In-Home PROVIDER AGREEMENT LETTER

July 2012

IMPORTANT – PLEASE READ

Dear Provider:

This letter contains important information about your new In-Home Parent/Caretaker Provider Agreement.

Attached with this letter are:

  • The In-Home Provider Agreement
  • Appendix A – Standards and Guidelines for Participation
  • Appendix B – CCIS Subsidized Child Care In-Home Provider Payment Rates
  • Appendix C – Rules for Participation in the Subsidized Child Care Program

The Agreement and Appendices are effective on July 1, 2012. Please review the attached Agreement and Appendices which include the following major changes:

Terms of the Agreement

  • You must provide verification of your Social Security Number to the Child Care Information Services (CCIS).
  • You cannot live in the home of children for whom you provide care.
  • The CCIS may terminate the Agreement if the child’s health condition changes ands/he no longer requires in-home care and/or the parent no longer needs care between the hours of 9p.m. and 6 a.m.
  • You may be terminated from the Subsidized Child Care Program if you violate the terms of this Agreement.

Conditions

  • The CCIS will refer all cases of suspected provider fraud to the Office of Inspector General (OIG). The Office of Child Development and Early Learning (OCDEL) may instruct the CCIS to delay or withhold payment, in part or in full, pending the outcome of an OIG investigation for suspected fraud.

Provider Certification

  • If a change occurs or if the parent does not pay the weekly co-payment, you must notify the CCIS on the business day following the day the co-payment becomes delinquent.

Appendix A

Provider Standards

  • On the sixth consecutive day of absence, you must report the absences to the CCIS.
  • You must provide the CCIS with photo-identification or two other forms of identification upon application.
  • You must provide proof of your address to the CCIS upon application and if you move.

Parent/Caretaker Guidelines

  • You must report if the Federal government has suspended or debarred you from participating in the subsidized child care program.

Submitting an Invoice for Payment

  • You must accurately complete attendance invoices each month and document all absences for children who are not in care. The invoice must be submitted to the CCIS monthly either online or on a form provided by OCDEL. The invoice must include the days of attendance and absence for each child.
  • The CCIS may audit providers who utilize the No Change code on a regular basis when completing Attendance Invoices. Non-compliance with accurate completion of Attendance Invoices may lead to termination of the Agreement and referral to the OIG for fraud investigation.

Please do the following:

  1. Read the In-Home Provider Agreement, Appendix A, Appendix B, and Appendix C carefully.
  2. Sign and date Page 7 of the In-Home Provider Agreement at “Provider Signature”. (Note: The parent/caretaker and provider must both sign the Provider Agreement.)
  3. Sign and dateand print your name on Page 8 of the In-Home Provider Agreement at “Provider Signature”, if you request an interpreter.
  4. Print your name on Page 7 of the In-Home Provider Agreement at “Print Signature of In-Home Provider”.(Note: The parent/caretaker and provider must both print their names.)
  5. Return Page 7(and Page 8 if you request an interpreter) of the In-Home Provider Agreement to:

CCIS NAME AND ADDRESS

To continue to receive child care payments, you must sign the In-Home Provider Agreement and return it to our office by___CCIS complete___. If we do not receive your signature page by this date, we will not continue to pay you for giving child care.

Contact our office at if you have any questions.

CCIS NAME