Consumer Rights
Consumer Responsibilities
DSHS responsibilities
Also see Hearings
Effective May 28, 2004
|
WAC 170-290-0025 What rights do I have when
I apply for or receive WCCC
benefits?
When you apply for or receive WCCC benefits you have the right to:
-
Be treated politely and
fairly without regard to race, color, creed, religion, sex, presence
of any sensory, mental or physical disability, sexual orientation,
political affiliation, national origin, religion, age, gender,
disability, or birthplace;
-
Have WCCC eligibility
determined within thirty days from your application date per WAC
170-290-0100(2);
-
Be informed, in writing, of
your legal rights and responsibilities related to WCCC benefits;
-
Only have your information
shared with other agencies when required by federal or state
regulations;
-
Get a written notice at
least ten days before we make changes to lower or stop benefits except
as stated in WAC
170-290-0120;
-
Ask for a fair hearing if
you do not agree with us about a decision per WAC
170-290-0260.
-
Ask a supervisor or
administrator to review a decision or action affecting your benefits
without affecting the right to a fair hearing;
-
Have interpreter or
translator service within a reasonable amount of time and at no cost
to you;
-
Choose your provider as
long as the provider meets the requirements in WAC
170-290-0125; and
-
Ask the fraud early
detection (FRED) investigator from the division of fraud
investigations (DFI) to come back at another time. You do not have to
let an investigator into your home. You may ask the investigator to
come back at another time. This request will not affect your
eligibility for benefits. If you refuse to cooperate (provide the
information requested) with the investigator, it could affect your
benefits.
|
|
Note: This is a reprint of the official rule as published by the Office of the Code Reviser.
If there are previous versions of this rule, they can be found using the Legislative Search page.
|
CLARIFYING INFORMATION
If a consumer does not cooperate with DFI, decide if you have enough
information to determine eligibility or continue current eligibility. If
not, you can request further information from the consumer by sending a
pending letter (on an unapproved case) or a request for information letter
(on an approved case). Follow denial, termination, or approval procedures
accordingly.
Effective December 1, 2005
|
WAC 170-290-0030 What must I do when I apply for or receive WCCC benefits?
When you apply for or receive WCCC benefits you must:
-
Give us correct and current information so we
can determine your eligibility and authorize child care payments
correctly;
-
Choose a provider who meets
requirements of WAC
170-290-0125;
-
Pay, or make a plan
to have someone pay, your WCCC copayment directly to your child care
provider;
-
Leave your children with
your provider while you are in WCCC approved activities. If you
are not in an approved activity and you want to use the provider, you
must make a plan to pay the provider yourself if the provider wants
payment.
-
If you use an in
home/relative provider, make sure care is being provided in the right
home per WAC 170-290-0130.
-
Cooperate (provide the
information requested) with the quality
assurance review process to remain eligible for WCCC. You become
ineligible for WCCC benefits upon a determination of noncooperation by
quality assurance and remain ineligible until you meet quality
assurance requirements or thirty days from the determination of
noncooperation.
-
Cooperate with the fraud
early detection (FRED) investigator. If you refuse to cooperate
(provide the information requested) with the investigator, it could
affect your benefits.
|
|
Note: This is a reprint of the official rule as published by the Office of the Code Reviser.
If there are previous versions of this rule, they can be found using the Legislative Search page.
|
Consumers must cooperate with quality assurance. Consumers are
ineligible for WCCC until they cooperate or up to a maximum of 30 days.
If the consumer reapplies, they may still be in non-cooperation with
quality assurance and be eligible for WCCC. You must decide if the
information requested by quality assurance is needed to determine new
eligibility. If so, you must request the information needed. If it is
not received deny the case following denial procedures. If you do
receive the information, inform quality assurance. Special note: A
consumer can become ineligible for WCCC for another 30 days if another issue
arises with quality assurance and they again do not cooperate.
Effective May 28th, 2004
WAC 170-290-0031 What
changes do I need to report when I apply for or receive WCCC?
-
Notify WCCC staff, within
five days, of any change in providers;
-
Notify your provider
within ten days when we change your child care authorization;
-
Provide notice to WCCC
staff within ten days of any change in:
-
The number of child
care hours you need (more or less hours);
-
Your household income,
including any TANF grant or child support increases or decreases;
-
Your household size
such as any family member moving in or out of your home;
-
Employment, school or
approved TANF activity (starting, stopping or changing);
-
The address and
telephone number of your in-home/relative provider;
-
Your home address and
telephone number; and
-
Your legal obligation
to pay child support.
-
Report to your child care
authorizing worker, within twenty-four hours, any pending charges or
conviction information you learn about your in-home/relative
provider.
-
Report to the child care
authorizing worker, within twenty-four hours, any pending charges or
conviction information you learn about anyone sixteen years of age
and older who lives with the provider when care occurs outside of
the child's home.
|
|
Note: This is a reprint of the official rule as published by the Office of the Code Reviser.
If there are previous versions of this rule, they can be found using the Legislative Search page.
|
Effective December 1, 2005
| WAC 170-290-0032 What
are the consequences if I do not report changes within the specified
time frames?
If you fail to report any changes as required in WAC
170-290-0031 within the stated time
frames, we may establish an overpayment per
WAC 170-290-0271
or you might have to pay more
than your normal share of child care costs, such as:
-
Paying a higher
copayment;
-
Paying for extra hours of
care when your activity requires more than ten hours a day of care;
-
Receiving an overpayment
for the number of days your child was absent including the absences the
licensed/certified or DSHS seasonal contracted day care provider is
allowed to bill (see publication
Child Care Subsidies, A Booklet
for Licensed and Certified Child Care Providers, DSHS 22-877)(Editor's note: this publication is now DEL 22-877).
An overpayment for absent days can occur when care is used when you
are not eligible for WCCC and can be up to five days a month;
|
|
Note: This is a reprint of the official rule as published by the Office of the Code Reviser.
If there are previous versions of this rule, they can be found using the Legislative Search page.
|
CLARIFYING INFORMATION:
If a consumer fails to report changes timely according to WAC 170-290-0031 authorize care back to the date:
The consumer is eligible for the increase in care and
An eligible provider did care.
This includes payment for:
|
EXAMPLE 1:
Misty is currently approved for half-day child care. She calls in August to request full-day child care for her provider back to June 25th. Misty's schedule supports full-day care and she used an eligible provider. Authorize care per Misty's request effective June 25th.
|
|
EXAMPLE 2:
Misty is currently approved for half-day child care. She calls in August to request full-day child care for her provider back to June 25th. Misty's schedule does not support full-day care until her activity schedule changed July 10th. Misty used an eligible provider. Authorize care per Misty's request effective July 10th.
|
If a consumer fails to report changes timely according to WAC 170-290-0031 the consumer may not be eligible for reimbursements and could receive overpayments.
|
EXAMPLE:
Daisy is approved
for WCCC February 1 through July 31 with a $200.00 copayment. Her income is reduced
beginning in March but she does not report the change until May 15th.
Daisy did not report the change timely per WAC
170-290-0031(3)(b). You review the income and child care need. If her
copayment is decreased, the change effective date is June 1. She is not
reimbursed the copayment difference for May because she did not report
timely.
|
-
Paying a higher copayment refers to a consumer not
being reimbursed if they do not report income decreases timely. A copayment
for a consumer is not increased during their eligibility period except for
as noted in WAC 170-290-0085. See
COPAYMENT section for more information.
WORKER RESPONSIBILITIES:
-
When a source other than the consumer reports
information, such as the provider or a neighbor, you must still confirm the
report with the consumer. You can call the consumer or send a
Request for
Information letter (DEL 07-076). The consumer is still responsible to
report changes within the stated timelines.
-
If the provider calls to report they are no longer
providing care you can terminate payment per the provider’s request. This
does not terminate the consumer’s eligibility. When this occurs, contact the
consumer by calling or sending a
DEL 14-417 Part 2 form and possibly a
Background
Authorization form (DSHS 09-653).
-
Information from another government source (such as ACES, SEMS, etc) does not need to be verified. The consumer or provider may be eligible for a reimbursement or an increase in care or payment depending on the information.
|
EXAMPLE:
A consumer is
eligible for WCCC January 1 through June 30. While reviewing the consumer’s
reapplication you find in SEMS their child support payments stopped in
March. The consumer did not report this information, but the state was
aware of the change. You can re-determine the consumer’s copayment for
April-June based on this decreased income.
The difference in the copayments can be a reimbursement to the consumer or a payment to the provider depending on how much the consumer paid the provider April-June for the copayment.
|
Effective December 1, 2005
|
WAC 170-290-0035 What responsibilities does
the WCCC
program staff have?
The WCCC program staff are
responsible to:
-
Determine your eligibility
within thirty days from the date you applied (application date as
described in WAC 170-290-0100(2)).
-
Allow you to choose your
provider as long as they meet the requirements in WAC
170-290-0125;
-
Review your chosen in
home/relative provider's background information.
-
Authorize payments only to
child care providers who allow you to see your children whenever they
are in care;
-
Only authorize payment when
no adult in your WCCC family is "able or available" to care for your
children (under WAC
170-290-0020).
-
Inform you of:
-
Your rights and
responsibilities under the WCCC program at the time of application and
reapplication;
-
The types of child care
providers we can pay;
-
The community resources
that can help you select child care when needed; and
-
Any change in your
copayment during the authorization period except under WAC
170-290-0120(5).
-
Respond to you within
ten days if you report a change of circumstance that affects your:
-
WCCC eligibility;
-
Copayment; or
-
Providers.
-
Provide prompt child care
payments to your child care provider.
|
|
Note: This is a reprint of the official rule as published by the Office of the Code Reviser.
If there are previous versions of this rule, they can be found using the Legislative Search page.
|
WORKER RESPONSIBILITIES:
Staff must determine eligibility
within 30 days of the date of application. Take the following steps if a client
has failed to provide the necessary information to determine eligibility:
-
Send a pending letter describing
exactly what items are needed. Allow for at least 12 days for a client to return
the information or contact the office (12 days allows for extra days needed due
to letters being mailed from Olympia by the central mail process).
-
Send a denial notice if the consumer
does not supply the information needed.
-
Re-pend the application if the
consumer requests additional time per WAC
388-458-0020.
|