DES CHILD CARE PROVIDER AGREEMENT - AMENDMENT 1.PDF
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att DEPARTMENT OF ECONOMIC SECURITY Your Partner For A Stronger Arizona Arizona DES Child Care Provider Registration Agreement (2021-2026) Amendment 1 Child Care Business Name* Address * Amendment Number * 1 Provider ID ADES Assigned Contract Number * Does the ADES Child Care Business Name, Address, and Provider ID match your records? * Yes No EFFECTIVE NOVEMBER 1, 2022, THE ABOVE REFERENCED CONTRACT IS HEREBY AMENDED AS FOLLOWS: In accordance with the Scope of Work, section 9 Written Amendments to This Agreement, the Provider Registration Agreement is revised as follows: AMEND SECTION (3) 3.46 AND 3.52 OF THE PROVIDER DEFINITIONS OF THE SCOPE OF WORK AS FOLLOWS: 3.46. Reimbursement Rate — the payment levels and amounts specified in the Child Care Provider Rate Agreement. The Reimbursement Rate minus the daily Co-Payment amount is the amount that ADES will pay the Provider. ADES will not reimburse for services covered by other grants, contracts, or payments. These rates are prescribed by the Maximum Reimbursement Rates Form CCA-1227-A. 3.52. Unit of Care — represented by a daily rate (“D” or "P") of care (15 minutes or more) on the AZCCATS Billing Document, Certificate of Authorization Form, and the Verbal Notice of Eligibility Form. 14 minutes or less is not a payable unit of care. AMEND SECTION (5) 5.1 OF THE PROVIDER REQUIREMENTS UNDER SECTION 5.1.1.10 OF THE SCOPE OF WORK AS FOLLOWS: 5.1.1.10. For all individuals, before being employed or volunteering in a position that provides direct services to children under this contract, the individual shall certify through the completion and submittal of the Direct Service Central Registry Clearance Position Certification Form DCS-1083A (Attachment 9) that: A. The person is not currently the subject of an investigation of child abuse or neglect in Arizona, or another state or jurisdiction; and B. The person has not been the subject of an investigation of child abuse or neglect in Arizona, or another state or jurisdiction, which resulted in a substantiated finding. AMEND SECTION (5) 5.6 OF THE PROVIDER ENHANCED RATES REQUIREMENTS UNDER SECTION 5.6.1.2 OF THE SCOPE OF WORK AS FOLLOWS: 5.6.1.2 ADES will review the Providers’ Quality First Star Rating on a weekly basis based on the weekly reported changes provided by First Things First (FTF). The Providers’ Star Rating as indicated on the FTF report will be used to determine the enhanced rate status and will be effective the first day of the following month. The enhanced rate will end on the last day of the month for providers who have declined their participation in Quality First or who have a change to their Star Rating. AMEND SECTION (5) 5.7 OF THE PROVIDER PAID ABSENCES REQUIREMENTS UNDER SECTION 5.7.1.4 OF THE SCOPE OF WORK AS FOLLOWS: 5.7.1.4. Only the units that would have been used on the absent day will be claimed. AMEND SECTION (5) 5.16 OF THE PROVIDER RECORD KEEPING REQUIREMENTS UNDER SECTION 5.16.1.4, 5.16.1.4 (A.) OF THE SCOPE OF WORK AS FOLLOWS: 5.16.1.4 Paid Absence(s) shall be identified on the record by adding the Paid Absence Date(s) and indicate if the Paid Absence(s) claim is a “D” or “P” Unit of Care. 1. If the Provider is using an electronic alternative method of attendance tracking, then the Provider is allowed to add electronic notes to the file to include Paid Absence Date(s) and indicate if the Paid Absence(s) claim is a“D” or “P” unit. AMEND SECTION (7) 7.2 and 7.2.6.2 OF THE PROVIDER CLAIMS FOR PAYMENT REQUIREMENTS OF THE SCOPE OF WORK AS FOLLOWS: 7.2 In accordance with the federal CCDF State Plan, states must conduct a Market Rate Survey every three years. ADES establishes its market rate survey to determine the maximum reimbursement rates for child care. ADES will reimburse Providers according to the established ADES Reimbursement Rates for child care services provided to Clients. ADES has 21 days to issue payment, upon receipt of a properly completed AZCCATS billing document. ADES encourages providers to submit timely billing. ADES will not pay for original or supplemental billing claims received by ADES more than nine (9) months after the date of service for which the payment is claimed. 7.2.6.2. Enter in the “Units” column the daily (D) or (P) unit, the number of units of service actually delivered, including any applicable paid absence(s) (PA), even if the number is the same as the preprinted number appearing on the billing form. REMOVE SECTION (7) 7.2.8 OF THE PROVIDER CLAIMS FOR PAYMENT REQUIREMENTS AS FOLLOWS: 7.2.8 Submit monthly claims for payment to ADES within 21 days after the service month in which services are provided. REMOVE SECTION (7) 7.5 OF THE PROVIDER ONE TIME REIMBURSEMENT RATE REVISION ADJUSTMENT PAYMENT REQUIREMENTS OF THE SCOPE OF WORK AS FOLLOWS: 7.5 One Time Reimbursement Rate Revision Adjustment 7.5.1 ADES will issue a one time payment for the Reimbursement Rate variance for the period from July 1, 2021, to September 30, 2021. 7.5.2 The one time payment will be calculated based on the approved billings from July 1, 2021, to September 30, 2021. 7.5.2.1 For the one time payment calculation, ADES will only consider approved billings that have been received by ADES by November 1, 2021. 7.5.2.2 Billings for the period from July 1, 2021, to September 30, 2021 that are received after November 1, 2021 shall not be considered as part of the calculation. 7.5.3 ADES will issue payment by November 30, 2021. RENAME Attachment 9 document to Direct Service Central Registry Clearance Position Certification Form on The Table of Contents on page 2. CHANGE all Exhibits to Attachments. This includes The Table of Contents on page 2 of the Child Care Provider Registration Agreement with the following: CURRENT EXHIBIT NAME NEW AMENDED ATTACHMENT NAME Exhibit 1 — TraCorp Instructions Attachment 10 — TraCorp Instructions Exhibit 2 — Disaster Emergency Evacuation Preparedness Plan Attachment 11 — Disaster Emergency Evacuation Preparedness Plan Exhibit 3 - About Me Questionnaire (CCA-1200A) Attachment 12 — About Me Questionnaire (CCA-1200A) Exhibit 4 — Provider/Parent/Guardian’s Agreement for Child Care Charges (CCA-0208A) Attachment 13 — Provider/Parent/Guardian’s Agreement for Child Care Charges (CCA-0208A) Exhibit 5 - DES Accepted Accreditation Agencies for Centers Attachment 14 — DES Accepted Accreditation Agencies for Centers Exhibit 6 — Verbal Notice of Eligibility (CC-031A) Attachment 15 — Verbal Notice of Eligibility (CC-031A) Exhibit 7 - Unpaid Copayment Worksheet (CCA-1021A) Attachment 16 — Unpaid Copayment Worksheet (CCA-1021A) Exhibit 8 — Notice to All Families Enrolled At DES Child Care Facility (CCA-1216A) Attachment 17— Notice to All Families Enrolled At DES Child Care Facility (CCA-1216A) Exhibit 9 — Sign-In/Sign-Out Record (CCA-0218A) Attachment 18 — Sign-In/Sign-Out Record (CCA-0218A) CHANGE the language throughout the Child Care Provider Registration Agreement to remove all Exhibits language and replace it with an Attachment as follows: 5.2.1.7 (B) Provider shall ensure that all staff who are responsible for completing billing must successfully complete the DE5417 Basic Billing for CCA Providers computer-based training through the Department’s current training system. Instructions on how to Access the training are found on the TraCorp Instructions (Attachment 10). 5.2.1.7 (C) Provider shall ensure that all staff who are responsible for writing and updating the Emergency Preparedness Plan shall successfully complete and provide proof of the Disaster Emergency Evacuation Preparedness (D.E.E.P.™) online training completion that is accessible on the ADHS website located at: http://azdhs.gov/documents/licensing/childcare-facilities/training/deep-onlinetraining.pdf, or an ADES approved Emergency Preparedness training. Provider shall reference Attachment 11 for the written Emergency Preparedness Plan Guide. 5.3.1 Not accept children for ADES reimbursed child care prior to the start date and after the stop date as indicated by the Department on the Certificate of Authorization from the ADES/CCA Eligibility Specialist or the Verbal Notice of Eligibility Form CC-031 (Attachment 15). 5.3.2 Complete the Verbal Notice of Eligibility Form CC-031 (Attachment 15) when receiving an oral authorization of services from the ADES/CCA Eligibility Specialist. 5.3.6 Obtain from, and review with the client, the About Me Questionnaire CCA-1200A (Attachment 12) 5.3.7 Complete a Provider/Parent/Guardian’s Agreement for Child Care Charges Form CCA-0208A (Attachment 13) for each child in care. 5.3.12 Instruct Clients on proper ADES sign-in/sign-out procedures. Refer to Notice to All Families Enrolled at DES Child Care Facility CCA-1216A (Attachment 17). 5.5.1.1 (A) ADES accepted Accreditation Agencies are identified on Attachment 14 and may be amended. 5.6.1.1 The Provider must either possess a Three (3), Four (4) or Five (5) Star Quality First Star Rating issued by First Things First or, be accredited by an ADES accepted Accreditation Agency (Attachment 14). The Provider must furnish ADES with the corresponding documentation of qualification(s). 5.15.1.3 Provider/Parent/Guardian’s Agreement for Child Care Charges Form for all DES families CCA-0208A (Attachment 13). 5.15.1.4 Unpaid Co-Payment Worksheet Form CCA-1021A (Attachment 16). 5.16 Record Keeping Requirements The Provider shall educate Clients on the importance of sign in and out procedures for proper payment reimbursement and child safety within the attendance method chosen. Refer to Notice to All Families Enrolled at DES Child Care Facility CCA-1216A (Attachment 17) 5.16.1.1 (A) Sign-In/Sign-Out Record Form CC-0218A (Attachment 18) provided by ADES; or 7.3.2.1 Submit an Unpaid Co-Payment Worksheet CCA-1021A Form (Attachment 16) to the Client’s Child Care Specialist. 7.3.2.2 Submit a current, completed and signed Provider/Parent/Guardian’s Agreement for Child Care Charges CCA-0208A Form (Attachment 13) with the Unpaid Co-Payment Worksheet CCA-1021A (Attachment 16). 7.3.3 The Provider shall not submit any portion of the outstanding Co-Payment balance that accrued more than 180 days prior to the date of ADES receipt of the Unpaid Co-Payment Worksheet CCA-1021A (Attachment 16). 7.3.4 Any payment received from the parent or responsible person after submitting the completed Unpaid Co- Payment Worksheet CCA-1021A (Attachment 16) to ADES shall be applied first to the outstanding Co-Payment balance, before being applied to any outstanding additional charges. ADD SECTION 5 TO THE DIVISION SPECIAL TERMS AND CONDITIONS UNDER AS FOLLOWS: 5. Claims for Payment In accordance with the federal CCDF State Plan, states must conduct a Market Rate Survey every three years. ADES establishes its market rate survey to determine the maximum reimbursement rates for child care. ADES will reimburse Providers according to the established ADES Reimbursement Rates for child care services provided to Clients. ADES has 21 days to issue payment, upon receipt of a properly completed AZCCATS billing document. ADES encourages providers to submit timely billing. ADES will not pay for original or supplemental billing claims received by ADES more than nine (9) months after the date of service for which the payment is claimed. Other: REVISE Attachment 14 to include Cognia and Arizona Center for Afterschool Excellence (AZCASE) as a DES accepted accreditation agency. INCLUDE Newly labeled attachments EXCEPT AS PROVIDED HEREIN, ALL TERMS AND CONDITIONS OF THE ORIGINAL CONTRACT AS HERETOFORE CHANGED AND/OR AMENDED REMAIN UNCHANGED AND IN FULL FORCE AND EFFECT. THE AMENDMENT SHALL BECOME EFFECTIVE ON THE DATE OF LAST SIGNATURE UNLESS OTHERWISE SPECIFIED HEREIN. BY SIGNING THIS FORM ON BEHALF OF THE CONTRACTOR, THE SIGNATORY CERTIFIES HE/SHE HAS THE AUTHORITY TO BIND THE CONTRACTOR TO THIS CONTRACT Contract Amendment* This amendment does require a signature; however, in order for you to receive a copy of this amendment, please click the box to verify your current information and acknowledge that you have received this amendment. Once the acknowledgment is made, you will receive an automatic email with the executed amendment. |, , certify that | have read over the full Child Care Provider Registration Agreement Contract language carefully and | understand all of its provisions. Printed Name * First Last Printed Name * Signature x draw type Title * Title Date * Email Address * A Date Email address needed to send completed Amendment. Equal Opportunity Employer/Program + Under Titles VI and VII of the Civil Rights Act of 1964 (Title VI & VII), and the Americans with Disabilities Act of 1990 (ADA), Section 504 of the Rehabilitation Act of 1973, the Age Discrimination Act of 1975, and Title Il of the Genetic Information Nondiscrimination Act (GINA) of 2008; the Department prohibits discrimination in admissions, programs, services, activities, or employment based on race, color, religion, sex, national origin, age, disability, genetics and retaliation. The Department must make a reasonable accommodation to allow a person with a disability to take part in a program, service or activity. For example, this means if necessary, the Department must provide sign language interpreters for people who are deaf, a wheelchair accessible location, or enlarged print materials. It also means that the Department will take any other reasonable action that allows you to take part in and understand a program or activity, including making reasonable changes to an activity. If you believe that you will not be able to understand or take part in a program or activity because of your disability, please let us know of your disability needs in advance if at all possible. To request this document in alternative format or for further information about this policy, contact 602-542-4248; TTY/TDD Services: 7-1-1. * Free language assistance for DES services is available upon request.