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EEC Advisory February – March 2011Summary of Responses from Break-Out

Groups

Agenda Items Included:

Legislative Report Framework Subsidy, Adoption and Foster Care Regulation

Changes License Plate Fund Birth to 8 Community Planning Market Rate Survey

Sub Groups Included:Business/CivicContractorsState AssociationsHigher Education

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Advisory Feedback: Legislative Report Framework

Regarding Report Design: The Report is much easier to read and follow.

Regarding QRIS content: Define what “fully implement” QRIS means. Clarify monitoring metrics Ensure that the public knows who the external

monitors will be. Clarify that this monitoring will not be a financial

burden for programs. QRIS Training is only offered on Saturday, consider

changing to be a blend of weekend and weekdays.

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EEC Subsidy Regulations

What Are the Subsidy Regulations?EEC is the Lead Agency responsible for compliance with early education and care services under the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (Pub. L. 104-193). As such, EEC is responsible for administering and providing early education and care programs and services to children, through grants, contracts and vouchers. The current regulations (606 CMR 10.00) identify the general provisions and eligibility requirements for families with children seeking subsidized child care in the Commonwealth.

EEC Child Care Subsidy Program GovernanceEEC’s Financial Assistance Program is governed by both federal and state laws and policies:

Federal Statutes -- The Child Care and Development Block Grant Act and the Social Security Act

Federal Regulations -- The Child Care Development Fund

Federal Policies, Program Instructions and Other Guidance

State Regulations -- Subsidized Child Care

State Policies -- EEC Financial Assistance Policy Guide

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FY11 EEC Budget Breakdown

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Why Amend the EEC Subsidy Regulations?

Factors contributing to the need to review and amend the Regulations include:

Identifying and Implementing Best Practices• Review regulations every 5 years (Subsidy Regulations last

updated in 2006)• Analyze other State child care subsidy laws and policies• Address unique challenges/ weaknesses identified due to

recent fiscal constraints/ system restructuring (e.g., closure/ limited access to EEC financial assistance, CPC transition, Voucher Pilot)

Targeting/ maximizing limited resources

Addressing user feedback/ achieving efficiencies

Addressing Federal & State Oversight concerns• Reduce opportunities for Fraud, Waste and Abuse• Ensure Program Integrity

Subsidy Regulation Changes - Required

While many of the issues identified to date have been addressed by revising the Policy Manual, and improving the process for updating policies, some regulation revisions are necessary, including:

Redefine Special needs of parent/ child Reduce Allowable Absences Redefine Self Employment Allow for eligibility verifications through inter-agency

data matches Streamline Review Process and recoupment process

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Technical Amendments to Subsidy Definitions, 606 CMR 10.02

The addition of new or revised definitions are necessary to ensure compliance with current laws/policies and to aid in the interpretation and enforcement of the regulations:

•Child Care Educator/Provider•Contracted Child Care Educator/Provider•Excessive Absence•Explained Absence•Full Time Care•Protective Services

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Identity, Residency & Citizenship Status – Issue and Proposed Remedy

• EEC seeks to formally codify the Citizenship and Immigration Status policy issued in April 2010, in order to:

o Address the deficiency in EEC’s regulations and policies identified by ACF the 2008-2009 Federal Improper Authorization for Payment review

Massachusetts, along with all other Year 2 States, were given a one time exemption to implement this requirement

o Achieve consistency between regulations and policies and to ensure efficient and uniform outcomes for families

Comments from Advisory Council and Providers

Questions regarding the impact of citizenship requirement on Head Start programs and Public School districts

Recognition that this is a federal requirement and is not optional for federal reimbursement

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Child Support Enforcement Requirement – Issue and Proposed Remedy

• Due to concerns about the accuracy of household size reported by families and in support of the mission of the MA Child Support Enforcement Agency (CSE), EEC proposes a requirement to mandate “cooperation” with CSE agency OR other proof of child support as a condition for child care assistance for single parent families

• At least 20 States currently impose a CSE requirement

• Benefits of instituting a Child Support Enforcement policy:

o Keep families out of povertyo Provide adequate food, shelter and clothingo Increased access to medical services & sense of securityo Add to the overall stability, security and well-being of families

and childreno Intended to lessen the existing burdens of second parent in the

household documentation

• Key issues to consider during implementation of policy:

o How many families seeking assistance are currently enrolled – avoid duplication

o Identify exceptions (i.e., domestic violence or child protection)o Required documentationo Monitoring and evaluation of effectiveness

Comments from Advisory Council and Providers

Recognize that particular circumstances lend themselves to waiver (e.g. domestic violence)

Just because other states are utilizing this approach does not mean that it makes sense for Massachusetts

May cause programs to lose clients because the regulations will become too intimidating

May incentivize parents to “disappear” from their children’s lives

Current regulation enables parents not to take responsibility for their own children

Request to solicit feedback from parents and other stakeholders through public comment process

Implementation questions regarding how requirement be enforced and how parents will be able to file with DOR

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Strengthen Child Attendance Requirement - Issue

• Review of annual billing and current EEC regulations related to absences identified potential abuse/waste.

• Current Regulatory Definitions, 606 CMR 10.02:

o Excessive absence = more than 3 consecutive unexplained absences or 11 or more explained absences w/in a 30 day period.

o Explained absences = any absence due to illness, emergency, or max. of 10 days vacation/ year.

• Current utilization and annualized billing (EEC’s annual billing for FY08-10 shows):

o Average annual billing by the CCR&Rs - $18.5Mo Average annual billing by contract providers - $18.5Mo Over each of past 3 years, providers have billed EEC for over

$37M related to absent dayso Absence rates for some children approach 50%o Providers acknowledge billing for “regularly scheduled” absences,

such as families that only need 4 days/week

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Strengthening Child Attendance Requirement – Best Practices

• In preparing its recommendations, EEC reviewed research which shows that chronic absenteeism in the early years, such as kindergarten, predicted continuing absences in later grades.

• In addition, we looked at other states to identify best practice:

o Ohio – limits absences to 10 in 6 monthso Maryland – limits absences to 60 in 12 monthso Delaware – limits absences to 5 per month

• MA public schools limit absences to 7 in 6 months

• These examples have ramifications on both families (termination) and providers (billing) giving incentive for proper use of funds and encouraging attendance/ good outcomes for children

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Strengthening Child Attendance Requirement – Proposed Remedy

• Options for implementation – excused absences:

Limit absences to 5 per month Limit absences to 15 per 3 months Limit absences to 30 per 6 months* Limit absences to 60 per 12 months Limit absences to 7 in 6 months, in

accordance with ESE policies

*The Recommendation above reflects an average of 5 absences per month enforced over a 6 month period.

• EEC does not propose any changes related to the definition of “excessive” absence.

Comments from Advisory Council and Providers

Good change; very supportive of 30 absences/6 mos. Support for reducing the number of absences Be clear on medical documentation needed to

substantiate approved absences Need to counsel families on why attendance is

important; may want to look at Head Start policies Questions regarding exceptions (i.e. children who are

hospitalized for an extensive period of time, children with chronic conditions, children with contagious diseases, etc.) and how these situations would be handled

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Self-Employment – Issue and Proposed Remedy

• Feedback from stakeholders identified inconsistent and inefficient policies for assessing eligibility for self-employed parents AND increased terminations, reductions and recoupment due to false, misleading or inaccurate documentation submitted.

• To improve program integrity and efficiency, EEC proposes to limit the types of work-related activities that satisfy the service need requirement:

1. No home-based self-employment, unless the work performed:

• creates a clear and present danger to children• requires regular face-to-face meetings or appointments with

clients, which prevents direct supervision of children

2. Propose a launch/grace period for new self-employment business – 3 month start up

3. Implement new mechanism for confirming minimum wage

• Current practice – divide gross income by estimated hours to determine hourly rate

• Proposed practice – divide gross income by MA minimum wage rate to determine hours

Comments from Advisory Council and Providers

Generally supportive of change

Question whether income taxes would still be required for self-employed

Concerns regarding whether people who work at home can provide an educationally rich environment for children

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Federal regulations establish two foundational requirements for all children seeking CCDF-funded child care services:

1.Children must reside with a family whose income does not exceed 85% of SMI; and

2.Reside with parent(s) who are working, or participating in job training or an education program, or are receiving or need to receive protective services.

In 2009-2010, ACF identified two instances where EEC policies and regulations and policy may not align with these mandatory requirements:

1.Children with Special Needs – 1) allowing children to remain in care up to 100% SMI; 2) allowing a categorical waiver of the work, education and training requirement, and 3) not clearly defining such families “in need of protective services.”

2.Parents with Special Needs – 1) allowing children to remain in care up to 100% of SMI, and 2) not clearly defining such families “in need of protective services.”

Special Needs: Federal Regulatory Compliance – General Issues

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Special Needs Children – Unique Issues

Current MA practice:• Parents are not required to engage in work, education and/or

training activities• Families may enter care at 85% SMI and exit at 100%• Children are eligible for full-time care regardless of need

Utilization and Estimated Annual Cost (based on 10/2010 data):•Parents with special need – 1,845 children/$12.17M•Children with special need – 902 children/$5.95M•Total annual cost – over $18M

Issues:• Exemption was originally based on assumption special needs

children are “educationally at risk”•Misaligned with federal exemption definition of “in need of protective services”•Research based risk factors show that ALL low-income children are “educationally at risk”

• Streamlining and coordinating resources:•Other agencies are charged with providing services to special needs children -- ESE (IEP) or DPH (IFSP)•EEC should support ESE and/or DPH with wrap-around services, for otherwise eligible children

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Special Needs Children – Proposed Remedy

Proposed change:• Align EEC regulations with Federal

regulations and require parents of children with special needs to participate in work, education or training

No Change:• Families will continue to remain eligible at

the 85%/100% income levels• Eligible children may continue to qualify for

full-time care, regardless of their parents’ service need

• EEC will continue to work with other state agencies to provide the necessary wrap-around support for eligible children

Comments from Advisory Council and Providers

Providers and CCR&Rs Very supportive of proposed change

Request not to raise the eligibility bar above IEP documentation to “at risk of protective services”; there are services out there that are a better match to address specific special needs

However, may create a gap when children leave IEP but are unable to get picked up by public schools

Current regulation has pushed out working families and changed the balance of classrooms; unable to meet the needs of all working Income Eligible families

Question regarding who will connect parents to other services and whether case workers will be trained regarding special needs

Question whether new requirement should include reviewing multiple risk factors for children, including environmental risk factors or using an assessment tool to verify eligibility

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The Department has identified the following concerns when reviewing its child care subsidy regulations and policies and makes the following findings/observations – for Parents:

• In practice, “special need of parent” definition misaligned with federal “in need of protective services” intention.• Examples identified through central office review:

headaches, backaches, carpal tunnel syndrome.

• Data shows inordinate number of special need of parent service need approvals in contract slots

• Special need of parent service need currently approved for indefinite time period irrespective of the stated need

• Federal laws prohibit use of CCDF funding for respite care

Special Needs Parents – Unique Issues

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Special Needs Parents – Proposed Remedy

EEC will seek to amend current policies related to Child Care Financial Assistance eligibility requirements for families with special needs parents to:

Only allow for new access through vouchers

Heighten the bar on what is deemed “at risk of needing protective service”

Only allow these to be short term vouchers -- 12 months, renewable once –- with the intended purpose of helping to serve as a bridge while parents seek other resources to address the “protective service” issue and/or become employable.

Comments from Advisory Council and Providers

Observation that many of these children are in care under this service need because DCF cases have closed and parents are marginal (i.e. mental health issues, substance abuse issues)

Some voiced support for focusing on helping parents achieve self sufficiency as existing regulation creates a conflict between enabling parent versus protecting the child

Must allow exceptions for parents with permanent, documented disabilities

Concern as to who is going to help these families get additional resources after 12 months and care ends

Concern that other resources may not be available upon the expiration of the 12 month vouchers

12 months may not be long enough– will there be an exception/ waiver process

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OVERVIEW OF REVIEW PROCESS

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Review Process: Issues

Caseload volume (by calendar year)• 2008 = 756 Requests for Review• 2009 = 1,438 Requests for Review • 2010 = 847 Requests for Review

Incomplete documentation Significant lag times within caseload processing Appellants have several “bites of the same apple” Child care may continue for several additional

weeks or months pending the outcome of the review and/or the informal hearing

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GOALS FOR THE REVIEW PROCESS

EEC seeks to revise the Termination and Reduction of Services and the Review Process sections to:

Streamline and Manage Efficiencies Address Federal and State Mandates to Recoup

Fees Parent recoupments (by calendar year)• 2008: 4 repayment agreements; 7 referrals to BSI/

AGO referrals. • 2009: 196 repayment agreements; 5 BSI/ AGO

referrals. • 2010: 359 repayment agreements; 1 BSI/AGO referral

Provide clarification for Parents, CCR&Rs and Contracted Providers

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Review Process: Proposal

Proposed updates to EEC Review Process regulations include:

Dismissals for failure to prosecuteClarify appropriate grounds for appealClarify documentation timelinesGrant opportunity for appeal related

to recoupment amounts

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Proposed Regulation Promulgation Timeline

Tasks Date

Vet Regulation Changes with Providers/ CCR&Rs; continue to make policy changes/ clarifications that do not require regulation changes

Fall 2010

Board reviews draft of proposed regulation changes; Committee discussions

Feb/March 2011

Board vote to put regulations out for public comment

March/April 2011

Public comment period; meetings with stakeholders/providers/ advocates

May/June2011

Board vote to promulgate regulations;Roll out implementation/ trainings

June/Sept.2011

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Feedback: Subsidy, Adoption and Foster Care Regulation Changes

Regarding Adoption Best practice in adoption should always be to

make an effort to track down the child’s family of origin, even though this is sometimes not easy to do. Members questioned whether the 20 hours of training for adoptive families should include CPR and First Aid.

Regarding Foster Care Consider allowing training that early

education and care programs offer to count toward that required for foster parents.

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Feedback: License Plate Funds

Consider offering fewer grants of a higher amount. In large systems, $5K is not much. Allow the system to apply by site. Allow up to $2,500 per site.

The costs for applying for a CDA should be allowed. The $300 application fee can be a lot, especially for family child care providers. This is relevant since a CDA will be required to move up in the QRIS.

(Commissioner Killins agreed to add an additional $50K, for a total of $450K, to the next grant release and to permit the funds for CDA costs.)

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Feedback: Market Rate Survey and Birth – 8 Community Planning

Due to time constraints, members were directed to the Advisory Web Page for materials that provide updates on the remaining agenda items, Birth to 8 Community Planning and the Market Rate Survey. These topics will be discussed at future Advisory meetings.

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Next Meetings:

Sub-Group Meetings:Friday, April 29, 2011

11:30am- 1:00pm K-12 LinkagesThursday May 5, 2011

 1:00 – 3:00pm Legislators

Full Advisory Council Friday, June 3, 2011 10:00am- 1:00pm

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Questions? Comments?

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