The guardian/conservator has the right to make final decisions about the ward/conservatee’s life.
The person with a disability uses support, but ultimately makes the final choice about his or her own life.
What is the role of the court?
Guardianship/Conservatorship
Supported Decision-Making
All changes must go through the court.
The person with a disability can change the supporters they use anytime they want without a court process.
If there is a problem with a conservator or guardian, or if the conservator or guardian dies, the court must approve any changes or appointment of new guardians/conservators. The court can replace a guardian or conservator with someone else if they think it’s best or grant the conservator/guardian more powers than they requested.
They can easily add supporters and get the insights of many people.
What are the protections against abuse?
Guardianship/Conservatorship
Supported Decision-Making
Typically, only one conservator/guardian makes all the decisions for one conservatee/ward.
There will usually be more than one supporter. They may provide support in different areas (i.e., a parent may help with money, while a friend or staff member may help with social decisions); or they may work together to provide support (i.e., two supporters help the person make medical decisions).
The court technically oversees the relationship but rarely does so in practice.
Having more than one supporter provides a check against abuse or manipulation by any one supporter. A monitor can also be chosen to oversee the supporters. This is recommended when finances are involved.
How are the person’s needs assessed?
Guardianship/Conservatorship
Supported Decision-Making
The abilities and needs of the person with a disability are determined by a judge or jury based on evidence provided during the hearing.
The strengths and needs of a person are discussed by the person and their supporters.
The court looks at what the person can do without any assistance or support.
The person’s abilities are based on what they can do alone and with supports.
The court assumes that these needs will remain the same over the course of the person’s life.
As the person continues to learn and develop decision-making skills over the course of their life, they can change the supports they need and the supporters who provide them.
The decision-maker will choose supporters, discuss what kinds of decisions they would like help with, develop a written plan called the Supported Decision-Making Agreement (SDMA), and sign the SDMA.
Choose:
The decision-maker chooses people to help them make decisions. These people are called supporters, and they can be family, friends, service providers…anyone that the decision-maker chooses, as long as the supporters agree to serve in this role.
Discuss:
The decision-maker decides what kinds of decisions they would like help with. Examples include decisions about how to spend money, where to live, education, relationships, or healthcare.
The decision-maker also decides what kind of help they would like in making certain types of decisions. For example, the decision-maker may want help with gathering or understanding information, or communicating a decision to others. The possibilities are endless.
Make a Plan:
Supported decision-making can be formal or informal.
The decision-maker and their supporters will make a written plan called a Supported Decision-Making Agreement (SDMA). The SDMA gives information about who the supporters will be, how the plan will be communicated, what kind of decisions will be supported, and what kind of support is requested.
Sign:
The decision-maker and their supporters sign the SDMA. This can be revised at any time and everyone will receive a copy.
Ronnie says, “Many people consult with family and friends before making big decisions, such as where to live or making a large purchase.”
Sometimes we talk with experts such as doctors to help us make complicated medical decisions. Talking to experts and others in various areas can help us understand complicated information, even though the final decision is up to us.
You sit down with Ronnie to talk about supported decision-making.
She tells you, “Supported decision-making is important to me because it allows individuals with disabilities to have a voice in the decisions that are made that impact their lives.”
Supported Decision-Making (SDM) is a process that allows people with disabilities to keep their decision-making capacity by choosing supports to help them make choices.
It was created on the premise that all people deserve a life of independence, gainful employment, and fulfilling relationships with friends and partners.
A person using SDM selects trusted advisors, such as friends, family members, or professionals, to serve as supporters. The supporters agree to help the person with a disability understand, consider, and communicate decisions, giving the person with a disability the tools to make their own informed decisions.
Ronnie pulls up a video. “Let’s watch this video about Dawn, and her experience with supported decision-making.”
SDM is an alternative to guardianship that some states have added to their guardianship regulation, like Maine, Texas, Alaska, Delaware, Wisconsin, and more. Once SDM is formally recognized, then a person with a disability will be able to sign a formal document with their supporters in which they all agree to take part in.
Ronnie says, “This document can help doctors, bankers, lawyers, and other third parties to understand and accept the decision of the person with a disability.”
Handwashing is one of the most important ways to prevent the spread of disease. It is important to use soap and water and wash your hands for at least 30 seconds or the time it takes to sing the ABC’s.
Hands should be washed:
Before, during, and after preparing food
Before eating food
Before and after caring for someone who is sick
Before and after treating a cut or wound
After using the bathroom, changing diapers, or helping someone in the restroom
After blowing your nose, coughing, or sneezing
After touching an animal, animal food or treats, animal cages, or animal waste
After touching garbage
If your hands are visibly dirty or greasy
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What You Need To Know About Handwashing
Simon tells you, “I never knew how important handwashing was until I watched this video. It’s gross to see how many germs stay on our skin.”
Watch this video for more information about how and why hands should be washed. The entire video must be watched before being able to move on.
The DCC-97, Provider Billing Forms (PBF) are available on the first day of each month to cover the prior month’s CCAP enrollments.
Providers who use the KICCS Provider Portal can access and submit their billing electronically.
Providers who do not use the Provider Portal access will receive their paper PBF in the mail. Paper PBFs are mailed out on the first business day of each month. Paper PBFs may be returned to DCC via email at CCAPProviderPayments@ky.gov , mailed using the address on the form, or faxed to (502) 564-3464.
The form below is a blank paper DCC-97 form. Once generated and ready to mail, the form would include the children’s names and care schedule from the current certificate prefilled on the ‘Scheduled’ line.
Click to view larger
Provider Portal PBF
The portal PBF below is filled out for May 2022 and is available to be submitted by the provider on June 1, 2022. The child’s care schedule from the DCC-94 certificate is prefilled on the ‘Scheduled’ line. The PBF shows the Care Level for the child which is determined by the child’s age and may change during the month if the birthday falls during that month. The Codes being paid either from the prefilled schedule, the provider exception line or both. The count which is the number of days being paid for each code. The Rate the provider charges per day for that care level and the copay rate. The form also has the daily calendar for billing for each day the child is scheduled to attend in the month of May with lines for Provider Exceptions and Worker (DCC staff) Exceptions. The exception codes are under the calendar boxes. Last, the Provider’s note box (for the provider to leave explanations of the exceptions) and the EAV Note box (for DCC staff to communicate with the provider).
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Once a provider submits the PBF, either by mail or online, it goes into the KICCS portal for DCC staff to process. The system puts the PBFs in the portal according to the order in which they are received. This can be affected by the speed of the internet being used or the server processing the information-both of which are out of human control.
Once the provider has submitted the PBF, Kentucky Administrative Regulations and DCC CCAP Policy require that provider billing forms are processed by DCC staff within ten (10) business days of receipt.
within 10
Business Days of Receipt
Questions about Payment Timeframes
Providers that have inquiries about the timeframe for payment should reference KRS Chapter 45.453. Providers shall receive a payment within thirty (30) working days of processing the PBF, except when there are payment discrepancies in the payment amount billed and the amount owed to the provider. In these instances, the Cabinet is not held to the thirty (30) day period for payment.
within 30 days
Unless there are payment discrepancies
Issuing Payments
Provider payments are issued in the form of a check unless the provider chooses to receive the payment as an electronic direct deposit. To set up direct deposit a provider must submit a DCC-93, Authorization for Electronic Deposit and a W9.
A DCC-93 and W9 can be requested by contacting CCAPProviderPayments@ky.gov. If the DCC-93 is incomplete, it will be returned to the provider for completion.
Unless there is a change in provider type or license number.
How to fill out a Provider Billing Form
When a DCC-97 Provider Billing Form is received, either in the portal or in paper form, it will have the expected attendance/care schedule (found on the DCC-94 Licensed and Certified Enrollment Agreement Enrollment Certificate) prefilled on the Scheduled line.
The next line, for Provider Exceptions, is left blank. Providers use the exception line to make needed changes to the prefilled schedule. If a child’s attendance is different from the expected prefilled schedule, the provider must enter the correct billing code to make the exception (change).
PBFs with a Flex Schedule do not have a prefilled care schedule but have an allotted number of days the child may attend. For example, the child may be allowed to attend 5 full days per week. If the provider is open 7 days a week these 5 full days may be any of the 7 days in the week and may change each week.
The CCAP email inbox frequently receives emails stating that the PBF is giving an error message that says, “Exceptions cannot be made….”. This happens when a provider is filling in the same code in the Provider Exception box that is prefilled on the PBF. The provider exception line is to make CHANGES to the prefilled code, not to add the same code.
If the care schedule is incorrect, it is the parent’s responsibility to contact DCBS Family Support (855-306-8959) for a care schedule correction. CCAP payment staff cannot make changes to certificate schedules.
Codes 43, 45, 55 and 65 are based on the provider’s circumstance.
Codes 40, 45, 50, and 60 are based on the child‘s circumstance.
The exception codes for each provider type are as follows: $=payable code
Licensed Provider Codes ($ = payable code)
01 –$ Full day-payable code for attendance of five (5) or more hours per day 02 –$ Part day-payable code for attendance less than five (5) hours per day 40 –$ Excused absence (five (5) per month permitted without documentation of the reason) NOTE: This code is only used for the purpose of the child being absent from the center on a day that the center was open, and the child was scheduled to be in attendance. It is not used if the provider was not open for business. 43 –$ Holiday, closed but payment requested NOTE: Limit of ten (10) days per year. If the provider is closed for holidays more than ten (10) days per year, a code 55 must be used for any days over the first 10 days. If this code is used on even one child in error the system automatically uses one of the 10 holidays for the year. 45 –$ Extraordinary absence (For absences which exceed five (5) days, written documentation of illness, (except for maternity leave), natural disaster (declared by nation, county or state), or death in the family must be on file and retained with the provider’s daily attendance sign-in sheets) 50 – Unexcused absence – any absence which exceeds five (5) per month and is not documented by one of the three (3) reasons shown for code 45 55 – Closed, no payment requested 60 –$ Last day attended –payable code-follow with code 55 to prevent overpayment 65 – Non-payable code used to end enrollment-follow with code 55 to prevent overpayment. Codes 60 and 65 were designed to give the provider a method of ending an enrollment for a child that is no longer attending the child care center.
Use the following for flex schedules:
401 –$ Flex excused absence (five (5) per month permitted) full day 402 –$ Flex excused absence (five (5) per month permitted) part day 431 –$ Flex closed but payment requested (scheduled holiday) full day 432 –$ Flex closed but payment requested (scheduled holiday) part day 451 –$ Flex extraordinary absence full day 452 –$ Flex extraordinary absence part day 601–$Flex last day attended – payable full day, follow with code 55 602 –$ Flex last day attended – payable part day, follow with code 55 651 – Flex day to end enrollment – non-payable full day, follow with code 55 652 – Flex day to end enrollment – non-payable part day, follow with code 55
Certified Provider Codes ($ = payable code)
01 –$ Full day- payable code for attendance of five (5) or more hours per day 02 –$ Part day-payable code for attendance less than five (5) hours per day 40 –$ Excused absence (five (5) per month permitted) 43 –$ Holiday, closed but payment requested NOTE: Limit of ten (10) days per year. If the provider is closed for holidays for more than ten (10) days per year, they must be shown as code 55. If this code is used on even one child in error the system automatically uses one of the 10 holidays for the year 50 – Unexcused absence – any absence in excess of five (5) per month 55 – Closed, no payment requested 60 – $ Last day attended –payable day, follow with code 55 65 – Non-payable day used to end enrollment, follow with code 55
Use the following for flex schedules:
401 –$ Flex excused absence (five (5) per month permitted) full day 402 – $ Flex excused absence (five (5) per month permitted) part day 431 – $ Flex closed but payment requested (scheduled holiday) full day 432 –$ Flex closed but payment requested (scheduled holiday) part day 601 –$ Flex last day attended – payable full day, follow with code 55 602 –$ Flex last day attended – payable part day, follow with code 55 651 – Flex day to end enrollment – non-payable full day, follow with code 55 652 – Flex day to end enrollment – non-payable part day, follow with code 55
Registered Provider Codes ($ = payable code)
01 – $ Full day 02 –$ Part-day 50 – Absence 60 – $ Last day attended –payable day, follow with code 55 65 – Non-payable day used to end enrollment, follow with code 55
Use the following for flex schedules:
601–$ Flex last day attended – payable full day, follow with code 55 602 –$ Flex last day attended – payable part-day, follow with code 55 651 – Flex day to end enrollment – non-payable full day, follow with code 55 652 – Flex day to end enrollment – non-payable part-day, follow with code 55
Important Reminders:
Provider Billing Forms (PBF) are ready for providers beginning the first day of the month.
PBFs are processed by DCC Staff during normal business hours M-F 8am-4:30pm. If the first falls on a weekend or a holiday processing will begin the first business day of the month.
PBFs are processed by billing staff within ten (10) business days of receipt or being submitted in the portal.
Providers shall receive payment within thirty (30) calendar days.
If there is a claim, the PBF may be signed monthly to have the claim payment taken out of your payment.
No payments or adjustments will be made ninety (90) or more days after the month care is provided.
Using correct billing codes helps prevent overpayments.
A provider may end an enrollment on a PBF using a code 60 or 65 followed by code 55. A code 60 will pay for the last day the child attended, and a code 65 will end an enrollment without payment.
A code 43 is for HOLIDAY pay only. If code 43 used even on one child during a billing cycle, the system picks it up and uses one of the center’s 10 holidays for the calendar year. During the December billing cycle, provider’s frequently question why they are out of holidays and it is generally because a child was coded in a previous month incorrectly.
Never submit a blank PBF and leave a provider note with directions on how to code the PBF. Coding the PBF is the provider’s responsibility. If you have questions, contact CCAPProviderPayments@ky.gov.
The purpose of the Child Care Assistance Program (CCAP) is to assist families in accessing and obtaining quality child care. CCAP funds are used to assist families with the cost of child care through payment of full or partial costs. Eligibility for CCAP is based upon the family’s gross monthly income, family size, and ability to meet all technical eligibility requirements.
Who is eligible to receive Child Care Assistance?
Parents, who have a child under age thirteen (13), or age thirteen (13) through eighteen (18) with a special need,
AND
Are employed; or
Are enrolled in a full-time educational program or in a certified trade school or accredited college or participate in the SNAP Employment & Training Program; or
Are unemployed but participating in an initial job search. Applications approved on Job Search are given 3 months of eligibility to locate work. (can be used once in a twelve (12) month period); or
Are a teen parent attending elementary, middle, or high school or pursuing a GED in a classroom setting; or
Are a Kentucky Transitional Assistance Program recipient who needs child care while they participate in Kentucky Works; or
Have a Protective/Preventative Service case needing care.
What happens during the Application Interview?
During the CCAP application interview, Family Support staff will:
Ask to view and copy documentation of the birth dates of children for whom benefits are requested.
Ask to view and copy proof of applicant’s identity.
Request social security numbers for all case members.
Request proof of citizenship or legal status of child if not established by birth verification.
Verify residency and household composition.
Request proof of child’s inability to care for himself if care is requested for a child age thirteen (13) through eighteen (18).
Verify all sources and amounts of income.
Explain all the parent rights and responsibilities, including the copay and overages.
Help in locating or choosing a child care provider.
How are Applications Approved?
The client must meet all technical eligibility requirements established by DCC to receive services. A case will be approved or denied within (30) days.
If the parent does not have all verifications at the time of the interview, the case will remain in a pending status for thirty (30) days to allow the parent time to return the paperwork. If verifications are not returned within thirty (30) days, the case will automatically deny.
If the application is approved for benefits, the certification is valid for twelve (12) months if the family continues to meet the technical eligibility requirements of the program.
Case Decided Within
30
Days
Verifications Due
30
Days
Certification Length
12
Months
What about Job Search approvals?
Applicants approved for CCAP services under the Job Search option are given a minimum of three (3) months of CCAP eligibility.
The CCAP case will discontinue at the end of the eligibility period if the parent is not:
working an average of 20 hours per week
enrolled in full-time education in a certified trade school or accredited college, or
participating in the SNAP Employment & Training Program
A DCC-94C will be sent to the provider 10 days before the date of discontinuance.
What’s Transitional Child Care/TCC?
CCAP families that are discontinued due to combined household incomes exceeding 85% State Median Income/SMI at case change and recertification are eligible for Transitional Child Care/TCC. This is an additional CCAP benefit period.
What this means for you as a provider:
The co-payments are always zero ($0).
The reduced rate is calculated at 50% of the Provider Subsidized Rate or the State Max Rate (whichever is lower). Example: If the State Max Rate for the child’s care level is $20, during the TCC period, the rate paid by the state would be $10.
The family is responsible for any overages charged by your center.
You will receive a DCC-94 – Notice of Change that outlines the new reimbursement rate and end date for each child. This will serve as your notice of eligibility discontinuance.
Parents will also receive a Notice of Change showing the new rates being paid by CHFS.
Normal billing procedures will be followed. The adjusted rate will be reflected on the Remittance Report.
What are Grace Periods?
3
Month Grace Period
During the eligibility period, a case may fall into a grace period. The CCAP grace period is a temporary period (up to three (3) months) during which a client is not meeting the minimum eligibility requirements but remains eligible for CCAP.
Grace periods are only applied to cases with active eligibility that have a break in the work, education, and training, or SNAP E&T requirement for circumstances such as maternity/medical leave, a loss of job, or reduction of hours in the eligible activity.
Grace periods will NEVER extend past the original 12-month recertification date. If the issue has not been resolved by the end of the grace period, the case will discontinue.
A DCC-94C will be sent to the provider 10 days before the date of discontinuance.
What are the Application Income Eligibility Requirements?
When a family applies for CCAP benefits, the countable monthly household income must be less than or equal to 85% of the State Median Income, SMI. At reported case changes and yearly recertification, families previously approved for CCAP benefits remain eligible if their countable monthly household income is less than or equal to 85% of the State Median Income level per month. (See table below).
Child Care Assistance Program Income Guidelines as of 7/1/22
Families will be assessed at 85% SMI at application, case change and renewal.
Family Size
85% of State Median Income per month
2
$3743
3
$4623
4
$5504
5
$6384
6
$7265
7
$7430
8
$7595
Over 8
Add $166 for each additional family member
How do CCAP Renewal Interviews work?
CCAP is a public assistance program designed to assist families with the cost of child care. Therefore, the CCAP case is the parent’s responsibility from the date of application until the date the case discontinues. At least forty-five (45) days before the end of a certification period, a DCC-90F Notice of Renewal Interview is mailed to the family, giving them time to begin the recertification process. Ways to renew:
Call (855) 306-8959
Visit the DCBS Family Support Office
Go online to the KYNECT Portal
The letter details what they need to bring to their appointment to ensure the case can be approved as quickly as possible. Same-day approval is only available if all required documentation is provided on the day the parent is in the office.
During the renewal interview, the DCBS Family Support worker informs the parent about responsibilities as a CCAP recipient:
The family may be assessed a daily copayment based on their income, household size, number of children, and other factors.
The amount of their copayment.
The responsibility of paying their copayment to their provider on a weekly basis.
They may be required to pay an overage if the provider charges more than the state’s maximum payment rate; and,
The parent may be responsible for payment of additional fees charged by the provider.
How do parents report a change in status?
The parent is responsible for reporting changes to the DCBS Family Support office within ten (10) days. Reported changes may affect the continued eligibility for CCAP and include:
10
Days
Start or end of a job
Change of employer or extra jobs
More or less hours worked
Increase or decrease in pay
More or less people in the household;
Self-employment;
Schedule change for day care;
Start or end of educational activity and/or participation in SNAP/E&T;
Have questions or need help with Universal Precautions? DAIL has nurse consultants available to provide resources, answer questions, and provide assistance.
Handwashing is one of the most important ways to prevent the spread of disease. It is important to use soap and water and wash your hands for at least 30 seconds or the time it takes to sing the ABC’s.
Hands should be washed:
Before, during, and after preparing food
Before eating food
Before and after caring for someone who is sick
Before and after treating a cut or wound
After using the bathroom, changing diapers, or helping someone in the restroom
After blowing your nose, coughing, or sneezing
After touching an animal, animal food or treats, animal cages, or animal waste
After touching garbage
If your hands are visibly dirty or greasy
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What You Need To Know About Handwashing
Simon tells you, “I never knew how important handwashing was until I watched this video. It’s gross to see how many germs stay on our skin.”
Watch this video for more information about how and why hands should be washed. The entire video must be watched before being able to move on.
Have questions or need help with Universal Precautions? DAIL has nurse consultants available to provide resources, answer questions, and provide assistance.
Mary Ailiff, DAIL Nurse Consultant Cell- 502-226-0578 Mary.Ailiff@ky.gov
