 35, No. 21, November 5, 2024
Section 8.9.3.17 - PAYMENT FOR SERVICES The department pays child care providers on a monthly basis, according to standard practice for the child care industry. Payment is based upon the child's enrollment with the provider as reflected in the child care placement agreement, rather than daily attendance. As a result, most placements reflect a month of service provision and are paid on this basis. However, placements may be closed at any time during the month. A signed child care placement agreement must be returned to the department for payment to be issued to the provider. The following circumstances under which the department may close placements or discontinue payment at a time other than the end of the month:
A. When the child care placement agreement expires during the month, or when the provider requests that the client change providers or the provider discontinues services; payment will be made through the last day that care is provided.B. Payment for notification of changes: (1) If a client fails to notify the department within 14 calendar days of their expected last day of enrollment, the department will pay the provider 14 calendar days from the last day of nonattendance. The child care placement agreement with the new provider shall become effective when payment to the previous provider ceases.(2) If the provider notifies the department of a child who is disenrolled or child care has not been used for 14 consecutive calendar days, the provider will be paid through the 14th calendar day following the last day of attendance.(3) If a provider does not notify the department of disenrollment or of nonattendance for 14 consecutive calendar days, the provider will be paid through the last date of attendance.(4) If a provider notifies the department that it has received notification from a client of non-attendance beyond 14 consecutive calendar days, the department will continue to pay the provider for the period of non-attendance, not to exceed six weeks, following the period of non-attendance. The provider must submit documentation of the client notification and reasoning to the department.(5) If a child was withdrawn from a provider because the health, safety, or welfare of the child was at risk, as determined by a substantiated complaint against the child care provider, payment to the former provider will be made through the last day that care was provided.C. The rates set forth below are informed by a cost estimation model and include expenses for registration/educational fees per child and child and family activities on behalf of clients under 8.9.3 NMAC.D. The amount of the payment is based upon the age of the child and average number of hours per week needed per child during the certification period. The number of hours of care needed is determined with the parent or legal guardian at the time of certification and is reflected in the provider agreement. Providers are paid according to the units of service needed which are reflected in the child care placement agreement covering the certification period.E. The department pays for care based upon the following units of service: Full time | Part time 1 | Part time 2 (only for split custody or in cases where a child may have two providers) | Part time 3 |
Care provided for an average of 30 or more hours per week per month | Care provided for an average of 8-29 hours per week per month | Care provided for an average of 8-19 hours per week per month | Care provided for an average of 7 or less hours per week per month |
Pay at 100% of full time rate | Pay at 75 % of full time rate | Pay at 50 % of full time rate | Pay at 25% of full time rate |
F. Hours of care shall be rounded to the nearest whole number. Hours for seeking employment is set at full-time.G. Monthly reimbursement rates: Licensed child care centers |
Infant | Toddler | Pre-school | School-age |
$ 1,075.00 | $ 775.00 | $ 700.00 | $ 500.00 |
Licensed group homes (capacity: 7-12) |
Infant | Toddler | Pre-school | School-age |
$ 1,040.00 | $ 1,000.00 | $ 830.00 | $ 475.00 |
Licensed family homes (capacity: 6 or less) |
Infant | Toddler | Pre-school | School-age |
$ 1,100.00 | $ 1,075.00 | $ 870.00 | $ 530.00 |
Registered homes, in-home child care, and FFN |
Infant | Toddler | Pre-school | School-age |
$ 425.00 | $ 425.00 | $ 375.00 | $350.00 |
H. The department pays a differential rate according to the license or registration status of the provider, national accreditation status of the provider if applicable, and star level status of the provider if applicable. In the case of a public health emergency, the department secretary may approve a differential rate be paid to licensed providers.I. Providers holding and maintaining ECECD approved national accreditation status will receive the differential rate listed in Subsection I below, per child per month for full time care above the base rate for type of child care (licensed center, group home or family home) and age of child. All providers who maintain ECECD approved national accreditation status will be paid at the accredited rates for the appropriate age group and type of care. In order to continue at this accredited reimbursement rate, a provider holding national accreditation status must meet and maintain licensing standards and maintain national accreditation status without a lapse. If a provider holding national accreditation status fails to maintain these requirements, this will result in the provider reimbursement reverting to a lower level of reimbursement. The licensee shall notify the licensing authority within 48 hours of any adverse action by the national accreditation body against the licensee's national accreditation status, including but not limited to expiration, suspension, termination, revocation, denial, nonrenewal, lapse or other action that could affect its national accreditation status. All providers are required to notify the department immediately when a change in accreditation status occurs.J. The department will pay a differential rate per child per month for full time care above the base reimbursement rate to providers achieving higher Star levels by meeting FOCUS essential elements of quality as follows: Licensed Child Care Centers |
2+ Star FOCUS |
Infant | Toddler | Pre-school | School-age |
$75.00 | $ 90.00 | $100.00 | $ 50.00 |
3 Star FOCUS |
Infant | Toddler | Pre-school | School-age |
$75.00 | $ 90.00 | $100.00 | $ 50.00 |
4 Star FOCUS |
Infant | Toddler | Pre-school | School-age |
$ 425.00 | $ 325.00 | $ 300.00 | $ 150.00 |
5 Star FOCUS or ECECD approved national accreditation |
Infant | Toddler | Pre-school | School-age |
$ 850.00 | $ 725.00 | $ 425.00 | $250.00 |
Licensed Family and Group Homes |
2+ Star FOCUS |
Infant | Toddler | Pre-school | School-age |
$ 75.00 | $ 50.00 | $ 80.00 | $ 70.00 |
3 Star FOCUS |
Infant | Toddler | Pre-school | School-age |
$ 75.00 | $ 50.00 | $ 80.00 | $ 70.00 |
4 Star FOCUS |
Infant | Toddler | Pre-school | School-age |
$ 175.00 | $ 175.00 | $ 205.00 | $ 150.00 |
5 Star FOCUS or ECECD approved national accreditation |
Infant | Toddler | Pre-school | School-age |
$ 275.00 | $ 250.00 | $ 290.00 | $ 195.00 |
K. In order to continue at the FOCUS reimbursement rates, a provider must meet and maintain the most recent FOCUS eligibility requirements and star level criteria. If the provider fails to meet the FOCUS eligibility requirements and star level criteria the provider reimbursement will revert to the FOCUS criteria level demonstrated.L. The department pays a differential rate equivalent to five percent, ten percent or fifteen percent of the applicable full-time/part-time rate to providers who provide care during non-traditional hours. Non-traditional care will be paid according to the following charts: | 1-10 hrs/wk | 11-20 hrs/wk | 21 or more hrs/wk |
After hours | 5% | 10% | 15% |
| 1-10 hrs/wk | 11-20 hrs/wk | 21 or more hrs/wk |
Weekend hours | 5% | 10% | 15% |
M. If a significant change occurs in the client's circumstances, (see Subsection F of 8.9.3.13 NMAC) the child care placement agreement may be modified and the rate of payment is adjusted. The department monitors attendance and reviews the placement at the end of the certification period when the child is re-certified.N. The department may conduct provider, parent, or legal guardian, audits to assess that the approved service units are consistent with usage. Providers found to be defrauding the department are sanctioned. Providers must provide all relevant information requested by the department during an audit.O. Payments are made to the provider for the period covered in the child care placement agreement or based on the availability of funds.N.M. Admin. Code § 8.9.3.17
Adopted by New Mexico Register, Volume XXXIII, Issue 20, October 25, 2022, eff. 11/1/2022, Amended by New Mexico Register, Volume XXXIV, Issue 13, July 18, 2023, eff. 8/1/2023