Montana's Special Needs Subsidy

General Overview

Montana’s Special Needs Subsidy is an integral part of the state Special Needs Services Program. This service provides financial support to low income families who are working or enrolled in a training/education program. The state of Montana seeks to increase access to child care services for families of children with disabilities. The primary purpose of this program is to assure that children with special needs receive quality, appropriate care while their parents are employed or in educational programs. Montana?s Special Needs Subsidy allows for payment directly related to the needs and abilities of an individual child in the context of their early childhood program. Because of this, the child care subsidy amount is different for every child.

In addition to an adjusted monthly child care subsidy payment, one-time expenses may be reimbursed using the state?s Best Beginnings Child Care Scholarship fund for support and resources such as adaptive equipment, tuition for specialized training, or individualized technical assistance needed to learn caregiving routines for the child.

Child care providers have a responsibility to make reasonable accommodations to include children with disabilities, developmental delays, and other special needs. Subsidies provided through this program are to be used to offset expenses to the provider for adaptations necessary to care for the child in the provider?s child care program. These costs must be for accommodations that, in the absence of financial supports, would place an undue burden upon the provider. Undue burden may include excessive cost or extensive change to the child care program. Examples of accommodations that may bring added costs include adding extra staff, caring for a smaller number of children (and thereby reducing provider income), or making structural or other types of accommodation.

Determining the subsidy amount
The amount and duration of child care subsidy is determined on an individual basis. The subsidy may be one-time-only or provided as an ongoing monthly subsidy. The amount of the subsidy is determined by completing the Special Needs Rating Scale which assesses the type and intensity of care required by the child. Once the Rating Scale is completed, the Individual Child Care Plan is used to document and further describe the type of modifications or adaptations needed for the child. Current (within a calendar year) and relevant documentation from an appropriate professional is required as well.

The Special Needs Subsidy Application Process

At the time of application for the child care subsidy:

1. The family goes to their local child care resource and referral program (CCR&R) to apply for child care subsidy.

2. CCR&R staff assist the family in determining eligibility and completing paperwork required for the subsidy. As part of this intake process, the CCR&R staff determine if it seems appropriate to refer for a special needs subsidy and if so, a referral is made to the Early Childhood Specialist.

3. A referral for the Special Needs Subsidy can be made at any time a family is receiving regular child care subsidy. In other words, if a family is already receiving child care assistance and a situation develops in which the provider and/or family has concerns about a child, the process can begin at that point.

4. The determination for referral is based on a) the diagnosis of a disability or developmental delay; b) parent description of the child’s current needs, or 3) past difficulty of finding or maintaining a child care placement for this child. In order to qualify for the special needs subsidy, a child must require special modifications or accommodations in the child care setting. The child may or may not have an identified disability diagnosis.

5. The Early Childhood Specialist will make a visit to the child care facility to meet the provider, observe the setting, and see how the child interacts with the environment, other children, and adults. The primary objective of this guided observation is to establish a relationship with the provider and to observe the setting.

6. After this observation visit has been made, the Early Childhood Specialist interviews the parent (and provider if possible) and completes the Special Needs Subsidy Rating Scale to identify the areas in which accommodations are required. The scoring worksheet at the end of the Rating Scale determines the amount of additional special needs subsidy that could be paid to the child care provider.

7. When the parents and provider meet together with the Early Childhood Specialist to complete the Rating Scale, the next step is to complete the Montana Individual Child Care Plan as a team. When the provider is not available at this time or other professionals need to be contacted before the Early Childhood Specialist has enough information to complete the Child Care Plan, an appointment should be scheduled by the Early Childhood Specialist to bring the essential team members together within 10 working days to complete the plan.

The Child Care Plan provides specific documentation of the child?s need, delineates required accommodations, identifies additional resources which may be available, and names at least two individuals who could provide additional information, if needed.

• When a child is receiving services from a developmental disabilities contracted service provider (Child and Family Service Provider), an appropriate staff person from that agency should be included in the development of the Child Care Plan if at all possible.

• When the child is receiving special education services, an appropriate school staff person should be included in the development of the Child Care Plan if appropriate and possible.

• When the child is not currently receiving early intervention or special education services, two things should occur. First, a referral should be made to the appropriate service provider to ensure that the family is aware of the special services available and that the child has access to these services. Second, the Early Childhood Specialist should assist the family in identifying a qualified professional who can participate in developing the Child Care Plan. This individual may be a physician, psychologist, social worker, or other professional who knows the child’s needs and can provide documentation that special accommodations are required.

• There may be some children who would benefit from the special needs subsidy but whose needs have not been documented. These children may be considered on a case-by-case basis.

8. The Early Childhood Specialist uses the completed Child Care Plan and the Special Needs Rating Scale together to document and apply for additional funds. These forms as well as all supporting documentation will be sent to the Special Needs Services Coordinator for review and approval.

If the Child Care Plan and the Special Needs Rating Scale provide similar information and documentation supports the need, the special needs subsidy rate will be approved until the end of the certification period.

If the Child Care Plan does not identify accommodations that require additional costs and/or there is no documentation for the child’s needs, the special needs subsidy rate will be denied. If additional documentation is needed before making a decision, the Special Needs Services Coordinator will request additional information to be gathered. Appeal of this decision should be directed to Montana’s Department of Public Health and Human Services (DPHHS).

The Special Needs Services Coordinator will respond to the Early Childhood Specialist within 10 working days of receiving the completed paperwork. If approved, a CCR&R staff person will enter a final amount into the system for the special needs subsidy to support the child care placement. This rate is approved until the end of the certification period. A copy of all paperwork must be given to: the family, the Early Childhood Specialist at the R&R, the Special Needs Services Coordinator.

Appropriate follow-up will be conducted by the Early Childhood Specialist as indicated on the Child Care Plan. In addition, a review of each case will be conducted at the end of the certification period by the Early Childhood Specialist with the family and provider. The Rating Scale will be completed again and the Child Care Plan updated appropriately. If nothing significant has changed, the Recertification Form is sent to the Special Needs Services Coordinator for review and approval for the continuing the rate. If there are changes to the Rating Scale and Child Care Plan, they should be sent to the Special Needs Services Coordinator with supporting documentation, and the process begins again. Supporting documentation must not be older than one calendar year.

Frequently Asked Questions

* Does the subsidy apply to children over the age of 13?
Yes, children with disabilities are eligible for subsidy until age 18.

* Does a child for whom English is a second language qualify?
Yes, when the rating scale establishes that the language barrier is creating a need for significant extra support for the child. In almost all such cases, it will be a temporary need for subsidy.

*Does the Child Care Plan have to be redone when there is a change in provider?
Yes, the situation should be re-evaluated because a change in setting could mean a significant change in the kind of support needed for the child. If the Rating Scale is re-done and there is no significant change, the Child Care Plan that already exists can stay in place. Document the assessment of the new placement. In general, the Child Care Plan stays with the child, not the provider.

* Can a Legally Unregistered Provider (LUP) qualify for the Special Needs Subsidy Program?
Yes, use the same procedures already described to establish eligibility when the child is in this type of placement.

* What is the role of early intervention specialists, therapists, physicians, public health nurses, and others who work with young children with disabilities and their families?
Collaboration is a key element in the eligibility process. Any professional providing support to the family can and should assist in the development of both the Rating Scale and the Child Care Plan. For example: an early intervention specialist or family support specialist may help the family describe adaptations needed for this child; a special educator may assist the family by providing a copy of the child’s IEP and activity suggestions to give to the child care provider; a therapist may be identified on the list of resources as someone who might provide technical assistance to help the child care provider learn range of motion exercises.

* What if the child care provider does not feel the Rating Scale was completed correctly?
If the child is already enrolled in a child care program, the child care provider should help the parent and the Early Childhood Specialist complete the Special Needs Rating Scale. Even if the child care provider was not involved in completing the Rating Scale, he or she should be part of the process of completing the Child Care Plan, which describes the child’s needs and provides supporting information for the subsidy rating. If the description of the child’s needs on the Rating Scale and the Child Care Plan do not match, the Early Childhood Specialist will need to gather additional information and can, in fact, adjust the subsidy amount based on this additional information.

* What if the parent is unable to provide information required for completion of the Special Needs Subsidy Rating Scale?
The Special Needs Subsidy Rating Scale is completed by the Early Childhood Specialist using a guided interview with the child’s parent or legal guardian and the provider. If the parent cannot provide the information required, the interview process must be adapted to meet the parent’s needs. This may include the use of an interpreter if English is not the person’s primary language, holding the intake interview in a different location if access is the issue, or rescheduling the interview so that the parent can have an advocate or support person available. When a DPHHS social worker is working with the family, this person should gather information about the child.

* Are all families of young children with disabilities eligible for this program?
Unfortunately, not all families are eligible for the child care subsidy. Eligibility is limited to families whose income falls below a certain percentage of the federal poverty guidelines. CCR&R agencies assist families in determining whether they qualify for subsidies in Montana’s Best Beginnings Child Care Scholarship Program and receive monetary support for child care. When the family meets the eligibility requirements and the child has a special need, the Special Needs Subsidy Rating Scale will be used to identify the extent of extra care required and the subsidy amount for the child.

Although not all families are eligible for financial support for child care under Montana’s Special Needs Subsidy Program, the Child Care Plan is a useful tool to describe adaptations that the child will need in order to be successful in a child care program. This tool also provides the structure to gather input from the parent, child care provider, and other professionals so that everyone can work together to ensure a successful child care placement. In addition, technical assistance is available to providers when the need is established.

* Do all children with disabilities qualify for the Special Needs Subsidy if the family meets the financial eligibility requirements?
The Montana’s Special Needs Subsidy Program is designed to assure that children with disabilities and other special needs receive high quality child care. The subsidy amount is directly linked to the child’s needs. Not all children with disabilities require significant modifications to participate in child care routines and activities. For example, a child with an identified speech delay might require the provider to adjust the way she asks the child to indicate choices or to listen carefully because the child has difficulty producing sounds clearly. These are reasonable accommodations which would be expected of the child care provider with no additional financial compensation. Some children who do not have an identified disability will qualify for an additional subsidy amount because they require significant modifications and adaptations. In particular, children with behavior challenges may be difficult to include in group settings and can require significant changes to the child care environment and routines.

*Do children have to have a diagnosed disability to qualify for the Special Needs Subsidy?
No, a diagnosis is not required. However, appropriate supporting documentation of necessary modifications is required. That documentation may take many forms, such as documentation from a social worker, therapist, physician, early interventionist, or school psychologist.

Special Needs Subsidy Rating Scale

PURPOSE
This form describes a child’s needs for extra care while in the child care setting. Together with the Montana Individual Child Care Plan and appropriate documentation, this form can be used to authorize an increased rate (Special Needs Subsidy Rate) to be paid to the child care provider. It serves as a guideline to help determine the level of additional care and supervision a child may need because of a physical, mental or behavioral condition. Because every child has individual needs, this form provides a way to describe the unique needs of this child and to begin to identify the type of support this child will need to maintain a placement in a typical child care program.

The Special Needs Subsidy Rating Scale provides a way to compare the care needs of one child with a special need with other children of the same age. The Special Needs Subsidy is designed to provide reimbursement for actual cost for care which exceeds those provided to other children. It is also important to remember that the subsidy applies to a child care setting, not a treatment or therapeutic setting. The subsidy can only pay for the cost of providing child care, not for the cost of therapy, intervention, or other specialized treatment.

PROCESS
The Special Needs Subsidy Rating Scale is intended to be completed by the Early Childhood Specialist at the local Resource and Referral Agency and the child’s parent(s) or guardian(s). When the child is already enrolled in a child care program, the child care provider should also be included. When the child is in the Child Protective Services system, the case worker may be the most appropriate person to assist in completing the Rating Scale.

This form, the Montana Individual Child Care Plan, and all supporting documentation should be sent for approval to:
Special Needs Services Coordinator
Child Care plus+
634 Eddy Avenue
The Univesity of Montana
Missoula, MT 59812-6696

Special Needs Rating Scale Form

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Special Needs Rating Scale Sample Interview Questions