Child Care Subsidy: Presumptive Eligibility Coding

The following article provides an example of Presumptive Eligibility Coding for Child Care cases:

Mike Brady applies for child care and is interviewed on 02/15/18. He has supplied all necessary verification to approve the child care with the exception of his employment verification. This is a new job for Mike. The worker and client both attempt to get the employment verification; but the local employer is not able to give the information. The local office informs the worker that all employment verifications must go through their corporate office which is located out of state and could take a week to 10 days. Since obtaining the employment verification is out of the client’s control, the worker may approve 30 days of Presumptive Eligibility child care pending the return of the employment information. The worker must approve 30 days of child care on the system using the unfinished issuance process closing the child care 30 days from the date of approval.

  1. Certify the Child Care Tab (Section E) with “Eff Months” (E6) equal to “02” (in cases where the entire 30 day approval falls within 1 month, code E6 equals to “01”)

  1. **SAVE THE CASE and PUSH CASE completely through**
  2. Code a close action on the Child Care Tab for reason “plan of service completed (81)”
  3. Enter “99” in the Effective Months: block.

  1. **SAVE THE CASE AND PUSH CASE completely through**NOTE: You will receive an edit PSE539 when it is time to enter the child care authorization. Proceed to Step 6.
  2. Enter the child care authorization on the “Auth Daycare” tab with the appropriate date. Also, the end date must be in place when you take the open action.

auth daycare tab

On 03/17/18, Mike turns in his first full pay stub that he received on 03/15/18. The worker is now able to make a full eligibility determination and continue the child care for Cindy. Mike will owe a copayment for Cindy’s care beginning 04/01/18.

  1. Certify the Child Care Tab (Section E) with “Eff Months” (E6) equal to “01” with a certification date of 3/17/18, the first day after the original 30 days. You will maintain the original application date of 2/15/18. (In the past you would have reopened the E section but this is no longer possible because of locked-in copayments.)

  1. **SAVE THE CASE and PUSH CASE completely through**
  2. Make a change to the E section (Child Care Tab) effective 04/01/18 and change the “Effective Months” to “99”

  1. Reopen the child care authorization on the “Auth Daycare” tab with the appropriate begin date.

  1. **SAVE THE CASE and PUSH CASE completely through.
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