BEFORE THE Department of PUBLIC
HEALTH AND HUMAN SERVICES
OF THE STATE OF MONTANA
TO: All Concerned Persons
1. On April 13, 2018, the Department of Public Health and Human Services published MAR Notice No. 37-837 pertaining to the public hearing on the proposed adoption and amendment of the above-stated rules at page 690 of the 2018 Montana Administrative Register, Issue Number 7.
2. The department has adopted the following rule as proposed: New Rule II (37.80.208). The department has amended the following rules as proposed: ARM 37.80.101, 37.80.102, 37.80.201, 37.80.205, 37.80.206, 37.80.301, 37.80.316, 37.80.501, and 37.80.502.
3. The department has adopted the following rule as proposed, but with the following changes from the original proposal, new matter underlined, deleted matter interlined:
NEW RULE I (37.80.207) BEST BEGINNINGS CHILD CARE SCHOLARSHIP PRESCHOOL (1) The Best Beginnings Child Care Scholarship will not reimburse child care services during preschool program hours at any of the following settings:
or preschool settings, as defined described in ARM 10.63.101;
(b) through (2) remain as proposed.
AUTH: 53-4-212, MCA
IMP: 52-2-713, 53-4-611, MCA
4. The department has thoroughly considered the comments and testimony received. A summary of the comments received and the department's responses are as follows:
COMMENT #1: A commenter stated the word "public" in New Rule I was confusing too many child care providers because providers view themselves as "public."
RESPONSE #1: In New Rule I, the department references "public preschool" as a program that is established under ARM 10.63.101. A preschool program that receives state or federal funding for preschool is not eligible for reimbursement during preschool program hours. To clarify the rule's intent, the department is revising New Rule I(1)(a) to remove the word "or" after "public" and changing the nature of the cross-reference regarding ARM 10.63.101, which describes public preschools.
COMMENT #2: Two commenters asked the department to consider allowing Montana preschool development grant and licensed Head Start facilities to be permitted to receive the Best Beginnings Child Care Scholarship (BBCCS) during operating preschool hours.
RESPONSE #2: These preschool programs may receive both federal and state funds to support the preschool hours. The department has determined that BBCCS will not provide additional support to the preschool program for the hours in the day already receiving public funding for preschool.
COMMENT #3: A commenter stated Family, Friend, and Neighbors (FFNs) should not be included in child care referral services.
RESPONSE #3: The department believes both families and FFNs will benefit from FFNs being part of child care referral services. FFNs are registered child care providers who receive annual training and inspections and meet health and safety standards. FFNs will offer parents more options for child care providers on a child care referral list.
COMMENT #4: A commenter suggested a child care reimbursement rate could be set as a percentage of the provider fee with the family paying the difference because areas such as Bozeman and Big Sky have a higher cost of living.
RESPONSE #4: The department used the 2016 Montana Child Care Market Rate Survey (Survey) to develop child care payment rules. The Survey polled child care providers across Montana and asked what providers charge for care of children by age and attendance. The Final Rules at 45 CFR Part 98 (Final Rules) require payment rates be set "in accordance with the results of the most recent market rate survey." The Survey also recommends one statewide rate, and the department followed this recommendation.
COMMENT #5: Two commenters stated a statewide reimbursement rate would be punitive to parents that live in an area where child care providers charge a rate lower than the statewide reimbursement rate. These providers will set their rates based on what the statewide reimbursement rate is and be a burden to private-pay families.
RESPONSE #5: Child care providers are business owners and can set their fees for child care as they see fit and appropriate to support their business. The department is responsible for setting child care reimbursement rates statewide for reimbursement of subsidized child care. The Survey polled child care providers across the state. The data is statistically valid and reliable, which is also a requirement of any market rate study per the Final Rules. The Child Care Policy Manual (Manual), in Policy Section 1-4: Scholarship Rates, "Best Beginnings Child Care Scholarship payments are made at a rate determined by the ECSB through a market rate survey, or at a provider’s rate, whichever is lower." Child care providers may not charge the state a higher rate than they charge the public.
COMMENT #6: A commenter stated the sliding fee scale could be adjusted to have smaller steps to allow for more parents to qualify and have a lower copayment. This would especially be helpful for single parent households.
RESPONSE #6: The department did not propose a revision to the sliding fee scale in this rulemaking. The department does not intend to change the current sliding fee scale at this time due to fiscal restraints.
COMMENT #7: A commenter asked if a licensed child care center with a preschool serving two and three-year-old children would be eligible for the BBCCS.
RESPONSE #7: A licensed child care center serving two and three-year olds is eligible to receive the BBCCS as long as the facility continues to meet the BBCCS requirements. New Rule I applies to preschool program hours. "Preschool" is defined in ARM 37.80.102 as "an educational program or school environment targeted to children at age four and up to kindergarten age." New Rule I does not apply to two and three-year olds.
COMMENT #8: A commenter asked about differences between ARM Title 37, chapters 80 and 95 in the following areas: child-to-staff ratios, age ranges, and preschool child age.
RESPONSE #8: The rule chapters referenced apply to two different functions of the department. Chapter 80 applies only to children receiving the BBCCS and child care providers serving children receiving the BBCCS, and age ranges including preschool-aged children are for payment purposes only. Chapter 95 applies to all child care providers licensed or registered to provide child care services by the department's Quality Assurance Division, Child Care Licensing Program.
COMMENT #9: A commenter asked what payment rates would be used: hourly rates, half-time day rate, or full-time day rate.
RESPONSE #9: The department will use a payment rate of a half-time day and
full-time day rate to reimburse the BBCCS.
COMMENT #10: A commenter asked about the removal of "Absent Days" from the Manual.
RESPONSE #10: The department is removing the definition for "Absent Days" from the Manual because it is provided in ARM 37.80.102, and its removal from the Manual will reduce confusion over terminology.
COMMENT #11: A commenter stated there is a shortage of infant/toddler slots due to the child-to-staff ratio and associated cost. The commenter stated an increase in either the reimbursement rate or child-to-staff ratio would help increase access and affordability for infants/toddlers.
RESPONSE #11: The department is required to uphold the child-to staff ratio rule found in ARM 37.95.623. The department is changing the age range for "infant/toddler" from birth to a child’s second birthday to birth through the end of the 35th month. The department believes that by extending the age range for infant/toddlers, an increase in access and affordability for infant care will occur because a higher rate of reimbursement for the BBCCS will be paid.
COMMENT #12: A commenter stated that changing the age range from an "infant" to an "infant/toddler" will cause more providers to accept younger children. This will cause child care providers to be burdened. A higher reimbursement rate for
three-year olds, instead of two-year olds, will decrease affordability.
RESPONSE #12: The department intends for the change in age range for "infant/toddler" to be a positive action for both families, children, and child care providers due to the increased reimbursement rate for the BBCCS for this age group.
COMMENT #13: A commenter supported the proposed "infant/toddler" definition because it would benefit child care providers who care for young children.
RESPONSE #13: The department thanks the commenter for the comment and agrees with the comment.
COMMENT #14: A commenter stated child care providers may have to raise their rates because the department is revising its reimbursement rates. If a child care provider raises their rates, this may be a burden to families.
RESPONSE #14: The department does not intend for child care providers to have to raise their rates. Child care businesses determine their rates based on their business needs. Reimbursement rates were determined using information from the Survey. Child care providers were asked what they charge private-pay families. Reimbursement rates were set based on the child care providers' responses.
COMMENT #15: A commenter supported the use of half and full-day rates because it will be easier for child care providers when submitting monthly invoices.
RESPONSE #15: The department thanks the commenter for the comment and agrees with the comment.
COMMENT #16: A commenter supported the department reimbursing for registration fees for children receiving the BBCCS and the requirement that the reimbursed registration fee must also be charged to all families enrolled with a child care provider.
RESPONSE #16: The department thanks the commenter for the comment and agrees with the comment.
COMMENT #17: A commenter requested the registration fee be increased to any amount up to $75.00.
RESPONSE #17: The department used data from the Survey, fiscal analysis, and fiscal impact data to determine a reasonable registration fee reimbursement amount. The department does not intend to change the registration fee limit at this time due to fiscal restraints.
COMMENT #18: A commenter stated the sliding fee scale should be increased so a parent earning above 150% of the federal poverty guidelines would be eligible for the BBCCS.
RESPONSE #18: The department did not propose a revision to the sliding fee scale in this rulemaking. The department does not intend to change the current sliding fee scale at this time due to fiscal restraints.
5. The department intends to apply the adoption of New Rule I (37.80.207), New Rule II (37.80.208), and the amendments to ARM 37.80.101, 37.80.102, 37.80.201, 37.80.206, 37.80.301, 37.80.316, 37.80.501, and 37.80.502 effective July 7, 2018. The department intends to apply the amendments to ARM 37.80.205 effective September 28, 2018.
/s/ Geralyn Driscoll /s/ Sheila Hogan
Geralyn Driscoll Sheila Hogan, Director
Rule Reviewer Public Health and Human Services
Certified to the Secretary of State June 26, 2018.