Computing the Bill 400-28-135-10
(Revised 10/1/16 ML #3439)
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NDAC 75-02-01.3-06
Child Care costs must be submitted on the SFN 616, Child Care Request for Payment for the actual calendar month the child care costs were incurred. When a form is received, the form must be reviewed to make sure it is complete (signed, dated and completely filled out). If the form is not complete, it must be returned to the caretaker or provider for completion.
Allowable hours are based on the determined level of care. Refer to ‘Allowable Child Care Hours and Level of Care 400-28-80’ to determine allowable hours.
Computing the Bill from SFN 616 Child Care Request for Payment:
- Use the amount reported in column 2. Total hours provided when the child was present.
- Add up to 16 additional hours from column 3. Hours billed when child was absent from care.
Note: More than 16 hours of absent care can be paid in certain situations. Refer to ‘Absent Days 400-28-80-25’.
- Use the amount reported in column 4. Total weeks of child care provided. The number of allowable hours determined in 1 and 2 above are then divided by the number of weeks to arrive at the average weekly hours for the month. This total is used to determine payment based on DN 241 Sliding Fee Scale.
Note: A week is defined as Sunday through Saturday, and the maximum number of weeks that can be used to determine the average weekly hours is 4. If a child needs care for 1 day in a week, the week counts as 1 towards the 4 week maximum provided the day of care is in the calendar month that is being billed. If the child does not need care for at least 1 day in a week, the week is not counted.
- Use the amount reported in column 5. Amount Billed. The actual amount reported on the billing form must be entered into the system.
The system will use the determined level of care to issue the correct payment amount. Co-payment amounts are then subtracted from the determined payment amount. Actual information reported on the billing report form must be entered into the system for tracking purposes.
If the provider charges total hours that are over the determined level of care, CCAP will continue to pay up to the state maximum rate based on the determined level of care. It is the responsibility of the household to report when there is an increased need in child care hours.
Example:
A household was approved at part time level of care for the certificate period. For the service month of May, the provider reported that the child was in their care for 110 hours over 4 weeks, which averages to 27.5 hours a week, or full time level of care for the month of May. Payment is issued based on the part time state maximum rate. The certificate remains at part time level of care, unless the household reports and verifies and increased need in child care.
If the provider charges for hours that are less than the determined level of care, CCAP will pay based on the actual hours reported on the child care billing report. This may result in a payment that is less than state maximum rate. The level of care is never decreased during the certificate period. See policy at Determining the Level of Care 400-28-80-50.
Example:
A household was approved at full time level of care for the certificate period. For the service month of May, the provider reported the child was in their care for 80 hours over 4 weeks, which averages to 20 hours a week, or part time level of care for the month of May. Payment is issued based on the part time maximum state rate. The certificate remains at full time level of care.
Child care can continue to be paid for a caretaker who has a break in their allowable activity schedule (holiday breaks, vacation time, etc.) if the provider charges for the time during the break.
Example #1:
A child incurred child care costs while mom is employed as indicated in the calendar below. Since the child incurred costs at least 1 day of each week in August, the child is considered in care for 5 weeks. However, the maximum weeks within a calendar month that can be allowed is 4.
| August |
1
|
2 | 3 | 4 | ||
| 5 | 6 | 7 |
8
|
9 | 10 | 11 |
| 12 | 13 | 14 |
15
|
16 | 17 | 18 |
| 19 | 20 | 21 |
22
|
23 | 24 | 25 |
| 26 | 27 | 28 |
29
|
30 | 31 |
Total child care hours incurred in the calendar month of August is 30 hours. To determine the average weekly hours, divide 30 hours (6 hours per day times 5 days) by 4 weeks, which equals 7.5 average weekly hours.
Example #2:
A child incurred child care costs while mom is job searching, as indicated in the calendar below. Since the child incurred costs at least 1 day in 2 of the weeks in August, the child is considered in care for 2 weeks.
| August |
1 |
2
|
3 | 4 | ||
| 5 | 6 | 7 |
8 |
9
|
10 | 11 |
| 12 | 13 | 14 |
15 |
16
|
17 | 18 |
| 19 | 20 | 21 |
22
|
23
|
24 | 25 |
| 26 | 27 | 28 |
29 |
30
|
31 |
Total child care hours incurred in the calendar month of August is 20 hours. To determine the average weekly hours, divide 20 hours (8 hours from the 2nd and 12 hours from the 23rd) by 2 weeks, which equals 10 average weekly hours.
Example #3:
A child incurred child care costs with 2 different provides in a calendar month, while mom was employed, as indicated in the calendars below. The average weekly hours must be determined for each Provider.
Provider #1
Since the child incurred costs at Provider #1 at least 1 day of each week in August, the child is considered in care for 5 weeks. However, the maximum weeks within a calendar month that can be allowed is 4.
| August |
1 |
2
|
3 | 4 | ||
| 5 | 6 |
7
|
8
|
9
|
10 | 11 |
| 12 | 13 |
14
|
15
|
16
|
17 | 18 |
| 19 | 20 |
21
|
22
|
23
|
24 | 25 |
| 26 | 27 |
28
|
29
|
30
|
31 |
Total child care hours incurred in the calendar month of August for Provider #1 is 104 hours. To determine the average weekly hours, divide 104 hours (8 hours times 13 days) by 4 weeks, which equals 26 average weekly hours.
Provider #2
Since the child incurred costs at Provider #2 at least 1 day in 3 weeks in August, the child is considered in care for 3 weeks.
| August |
1 |
2 |
3
|
4 | ||
| 5 |
6
|
7 |
8 |
9 |
10
|
11 |
| 12 |
13
|
14 |
15 |
16 | 17 | 18 |
| 19 | 20 | 21 |
22
|
23 |
24 | 25 |
| 26 | 27 | 28 |
29 |
30 |
31
|
Total child care hours incurred in the calendar month of August for Provider #2 is 32 hours. To determine the average weekly hours, divide 32 hours (8 hours times 4 days) by 3 weeks, which equals 10.66 average weekly hours.
If the average weekly hours of child care provided on the billing form are not within a reasonable amount of the caretaker's average weekly activity hours that were determined at the time the certificate was issued, the eligibility worker may contact the caretaker to resolve the difference. This applies even if the State Rate is the same regardless of the difference in hours.
The family is responsible for the costs of child care to the provider that exceeds the Level of Care determination on the certificate for the payment month.
