Form 1 FY 2017-2019 CCDF Tribal Plan Preprint

CHILD CARE AND DEVELOPMENT FUND

for

TRIBE:

FFY 2017-2019

This Plan describes the CCDF program to be administered by the Tribes for the period 10/1/2016 – 9/30/2019. As provided for in the applicable statutes and regulations, the Tribal Lead Agency has the flexibility to modify this program at any time, including amending the options selected or described herein.

For purposes of simplicity and clarity, the specific provisions printed herein of applicable laws and regulations are sometimes paraphrases of, or excerpts and incomplete quotations from, the full text. The Tribal Lead Agency acknowledges its responsibility to adhere to them regardless of these modifications.

Public reporting burden for this collection of information is estimated to average 120 hours per response, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.

(Form ACF 118-A; OMB Approval Number: XXXX-XXXX, expires XX/XX/XXXX)

TABLE OF CONTENTS

Tips for Completing the Tribal CCDF Plan Preprint

Preprint Design Technical Assistance

1. Define CCDF Leadership and Coordination with Relevant Systems

   1. Tribal CCDF Applicant

   2. Designated Tribal Lead Agency

   3. Administration through Contracts or Agreements

   4. Consultation in the Development of the Tribal CCDF Plan

   5. Consultation in the Development of the State CCDF Plan

   6. Coordination of Services

2. Provide Stable Child Care Financial Assistance to Families

   1. Eligible Children and Families

   2. Application and Eligibility Determination/Redetermination Processes

   3. Improving Access for Vulnerable Children and Families

   4. Family Contribution to Payment

3. Ensure Equal Access to High Quality Child Care for Low-Income Children

   1. Description of Direct Child Care Services

   2. Assessing Child Care Market Rates

   3. Setting Payment Rates for Child Care Services

   4. Payment Practices and Timeliness of Payments to Providers

   5. Family Contribution to Payment

   6. Supply Building Strategies to Meet the Needs of Certain Populations

4. Ensuring the Health and Safety of Children in Child Care Settings

   1. Requirements and Standards

   2. Disaster Preparedness and Response

   3. Monitoring and Enforcement Policies and Practices

   4. Criminal Background Checks

   5. Exemption of Relative Providers

5. Supporting Continuous Quality Improvement

   1. Child Care Quality Improvement Goals

   2. Quality Improvement through Provider Training and Professional Development

   3. Other Quality Improvement Activities

   4. Funding for Quality Activities

6. Program Integrity and Accountability

   1. Program Integrity and Accountability Measures

7. Tribal CCDF Funding

   1. Child Count

   2. Estimated FY 2017 CCDF Funding Allocation

   3. Intent to Use CCDF Funds for Construction or Major Renovation

8. Optional Abbreviated Plan for Tribes Receiving Allocations under $250,000

Tips for Completing the Tribal CCDF Plan Preprint

Preprint Design

Technical Assistance

Section 1 – Administration

Section 2 – Child Care Services Offered

APPENDIX 1: Child Count Declaration Form

APPENDIX 2: CCDF Program Assurances and Certifications APPENDIX 3: List of Certifications

APPENDIX 4: Amendments Log

Tips for Completing the Tribal CCDF Plan Preprint

Preprint Design

The Tribal CCDF Plan Preprint is organized into seven sections critical areas:

• Section 1 identifies the Tribe or Tribal Organization applying for CCDF funds, including how that applicant entity delegates the administration of the CCDF program, how it develops its CCDF Plan, and how it plans to coordinate CCDF-funded services with other relevant entities;

• Section 2 details how the grantee decides who is eligible for CCDF-funded services, the means by which parents are informed and can apply for services, how the grantee gives priority to children with special needs, and how family co-payments are determined;

• Section 3 describes CCDF-funded services available, how assessment of market rates is determined, how payment rates for services are computed, how timely payments are made to providers, and the strategies used to increase the supply and quality of services;

• Section 4 identifies what health and safety standards the grantee applies to which categories of providers, what plans the grantee has for disaster preparedness, how policies and procedures are monitored and enforced, what type of criminal background checks are required, and what exemption of health and safety requirements is available to relative providers;

• Section 5 details the grantee’s goals for quality improvement, describes professional development opportunities and strategies for retention of providers, lists types of consumer information offered to parents, and other quality improvement activities;

• Section 6 describes the program’s integrity and accountability measures; and

• Section 7 identifies whether a grantee has policies and procedures for conducting a child count, how the grantee intends to use discretionary targeted funds, and whether the grantee intends to use CCDF funds for construction/renovation.

• Section 8 is an optional abbreviated Plan that Tribes or Tribal Consortia receiving annual CCDF allocations of less than $250,000 may choose to complete and submit. Tribes that select this option are not required to complete Sections 1-7 of the Plan. However, Tribes with allocations of less than $250,000 can choose to complete Sections 1-7 and in doing so will be required to complete all parts/sections unless specifically exempted as noted in the instructions. Note: Tribes can use their FY 2015 or FY2016 allocations to determine whether a Tribe is below the $250,000 threshold.

Within each section, questions are grouped by topic to make the Preprint easier to read and complete.

When a question requires a “yes” or “no” response, the order of the yes/no options changes depending on the question so that the simplest response is first and the more complex response follows. For example, if a “yes” response would require an explanation and a “no” response would not, the “no” option will appear first. Similarly, if a “no” response has additional sub- questions that need to be answered but a “yes” response does not, the “yes” option would appear first. This structure is used to simplify the Plan development process by allowing the

person completing the Plan Preprint to skip over response choices that are not relevant; it is NOT designed to imply that the first answer is the correct answer or the default answer. All questions should be answered in the way that best reflects what is actually happening in the Tribal CCDF program.

Guidance boxes are provided after questions that require additional clarification. These boxes may include definitions of unfamiliar terms or phrases, suggestions for details to include in a narrative response, explanations of Office of Child Care (OCC) policy on the topic, and/or references to related questions. It is important to read the relevant Guidance box before answering each question.

Where appropriate, instructions are included that allow Tribes/Tribal Organizations to skip over certain optional questions that do not apply.

In some cases, OCC has included questions in the Preprint that are optional meaning Tribe can respond with a “no” for all Tribes/Tribal Organizations; these questions do not yet apply to Tribal grantees and are for informational purposes ONLY. They are designated by a bold, red, delta symbol (∆). The answers provided will help OCC understand how prepared Tribal CCDF programs are to implement the forthcoming CCDF regulations and what kinds of training and technical assistance may be most helpful during the implementation process.

Technical Assistance

Tribes and Tribal Organizations should contact the appropriate OCC Regional Office for guidance and support in completing the Tribal CCDF Plan Preprint. Contact information for the OCC Regional Program Managers can be found online at https://www.acf.hhs.gov/programs/occ/resource/regional-child-care-program-managers.

Tribes and Tribal Organizations having additional needs for technical assistance can report their projected needs in the annual ACF-700 report (Question #4).

1. Define CCDF Leadership and Coordination with Relevant Systems

This section provides information on how the CCDF program is administered, including the designated Tribal Lead Agency and the administrative structure. It also addresses who was consulted in the development of the Tribal CCDF Plan and how the Tribal Lead Agency plans to coordinate CCDF services with other entities.

1. Tribal CCDF Applicant

1. Tribe (i.e., the official name of the Tribe as listed in the Federal Register) or Tribal Consortium Applicant

1. Name of the Tribe (or Tribal Consortium):

2. Name of Tribal Chair/President/Leader:

3. Title:

4. Address:

5. City, State, Zip Code:

6. Telephone Number: ( ) - Ext:

7. Fax Number: ( ) -

8. Email Address:

Note: ACF will send official grant correspondence such as grant awards, grant adjustments, Plan approvals, and disallowance notifications to the designated contact identified here. (658D(a))

2. Are you a Tribal Consortium?

No. (skip to Section 1.2)

Yes. Provide a comprehensive list with each new Plan of the participating member Tribes/Alaska Native Villages and include demonstrations from the consortium’s participating Tribes indicating that the consortium has the authority to seek funding on their behalf. Examples of demonstrations include a Tribal Resolution, a letter signed by the Tribal Leader, or another official document from the Tribal/Village government. (98.80(c)(1), 98.81(b)(8)(i))

Guidance: For Alaska Native Regional Nonprofit Corporations, the list and demonstrations are for purposes of Discretionary Funds only.

The list is provided as Attachment #:

The demonstrations are provided as Attachment #:

Note: If there is any change in the consortium membership, the Tribal Lead Agency must notify ACF through an amendment to the Plan.

3. A Tribal consortium must describe how it coordinates services on behalf of each of its participating member Tribes/Villages. Include a brief summary of how the consortium is coordinating services (including direct services) on behalf of each participating member. (98.81(b)(8)(ii),98.83(c)(1))

Guidance: The description should address how child care services are provided to each member Tribe/Village. The description should reference all Tribal CCDF-Operated Centers that receive CCDF funds as part of the consortium and those should be listed in the table in Section 3.1.2.

Describe:

2. Designated Tribal Lead Agency

The Tribe or Tribal consortium will designate an agency to represent the Tribe/consortium as the Tribal CCDF Lead Agency. This designated agency agrees to administer the Tribal CCDF program in accordance with applicable Federal laws and regulations and the provisions of this Plan, including the attached assurances and certifications. (Appendix 2). (658D, 658E(c)(1))

1. Identify the Lead Agency designated by the Tribe or Tribal consortium to administer the CCDF program.

1. Name of Tribal Lead Agency:

2. Web Address for Tribal Lead Agency (if any):

2. Who is the Tribal CCDF Administrator?

Identify the CCDF Administrator designated by the Tribal Lead Agency, the day-to-day contact, or the person with responsibility for administering the Tribal CCDF program. If there is more than one designated contact with shared responsibility for administering the CCDF program, please identify the co-administrator/assistant administrator and include contact information.

Note: ACF will send programmatic communications such as program announcements, program instructions, and data collection instructions to the designated contact identified here.

1. Contact Information for the Tribal CCDF Administrator: Name of Tribal CCDF Administrator:

Title:

Mailing address:

Physical address (if different than mailing address): Telephone Number: ( ) - Ext: Fax Number: ( ) -

Email Address:

2. Contact Information for Tribal CCDF Co-Administrator/Assistant Administrator (if applicable):

Name of Tribal CCDF Co-Administrator/Assistant Administrator:

Title:

Telephone Number: ( ) - Ext:

Email Address:

Describe the role of the Co-Administrator/Assistant Administrator:

2. Administration through Contracts or Agreements

The Tribal Lead Agency has broad authority to administer the CCDF program through contracts or agreements with other governmental, non-governmental, or other public or private local agencies. The Tribal Lead Agency remains the single point of contact and retains overall responsibility for the administration of the CCDF programs. (658D(b)(1)(A), 658E(c)(3)(C), 98.11, 98.16(c)(1)) Examples of such agreements could include:

• The Tribal Lead Agency has a written agreement with another Tribal department to operate Tribal child care centers or to conduct background checks, etc.;

• The Tribal Lead Agency may contract with the local child care resource and referral agency to operate the Tribe’s child care program (including determining family eligibility and issuing payments to child care providers or providing high quality activities).

1. Will the Tribal Lead Agency directly administer and operate the CCDF program? (98.16(c)(1)

Guidance: This question does not pertain to the demonstrations referenced in Section 1.1.2 between a consortium and its participating/constituent member Tribes/Villages.

Yes, the Tribal Lead Agency will directly administer and operate all aspects of the CCDF program. (skip to Section 1.4)

No, the Tribal Lead Agency will not directly administer and implement all aspects of the CCDF program.

1. List the names of those entities that will administer/operate aspects of the CCDF program and describe which aspects of the CCDF program they will administer/operate:

2. Describe how the Tribal Lead Agency will maintain overall control of the CCDF-funded program components administered and operated by the entities listed above:

3. Attached copies of the contracts or agreement as Attachment #

2. Consultation in the Development of the Tribal CCDF Plan

In the development of the Tribal CCDF Plan, the Tribal Lead Agency is required to consult with representatives of general purpose local/Tribal government. (658D(b)(2), 98.14(b)) Tribal Lead Agencies are also required to conduct a public hearing to provide the public an opportunity to comment on the provision of the child care services under the CCDF Plan.

Note: For the purposes of developing this Plan, consultation involves meeting with, or obtaining input from, appropriate representatives of the Tribal community.

1. Check the boxes to describe how the Tribal Lead Agency consulted with representatives of local/Tribal government, on the development of the Plan:

Regular meetings: Conference Calls: Emails:

Working committees: Other: Describe:

2. Did the Tribal Lead Agency consult with any other Tribal or non-Tribal organizations or entities on the development of the Plan?

No.

Yes. Describe:

3. Tribal Lead Agencies are required to conduct a public hearing to provide the public an opportunity to comment on the provision of child care services under the CCDF Plan. (658D(b)(1)(C), 98.14(c)(1-3), 98.16(e))

Guidance: The Tribal Lead Agency must conduct at least one public hearing prior to the submission of the Tribal CCDF Plan, but no earlier than January 1, 2016. Lead Agency must provide a notice of the hearing throughout the Tribal Lead Agency’s service area. This notice must be provided no later than 20 days prior to the date of the hearing. Tribal Lead Agencies must make the contents of the Plan available to the public in advance of the hearing. (98.14(c)(3))

Describe the Tribal Lead Agency’s public hearing process:

1. Date(s) of public hearing notice(s) (at least 20 days prior to the public hearing):

2. Date(s) of public hearing(s) (no earlier than January 1, 2016) :

3. Location(s) of the public hearing(s):

4. How was the public notified of the public hearing? Check all that apply.

Parent newsletter Tribal/local media

Internet. List website address(es) Social media (such as Facebook, Twitter, etc.) Posting on community bulletin board, etc.

Other:

5. How the content of the Plan was made available throughout the service area prior to the public hearing? Check all that apply.

Tribal offices (including CCDF offices) Internet (provide website(s)): Email

Other:

6. Describe how the input from the public hearing(s) was taken into consideration in the development of the final Plan:

4. ∆ Does the Tribal Lead Agency make the final CCDF Plan and any subsequent Plan Amendments available to the public?

No.

Yes. Describe:

2. Consultation in the Development of the State CCDF Plan

The CCDBG Act of 2014 requires States, at the option of the Tribe or Tribal organization to collaborate and coordinate with Tribes and Tribal organizations in the development of the State CCDF Plan in a timely manner. (658D (b)(1)(E))

1. Did the Tribe provide input into the development of the State’s CCDF Plan?

No.

Yes. Describe:

2. Coordination of Services

As part of its CCDF Plan development process, the Tribal Lead Agency is required to coordinate services with other Tribal, Federal, State, and/or local child care and early childhood development programs and with agencies responsible for public health, employment services/workforce development, public education, and Temporary Assistance for Needy Families. (658D(b)(1)(D), 98.14(a), 98.16(d))

1. Describe how the Tribal Lead Agency coordinates the delivery of CCDF services with the following agencies or entities:

1. Other Tribal, Federal, State and local child care and early childhood development programs, including, to the extent possible, Head Start/Early Head Start; Early Head Start – Child Care Partnerships; Maternal, Infant, and Early Childhood Home Visiting; State CCDF; Child and Adult Care Food Program (CACFP); Summer Food Service Program; and programs serving infants and toddlers, preschool-age children, children with disabilities, homeless children, and children in foster care

Describe:

2. Employment services/workforce development Describe:

3. Public health (including the agency responsible for immunizations and dental care)

Describe:

4. Public education Describe:

5. Social services (including agencies providing mental health services)

Describe:

6. Temporary Assistance for Needy Families (TANF)

Describe:

7. Public-private partnerships Describe:

8. Other

Describe:

2. Did the Tribal Lead Agency coordinate with Head Start/Early Head Start or other programs/agencies to assess the needs and what resources are available to support early childhood development?

No.

Yes. Describe:

3. ∆ How does the Tribal Lead Agency determine the Tribal community’s child care needs, including the needs of any underserved populations, such as infants and toddlers, special needs children, and non-traditional hour care? For example, does the Tribal Lead Agency conduct a needs assessment, survey community members, etc.? Describe:

2. Provide Stable Child Care Financial Assistance to Families

1. Eligible Children and Families

At the point in time when eligibility is determined, children must: (1) be under the age of 13; (2) meet the Tribal Lead Agency’s definition of “Indian Child”; (3) reside within the Tribal Lead Agency’s defined “service area”; (4) reside with a family whose income does not exceed 85 percent of the Grantee Median Income (GMI) for a family of the same size; and (5)(a) reside with a parent or parents who are working or attending a job training or educational program; or (b) receive, or need to receive, protective services and reside with a parent or parents not described in (5)(a) above. (658P(4))

1. Eligibility Criteria Related to the Child

1. Programs and activities are to be carried out for the benefit of Indian children. 98.81(b)(2)(i)

Guidance: While Tribal Lead Agencies have some flexibility in defining “Indian Child,” the definition must be limited to children from federally recognized Indian Tribes, consistent with the Child Care and Development Block Grant Act’s definition of Indian Tribe. This could include children who are tribal members, whose membership is pending, who are eligible for membership, and/or who are children/descendants of members. This could also include adopted children, foster children, and step- children, etc.

The Tribal Lead Agency defines an “Indian child” as: .

2. Programs and activities are to be carried out for the benefit of Indian children living on or near the Indian reservation or, for those Tribes that do not have reservations, the Tribe’s existing service area. If a Tribal Lead Agency establishes a different service area for CCDF purposes, it must be within a reasonably close geographic proximity to the borders of the Tribe’s reservation or existing service area. (658O(c)(2)(B), 98.80(e), 98.81(b)(2)(ii), 98.81(b)(3)(ii), 98.83(b))

Guidance: There is an expectation that the Tribal Lead Agency will be able to provide services to families throughout the service area. ACF will not approve an entire state as a Tribe’s service area. Tribes can limit services within the reservation boundaries or can go beyond the reservation boundaries. For example: "permanent residence is within the reservation boundaries, however the participant is temporarily attending school outside of the reservation area," or "resides within 20 miles of the reservation boundaries," etc.

Define the Tribal Lead Agency’s CCDF Service Area:

Optional: In addition to the description above, a clearly labeled map of the service area is attached. Attachment #

3. The Tribal CCDF program serves children from (weeks/months/years) to (weeks/months/years) (Note: Maximum age is through age 12).

4. Does the Tribal Lead Agency allow CCDF-funded child care for children age 13 and above but below age 19 years who are physically and/or mentally incapable of self-care? (658P(3), 98.20(a)(1)(ii))

Yes, and the upper age is (maximum age is through age 18). Define “physical or mental incapacity”:

No.

5. Does the Tribal Lead Agency allow CCDF-funded child care for children age 13 and above but below age 19 years who are under court supervision? (98.20(a)(1)(ii))

Yes, and the upper age is (maximum age is through age 18). No.

2. How does the Tribal Lead Agency define the following terms for CCDF eligibility purposes?

1. “residing with”:

2. “in loco parentis” (refers to an individual who assumes parental status and responsibilities for another child, such as a foster parent or other guardian):

3. Eligibility Criteria Based on Reason for Care

1. In order to be eligible to receive CCDF services, children must reside with a parent(s) who are working, attending a job training program, or attending an educational program. Check all parent participation options below that the Tribal Lead Agency allows; for each option checked, provide a brief definition of the term as used for CCDF eligibility purposes.

Guidance: Tribal Lead Agencies have broad flexibility in defining “working,” “attending a job training program,” and “attending an educational program.” The definitions provided below should include any allowable activities, including travel time and study time. For example, a definition of “working” could include working for a salary or wages, self-employment, subsistence activities, job search, and/or volunteering, as well as the travel time to and from the activity. Definitions should also address any limitations, such as minimum hours required or maximum hours allowed.

Eligibility based on working Define “working”:

Eligibility based on attending a job training program Define “attending a job training program”:

Eligibility based on attending an educational program Define “attending an educational program”:

2. Does the Tribal Lead Agency provide child care to children who receive, or need to receive, protective services?

No (skip to 2.1.4).

Yes. Complete 1-4 below.

Guidance: Tribal Lead Agencies have the flexibility to define protective services beyond formal child welfare or foster care cases, including but not limited to, homeless children. If the Tribal Lead Agency provides CCDF-funded child care to children in foster care whose foster care parents are not working, or who are not in education/training activities, for CCDF purposes, these children are considered to be in protective services and must be included in this definition.

1. Define “protective services” for the purposes of eligibility:

2. Does the Tribal Lead Agency waive the co-payment and income eligibility requirements on a case-by-case basis for cases in which children receive, or need to receive, protective services? (658E(c)(5), 98.20(a)(3)(ii)(A-B))

Yes. No.

3. Does the Tribal Lead Agency provide CCDF-funded child care to children in foster care whose foster care parent(s) are not working, or who is not in education/training activities? (98.20(a)(3)(ii), 98.16(f)(7))

Yes, and foster care is included under the Tribal Lead Agency’s definition of protective services in 2.1.3(b)(1) above. (This means that, for CCDF purposes, the Tribal Lead Agency considers these children to be served under the protective services eligibility category.)

No.

4. Does the Tribal Lead Agency provide respite child care for children in protective services? (98.16(f)(7))

Guidance: CCDF allows for “respite care” only for brief, occasional periods in excess of the normal “less than 24 hr. period” allowed for CCDF child care. Respite care is available for parents in protective services cases (including foster parents, if the Tribal Lead Agency checks “yes” under 2.1.3(b)(3) above) who need relief from caretaking responsibilities. For example, CCDF could pay a provider to care for a protective services child for one weekend a month. This definition of ‘‘respite child care’’ may differ from how Tribes define it for other purposes (e.g., child welfare). Since respite care is provided to give parents time off from parenting, rather than care to allow the parent to participate in work or in education or training, CCDF cannot be used for respite care for children with disabilities unless the child also needs or is receiving protective services.

Yes, and respite care is included under the Tribal Lead Agency’s definition of protective services in 2.1.3(b)(1) above.

No.

4. Eligibility Criteria Based on Family Income

1. How does the Tribal Lead Agency define “income” for the purposes of eligibility?

Guidance: Tribal Lead Agencies have flexibility in defining “income.” This flexibility allows for the exclusion or deduction of certain types of income, as defined by the Tribe, from calculations of total family incomes for purposes of eligibility determination.

Define “income”:

2. Tribal Lead Agencies must establish CCDF family income eligibility limits. Those limits cannot exceed 85% of the Grantee Median Income (GMI). A Tribal Lead Agency has the flexibility to use either State Median Income or Tribal Median Income as its GMI. Check the appropriate box below to indicate which option the Tribal Lead Agency has selected:

State Median Income (SMI) for a family of the same size.

Source: Year:

Tribal Median Income (TMI) for a family of the same size residing in the area served by the Tribal Lead Agency.

Source: Year:

3. Complete the CCDF income eligibility table. The effective date of the table is: .

1. Column (a) lists the current GMI for each family size. Column

(b) lists 85% of the current GMI for each family size (by law, this is the maximum allowable income for CCDF eligibility). All Tribal Lead Agencies must complete columns (a) and (b).

2. Tribal Lead Agencies have the option of setting income eligibility limits below 85% of the current GMI. Has the Tribal Lead Agency chosen to set income eligibility limits below 85% of the current GMI?

No (do not complete columns (c)-(f); skip to 2.1.5).

Yes. Complete columns (c) and (d) to show the Tribal Lead Agency’s maximum income eligibility level for each family size at the time a family applies for CCDF services.

2. Once a family’s eligibility has been determined, Tribal Lead Agencies have the flexibility to allow families to continue to receive CCDF assistance if their income increases above the eligibility limit shown in column (c), as long as their income does not exceed the eligibility limit shown in column (b) (85% of the

current GMI). Does the Tribal Lead Agency allow families to continue to receive CCDF assistance during their eligibility period (as defined in 2.2.3) if their income increases but remains at or below 85% of the current GMI?

No (do not complete columns (e) and (f); skip to 2.1.5).

Yes, families can continue to receive assistance until their income reaches an amount up to 85% of the current GMI. Complete columns

(e) and (f) to list the Tribal Lead Agency’s maximum “exit” income levels; the income limit in column (e) cannot exceed the amount shown in column (b).

Table 2.1.4(c): Tribal CCDF Income Eligibility Levels
	(a)	(b)	(c)	(d)	(e)	(f)
Family Size	100% of Grantee Median Income (GMI)	85% of GMI	(IF APPLICABLE) Maximum Income Level if lower than 85% Current GMI		(IF APPLICABLE) Maximum “Exit” Income Level (cannot exceed 85% GMI)
	$/month	$/month [Multiply (a) by 0.85]	$/month	% of GMI [Divide (c) by (a), multiply by 100]	$/month	% of GMI [Divide (f) by (a), multiply by 100]
1*
2
3
4
5
6
7
8

*Note: On a case-by-case basis, Tribal Lead Agencies may consider a child in foster care to be a “family of one” for purposes of determining CCDF income eligibility.

5. ∆ During eligibility determination or redetermination process, does the Tribal Lead Agency take into account fluctuations in family income?

Guidance: Tribal Lead Agencies have the flexibility to take into account irregular fluctuations in income when determining and redetermining eligibility. This is particularly important for families who rely on work that is unpredictable or seasonal in nature, such as agriculture, construction work, or subsistence activities such as hunting and fishing. These families may experience a temporary spike in income due to working increased hours over a short period, yet those earnings are not representative of the family’s income over the course of a year.

No.

Yes. Describe:

6. Does the Tribal Lead Agency establish additional eligibility criteria? (98.16(g)(5), 98.20(b))

Guidance: The Tribal Lead Agency has flexibility in establishing additional eligibility criteria. Additional criteria could include, for example, application to the State CCDF program first; higher income limits in one part of the tribal service area; or an asset/resource limit.

No.

Yes. Describe:

If additional eligibility criteria include different income eligibility limits, please attach additional income eligibility tables and indicate attachment number(s):

2. Application and Eligibility Determination/Redetermination Processes

1. Tribal Lead Agencies must inform parents of eligible children and the general public of the process by which they can apply for Tribal CCDF assistance. (658E(c)(2)(E)(i)(1))

Parents are informed of the availability of child care assistance services under Tribal CCDF through (check all that apply):

Tribal Lead Agency Child care providers

Child care resource and referral agencies

Public and/or tribal schools

Early Head Start/Head Start programs Health Clinics

TANF offices Other tribal offices

Other governmental offices

Community outreach events Radio and/or television Social media

Internet (provide website):

Other. Describe:

2. How can parents apply for child care services? Check all that apply.

In-person interview or orientation

Phone Mail/fax

At the child care provider’s site

Electronically via online application or email. Provide web link Other. Describe:

3. Describe how the Tribal Lead Agency documents and verifies child and family eligibility:

4. ∆ Which strategies, if any, will the Tribal Lead Agency use to assure the timeliness of eligibility determinations upon receipt of applications? Check all that apply.

Time limit for making eligibility determinations. Define time limit: Track and monitor the eligibility determination process

Other. Describe: None

5. ∆ How often does the Tribal Lead Agency redetermine eligibility for CCDF families?

Every 12 months Other. Describe:

6. ∆ Does the Tribal Lead Agency require CCDF families to provide information on the parents’ job/ training status or income in between determination periods?

No.

Yes. Describe:

7. ∆ Does the Tribal Lead Agency have redetermination policies and procedures to ensure that parents do not have their employment, education or job training unduly disrupted? Examples include: allowing telephone applications; having an abbreviated application; and reduced documentation requirements.

Guidance: Tribal Lead Agencies have the flexibility to establish procedures that help ensure that parents do not have to unduly disrupt their employment, education, or job training activities in order to comply with the Tribal Lead Agency’s requirements for redetermination of eligibility for assistance.

No.

Yes. Describe:

8. Tribal Lead Agencies are required to inform parents who receive Temporary Assistance for Needy Families (TANF) benefits about the exception to the individual penalties associated with the work requirement for any single custodial parent who has a demonstrated inability to obtain needed child care for a child under 6 years of age (98.16(p) and 98.33(b-c)).

Guidance: The TANF agency, not the Tribal CCDF Lead Agency, is responsible for establishing the following criteria or definitions. These criteria or definitions are offered in this Plan as a matter of public record. This question is for informational purposes.

1. Identify the TANF agency that established these criteria or definitions: State TANF Agency:

Tribal TANF Agency:

2. In the spaces below, provide the criteria or definitions used by the TANF agency to determine whether the parent has a demonstrated inability to obtain needed child care:

1. "appropriate child care":

2. "reasonable distance":

3. "unsuitability of informal child care":

4. "affordable child care arrangements":

3. How are parents who receive TANF benefits informed about the exception to individual penalties associated with the TANF work requirements? Briefly describe the process:

2.2.9 The Tribal Lead Agency must have procedures in place to ensure that providers receiving CCDF funds afford parents unlimited access to their children, and access to the providers caring for their children, during normal hours of provider operation and whenever the children are in the care of the provider. (658E(c)(2)(B)) 98.31, 98.16(n))

How does the Tribal Lead Agency ensure that parents have unlimited access? Describe:

3. Improving Access for Vulnerable Children and Families

At a minimum, CCDF requires Tribal Lead Agencies to give priority for child care assistance to “children with special needs.” Tribal Lead Agencies may also establish additional priority categories. (658E(c)(3)(B))

1. Describe how the Tribal Lead Agency will prioritize or target child care services for children with special needs. (658E(c)(3)(B))

Guidance: Tribal Lead Agencies have flexibility in how they define “children with special needs.” Tribal Lead Agencies are not limited in defining “children with special needs” to only those children with physical or mental disabilities. For example, Tribal Lead Agencies could consider children in the child welfare system, children of teen parents, or homeless children in their definition of “children with special needs.”

1. Define “children with special needs”:

2. Describe how the Tribal Lead Agency will give priority for child care services to children with special needs: (658E(c)(3)(B), 98.44(b)

2. Does the Tribal Lead Agency have additional priority rules or categories? (658E(c)(3)(B), 98.16(g)(5), 98.20(b))

No.

Yes. Define the additional priority rules/categories and describe how priority is given: Definition(s):

Describe how priority is given:

3. ∆ Does the Tribe have procedures to improve access to child care for homeless children and families? Procedures might include special outreach, grace periods for submitting documentation, etc.

Guidance: Tribal Lead Agencies have the flexibility to establish procedures to improve child care access for homeless children, including procedures allowing a grace period during which homeless children can receive CCDF assistance while their families are, for example, gathering required documentation or taking the necessary actions to comply with immunization and other health and safety requirements as described in Section 4.

No.

Yes. Define “homeless” and describe your procedures.

Define “homeless”: Describe procedures:

3. Ensure Equal Access to High Quality Child Care for Low-Income Children

1. Description of Direct Child Care Services

Guidance: CCDF services may be provided through a subsidy program where the grantee offers certificates (so that parents may choose from different categories of care), through a Tribal CCDF-Operated Center, or through grants or contracts for child care slots (i.e., agreements between the grantee and provider to provide child care services). Currently, Non-Exempt Tribal Lead Agencies are required to operate a certificate program that permits parents to choose care from all four categories of care. Exempt Tribal Lead Agencies have the option of operating a certificate program, but are not required to offer all four categories of care. Refer to Section 7.2.2 to determine whether the Tribal Lead Agency is currently considered Exempt or Non-Exempt.

1. Child Care Services Available through Certificates (658E(c)(2)(A), 658E(c)(3)(A)&(B), 658P(6)&(7), 98.16(g)(1), 98.30, 98.50)

   1. Does the Tribal Lead Agency operate a subsidy program offering certificates that allow parents to choose from a variety of categories of care?

No (skip to 3.1.2) (Exempt Tribal Lead Agencies only).

Yes, parents can choose from the following categories of care (check all that apply; Non-Exempt Tribal Lead Agencies must offer all four categories of care below):

Center-based child care Family child care home

Group child care home In-home child care

Describe the child care certificate payment process:

2. If the Tribal Lead Agency allows for in-home care (i.e., care provided in the child’s own home), does the Lead Agency limit the use of in-home care in any way?

No.

Yes. What limits does the Tribal Lead Agency set? Check all that apply.

Restricted based on minimum number of children in the care of the provider (to meet minimum wage law or Fair Labor Standards Act). Describe:

Restricted based on provider meeting a minimum age requirement. Describe:

Restricted based on hours of care (a certain number of hours, non- traditional work hours, etc.). Describe:

Restricted to care by relatives. Describe:

Restricted to care for children with special needs or medical conditions. Describe:

Other. Describe:

2. Child Care Services Available through Tribal CCDF-Operated Centers

Does the Tribe operate one or more child care centers using CCDF funds for operational costs?

Guidance: Tribal Lead Agencies that use CCDF funds to directly support the operational costs of a child care center are said to have a “Tribal CCDF-Operated Center.” The Tribe or its designee (not necessarily the Tribal Lead Agency itself) oversees operations of the child care center: paying facility costs (e.g., rent and utilities), hiring and managing staff, purchasing equipment and supplies, and screening families for eligibility.

No (skip to 3.1.3).

Yes. Complete the table below.

Table 3.1.2 Tribal CCDF-Operated Center(s)
Identify Tribal CCDF-Operated Centers For each Tribal CCDF-Operated Center, provide the center’s name and physical address (including City and State) One Center Per Row	Types of Services (Check all that apply)				Age Groups Served (Check all that Apply)
	Full-Time	Part-Time	Before/After School	Other Services (Briefly Describe)	Infants	Toddler	Preschool	School Age
     				     
     				     
     				     
Note: If the Tribal Lead Agency has more than 3 Tribal CCDF-Operated Centers, please use an attachment to provide the information above for each additional center (Attachment #     

3. Child Care Services Available through Grants or Contracts for Child Care Slots

1. Does the Tribal Lead Agency provide child care services through grants or contracts for child care slots? (658E(c)(2)(A), 658Q(b))

Note: Do not check “yes” if every provider is simply required to sign an agreement in order to be paid in the certificate program.

No (skip to 3.1.4). Yes. Describe:

1. The type(s) of child care services available through grant-/contract-funded slots (such as “center-based infant care”):

2. How parents are informed of the availability of grant-/contract-funded slots:

3. How parents apply for those slots:

2. ∆ Does the Tribal Lead Agency use grants or contracts for child care slots to increase the supply and/or improve the quality of child care programs? (658E(c)(2)(M))

No (skip to 3.1.4).

Yes, grant-/contract-funded slots are used to increase the supply and/or improve the quality of the following types of child care programs:

Providers offering native language education or a culturally-based curriculum

Providers to serve specific populations (such as children with disabilities, infants and toddlers, school-age children, homeless children, and children in isolated geographic areas)

Providers to serve children needing care during non-traditional hours

Providers offering comprehensive services, such as child care integrated into Head Start or Early Head Start

Providers meeting higher quality standards, such as programs with higher Quality Rating and Improvement System (QRIS) ratings or nationally accredited programs

Providers offering bonuses, higher pay, or other financial incentives to teaching staff for reaching higher levels of education and/or qualifications

Other. Describe:

4. Are all of the direct child care services described in 3.1.1-3.1.3 available throughout the entire service area? (98.16(g)(3))

Yes.

No. Describe where direct services are, and are not, available within the service area:      

Non-Exempt Tribes must also answer the following two questions below.

5. How are parents informed of the option to choose from the full range of child care provider categories – centers, family child care homes, group child care homes, and in-home providers? (658E(c)(2)(A)(i), 658P(2), 658Q)) Check all that apply.

Certificate provides information about the choice of providers, including high quality providers

Consumer education materials on choosing child care Verbal communication at the time of application

Community outreach, workshops, or other in-person activities Other. Describe:

6. How are parent(s) of each eligible child advised that s/he has the option of receiving a child care certificate or selecting a provider that has grant-/contract-funded slots? (658E(c)(2)(A)(i), 658P(2)) Describe:

2. Assessing Child Care Market Rates

1. Market Rate Survey Requirements

Tribal Lead Agencies are required to establish payment rates for child care services that ensure eligible families equal access to child care services comparable to those services provided to families not eligible to receive CCDF services. At a minimum, Tribal Lead Agencies are required to show how payment rates are adequate based on a local Market Rate Survey (MRS) conducted no earlier than two years (07/1/2014) prior to the date of the Plan submission.

Because Market Rate Surveys might not be feasible for some Tribal Lead Agencies, Tribal Lead Agencies have three options for fulfilling the local Market Rate Survey requirements:

1. Conducting a local Market Rate Survey,

2. Using the State’s local Market Rate Survey, or

3. Providing alternative documentation in lieu of a local Market Rate Survey (if applicable criteria are met).

Which option does the Tribal Lead Agency use in fulfilling the local Market Rate Survey requirements? Please select only ONE option. (98.16(l), 98.43)

Option 1 – The Tribal Lead Agency conducts its own Market Rate Survey.

1. Date the Market Rate Survey was conducted: / /

2. How did the Tribal Lead Agency use the results of this Market Rate Survey to assist in establishing payment rates for child care services? Describe:

Option 2 – The Tribal Lead Agency uses the State’s Market Rate Survey.

1. Name of State(s):

2. Date the State’s Market Rate Survey was conducted: / /

3. How did the Tribal Lead Agency use the results of this Market Rate Survey to assist in establishing payment rates for child care services? Describe:

Option 3 – The Tribal Lead Agency provides alternative documentation in lieu of a local Market Rate Survey. The Tribal Lead Agency must identify and meet one of the two criteria listed below.

Please select only one criterion.

Criteria 1 – Check if the Tribal Lead Agency:

Provides CCDF direct services solely in a Tribal CCDF-Operated Center(s) and does not provide services through certificates, grants, or contracts;

AND/OR

Funds CCDF direct services solely in unregulated home-based settings such as in- home care (i.e., care in the child’s own home) or unregulated family child care homes, and does not fund any CCDF services in centers, regulated family child care homes or regulated group homes.

Criteria 2 – Check if the Tribal Lead Agency:

Documents that all child care providers in the service area that would potentially be included in a market rate survey: (a) serve only children receiving CCDF subsidies and

(b) serve no private-pay children.

3. Setting Payment Rates for Child Care Services

Tribal Lead Agencies are required to establish payment rates for child care services that ensure eligible families equal access to child care services comparable to those services provided to families not eligible to receive CCDF services. (658E(c)(4), 98.16(l), 98.43(a), 98.43(b), 98.43 (b)(1) and 98.43(b)(2)).

Note: For Tribal Lead Agencies that only offer direct services through one or more Tribal CCDF- Operated Centers and/or grants/contracts for slots, skip to 3.3.2.

1. The Tribal Lead Agency’s payment rates are attached as Attachment #: and the effective date of those payment rates is: .

Guidance: The attached payment rates should reflect the variety of care offered in your program (for example, different rates based on the child’s age, the category of care, hours of care offered). Tribal Lead Agencies are reminded that payment rates cannot be based on a family’s eligibility or circumstances. This means, for example, that the Tribal Lead Agency may not establish payment rates for TANF families that differ from the payment rates for child care for the working poor, or for families in education or training.

Will the attached payment rates be used in all parts of the Tribal service area?

Yes.

No. Additional payment rates are attached as Attachment #: and the effective date of those payment rates is: . Describe or list the geographic areas where each set of rates is used:

2. Does the Tribal Lead Agency provide child care services solely through a Tribal CCDF-Operated Center(s) and/or grants and contracts for child care slots?

Guidance: For Tribal Lead Agencies that only offer direct services through a Tribal CCDF-Operated Center(s) and/or grants and contracts, the Tribe could provide information about its CCDF budget, including the average cost of providing care per child, or information about what the center(s) would charge a non-subsidized child for care in lieu of a payment rate schedule.

No.

Yes. Complete the following and skip to 3.4:

1. Attach information on actual cost of care per child, budget information, or other documentation regarding the cost of providing child care services (Attachment

#: ).

2. How is the attached information used to determine the amount of CCDF funds used to pay for care provided in your Tribal CCDF-Operated Center(s) and/or for grant-

/contract-funded slots? Describe:

3. ∆ For Programs that Offer Certificates: Does the Tribal Lead Agency provide any type of tiered payment or differential (add-on) rates? (658E(c)(4)(B)(iii), 658E(c)(4)(C)(ii))

Guidance: Tribal Lead Agencies set payment rates based what providers in the CCDF service area charge for care. Providers usually set their prices based on a number of factors, such as the costs of providing care, their geographic location, the age of the child, the hours when care is provided, and the quality of care. Taking those factors into account means that Tribal Lead Agencies may set different rates for different kinds of care; for example, payment rates for infants may be higher than rates for school-age care because the higher costs of providing infant care mean that providers usually charge more for that service than they do for school-age care.

In addition to these kinds of rate differences based on variations in provider prices, Tribal Lead Agencies can choose to set tiered payment rates or create rate add-ons (sometimes called “differential rates”) on top of their regular payment rates. These tiered rates and add-ons are additional amounts paid to providers as a way to increase payment rates for targeted needs. For example, a Tribal Lead Agency could try to encourage more care during non-traditional hours by paying providers who work evenings a 15% add-on over the regular payment rate. An example of tiered rates might be paying family child care providers who earn a CDA 5% more than the regular rate and paying those that earn accreditation 10% more. Tiered rates and add-ons are often used to encourage and support care for specific populations (such as children with special needs, infants and toddlers, school-age children, children in remote rural areas, or homeless children) and to encourage providers to increase or sustain their program quality.

No.

Yes. Check all that apply:

We use a Tribally-defined system of tiered payment or differential rates. Describe: We follow the State(s)’ tiered/differential payment system. State(s):

Note: Include tiered/differential rates on the payment rate attachment(s) in 3.3.1.

4. For Programs that Offer Certificates: How does the Tribal Lead Agency ensure that payment rates are sufficient to ensure equal access? Equal access would offer children receiving CCDF subsidies access to the same services (type of care, quality of care) as children not receiving CCDF. Check all that apply and provide a summary of data and facts the Tribal Lead Agency used to determine equal access. (658E (c)(4)(A))

Payment rates are set at the 75th percentile or higher of the most recent survey. Describe:

Feedback from parents, including parent surveys or parent complaints. Describe:

Using tiered rates/differential rates (as described in 3.3.3) to increase access for targeted needs.

Other. Describe:

4. Payment Practices and Timeliness of Payments to Providers

The Tribal Lead Agency should follow generally accepted payment practices for child care providers in the Tribe’s CCDF service area and, to the extent practicable, implement enrollment and eligibility policies that allow providers to receive payment for a child’s occasional absences. (658E(c)(2)(S)) These practices help to provide stability of funding and encourage more child care providers to participate in the subsidy program.

Note: For Tribal Lead Agencies that only offer direct services through one or more Tribal CCDF- Operated Centers, skip to 3.5.

1. ∆ Does the Tribal Lead Agency use any of the following payment practices? Check all that apply.

Pays providers prior to the delivery of child care services. Describe:

Pays providers based on enrollment instead of attendance (i.e., pays full payment even if child is occasionally absent). Examples might include paying for a set number of days in a month or making full payment if a child attends at least a certain percent of authorized time. Describe:

Pays on a full-time or part-time basis (rather than smaller increments such as hourly). Describe:

Pays the standard fees that the provider charges private-paying parents (e.g., registration fees, deposits, supplies, field trips). Describe:

Provides prompt notice to providers regarding any changes to the family’s eligibility status that may impact payment. Describe:

Has a timely appeal and resolution process for payment inaccuracies and disputes. Describe:

Other. Describe:

No, the Tribe does not use any of the payment practices listed above.

2. ∆ How does the Tribal Lead Agency ensure the timeliness of payments to providers? Check all that apply.

Pays providers within a certain number of days of billing for services. Describe: Tracks and monitors the payment process. Describe:

Uses electronic tools (e.g., automated billing, direct deposit). Describe:

Other. Describe:

The Tribe does not use any strategies to ensure the timeliness of payments to providers.

4. Family Contribution to Payment

The statute requires Tribal Lead Agencies to establish a sliding fee scale that varies based on family income and the size of the family to be used in determining each family's contribution (i.e., co- payment) to the cost of child care. Co-payments should not be a barrier to families receiving CCDF. (658E(c)(5), 98.42(b)). In addition to income and size of the family, the Tribal Lead Agency may use other factors when determining family contributions/co-payments.

1. Attach a copy of the sliding fee scale (Enter Attachment #: )

Will the attached sliding fee scale be used in all parts of the service area?

Yes. Effective date:

No. Attach other sliding fee scale(s) and their effective date(s). Attachment(s) #: Effective date(s):

2. Does the Tribal Lead Agency use other factors in addition to income and family size to determine each family's co-payment? Examples of additional factors could include: multiple children in care.

No.

Yes. Describe:

3. ∆ How will the family’s co-payment be calculated and to whom will it be applied? Complete (a)-(c) below.

1. The co-payment is a: dollar amount percent of income.

2. The co-payment amount is applied: hourly daily weekly monthly other: .

3. The co-payment is applied: per family per child.

4. How will the Tribal Lead Agency ensure the family’s co-payment, based on a sliding fee scale, is affordable and not a barrier to families receiving CCDF? Examples could include limiting maximum co-payment to a specific percentage of family income or reducing co-payments for additional children in care.

5. The Tribal Lead Agency may waive co-payments from families whose incomes are at or below the poverty level for a family of the same size (98.42(c)).

The poverty level used by the Tribal Lead Agency for a family of 3 is $ . The source of the poverty level used by the Tribal Lead Agency is (include date of publication): .

Check the option which the Tribal Lead Agency has chosen to use:

ALL families, including those with incomes at or below the poverty level for a family of the same size, ARE required to pay a co-payment.

SOME families with incomes at or below the poverty ARE NOT required to pay a co- payment. The Tribal Lead Agency waives the co-payment for families in the following circumstances:

NO families with incomes at or below the poverty level for a family of the same size are required to pay a co-payment.

4. Supply Building Strategies to Meet the Needs of Certain Populations

1. ∆ Will the Tribal Lead Agency develop and implement any strategies to increase the supply and improve the quality of child care services for children in underserved populations? Underserved populations may include infants and toddlers, children with disabilities, children in underserved geographic areas, and children who receive care during non-traditional hours.

No.

Yes. Check all that apply and describe the strategies used to increase supply and improve quality for each specific population. Examples of strategies might include offering grants and contracts for slots (as discussed in 3.1.3); providing start-up or quality improvement grants; providing technical assistance and support to providers; recruiting providers; and paying tiered payment rates (as discussed in 3.3.3).

Infants and toddlers. Describe: School-age children. Describe: Children with disabilities. Describe:

Children in underserved geographic areas. Describe: Children who receive care during non-traditional hours. Describe: Homeless children. Describe:

Other specific populations. Describe:

4. Ensuring the Health and Safety of Children in Child Care Settings

1. Requirements and Standards

Tribal Lead Agencies must have health and safety requirements for all categories of CCDF child care providers addressed in Section 3.1. These may be Tribally-developed standards and/or a Tribal Lead Agency may choose to follow the child care licensing standards for the State(s) where the Tribal Lead Agency certifies providers. At a minimum, the Tribal Lead Agency must have health and safety requirements in the following topic areas: Prevention and Control of Infectious Disease, Building and Physical Premises Safety, and Health and Safety Training. (658E(c)(2)(F), 658E(c)(2)(I), and 98.41)

1. The Tribal Lead Agency certifies that it has requirements related to Prevention and Control of Infectious Disease, Building and Physical Premises Safety, and Health and Safety Training applicable to CCDF providers in each of the following categories of care offered by the Tribal Lead Agency; check all that apply and indicate the source of the health and safety standards:

Guidance: For each category of care offered:

• If the Tribal Lead Agency has developed its own standards (even if those standards were adapted from other sources, such as Caring for Our Children or State licensing standards), check “Tribal Standards.”

• If the Tribal Lead Agency requires providers to meet standards established by a State Agency (such as State licensing or State department of education), check “State Standards.”

• If the Tribal Lead Agency requires providers to meet standards from more than one source (for example, State licensing standards for off-reservation providers and Tribally-developed standards for providers on the reservation), check “Tribal Standards,” “State Standards,” and “Other Source(s)/Combination of Sources” and describe which standards apply to which providers.

• If the Tribal Lead Agency requires providers to meet standards from a source not listed in the table in columns (a), (b), and (c) (such as Indian Health Service or the Child and Adult Care Food Program), then check “Other Source(s)/Combination of Sources” and describe the source(s) of the standards.

Table 4.1.1 Health and Safety Standards Used by the Tribal Lead Agency
Provider Categories	Tribal Standards	State Standards	Head Start/ Early Head Start Standards	Other Standards/ Combination of Standards
Center-Based Child Care				Describe:
Tribal CCDF-Operated Center(s) (if different)				Describe:
Family Home Child Care				Describe:
Group Home Child Care				Describe:
In-Home Child Care				Describe:
Other				Describe:      
Provide a website to your Tribal Child Care Standards:      

2. ∆ Do your Tribal CCDF requirements include staff-to-child ratios and group size limits?

No.

Yes. Describe:

3. ∆ Do your Tribal CCDF requirements include qualifications for providers appropriate to the type of child care setting, such as minimum age allowed, minimum education level, health clearance, etc.?

No.

Yes (check all that apply):

Center-based child care (including school-age care programs). Describe: Tribal CCDF Operated Center(s) (if different). Describe:

Family child care home/group child care home. Describe: Group child care home. Describe:

In-home providers. Describe:

Other. Describe:

4. ∆ Does the Tribal Lead Agency have child abuse reporting requirements in place? (42 U.S.C.

5106a(b)(2)(B)(i), 658E(c)(2)(L))

Yes. No.

5. In addition to the requirements identified in 4.1.1, does the Tribal Lead Agency have health and safety requirements for CCDF providers in the following areas? Check all that apply.

Health and Safety Requirements	Center-based	Tribal CCDF-Operated	Family Home	Group Home	In-Home	Other
Prevention of sudden infant death syndrome and use of safe sleep practices
Administration of medication, consistent with standards for parental consent
Prevention of and response to emergencies due to food and allergic reactions
Prevention of shaken baby syndrome and abusive head trauma
Emergency preparedness and response planning for emergencies resulting from a natural disaster or a human-caused event (such as violence at a child care facility)
Handling and storage of hazardous materials and the appropriate disposal of bio contaminants
Precautions in transporting children (if applicable)
First aid and cardiopulmonary resuscitation (CPR) certification
Nutrition
Access to physical activity
Limiting screen time
Caring for children with special health or development needs

6. Does the Tribal Lead Agency require training during a preservice or orientation period (period prior to a provider caring for CCDF-funded children or shortly after care begins) and/or ongoing training appropriate to the provider setting that addresses the requirements relating to the topics checked in 4.1.5 above?

1. Preservice/orientation training

Yes. Describe the preservice/orientation training requirements, including categories of providers, topics required, and the minimum number of hours required:

No.

2. Ongoing training

Yes. Describe the ongoing training requirements, including categories of providers, topics required, and the minimum number of hours required:

No.

4.2 Disaster Preparedness and Response

4.2.1 ∆ Does the Tribe or Tribal Lead Agency have plans in place to ensure continued CCDF assistance and child care services after a disaster? (658E(c)(2)(U)

Yes. Describe: No.

3. Monitoring and Enforcement Policies and Practices

Tribal Lead Agencies are required to have procedures in place to ensure that all CCDF-funded providers, including Tribal CCDF-Operated Centers and programs exempt from Tribal and/or State licensing (such as faith-based providers and school-based programs), comply with all applicable health and safety requirements. (658E(c)(2)(J))

1. Does the Tribal Lead Agency have in effect monitoring and enforcement policies and procedures to ensure that CCDF providers comply with applicable health and safety requirements?

Yes, the Tribal Lead Agency has comprehensive, written monitoring and enforcement policies and procedures.

Yes, the Tribal Lead Agency has monitoring and enforcement policies and procedures in place but only some are in writing.

Yes, the Tribal Lead Agency has monitoring and enforcement policies and procedures in place but none are in writing.

2. How does the Tribal Lead Agency monitor its CCDF providers for compliance with its health and safety requirements?

1. Describe the Tribal Lead Agency’s monitoring process, including whether other entities (such as State licensing or Indian Health Service) are involved in the monitoring process and how Tribal CCDF-Operated Centers are monitored OR attach a copy of the Tribal Lead Agency’s written monitoring policies and procedures:

2. Complete the following table:

Table 4.3.2 Frequency of Monitoring and Inspections
Provider Categories	Routine Announced Visits	Routine Unannounced Visits
Center-Based Child Care	Frequency:       Conducted by:      	Frequency:       Conducted by:     
Tribal CCDF Operated Center(s) (if different)	Frequency:       Conducted by:      	Frequency:       Conducted by:      
Family Home Child Care	Frequency:       Conducted by:      	Frequency:       Conducted by:      
Group Home Child Care	Frequency:       Conducted by:      	Frequency:       Conducted by:      
In-Home Child Care	Frequency:       Conducted by:      	Frequency:       Conducted by:      
Other	Frequency:       Conducted by:      	Frequency:       Conducted by:      

3. ∆ Does the Tribal Lead Agency share provider-specific information with parents regarding the results of health and safety monitoring? For example, the Tribal Lead Agency could share summaries of Tribal/State monitoring reports with parents of children enrolled with that child care provider. (658E(c)(2)(D-E))

No.

Yes. Describe:

4. Describe how the Tribal Lead Agency meets the requirement to maintain a record of substantiated parental complaints: (658E(c)(2)(C))

1. How does the Tribal Lead Agency define “substantiated parental complaint”?

2. How does the Tribal Lead Agency maintain a record of substantiated parental complaints about providers (e.g., how long are records maintained and in what format)?

3. How does the Tribal Lead Agency make substantiated parental complaints available to the public on request?

4. Does the Tribal Lead Agency maintain complaints from other individuals about providers?

No.

Yes. Describe:

5. Monitoring Inspectors (658E(c)(2)(K))

1. ∆ Does the Tribal Lead Agency have qualifications for the individuals who will monitor/inspect Tribal CCDF providers and facilities?

Yes. Describe:

No.

N/A. As noted in Table 4.3.2, all monitoring visits are conducted by other entities.

2. ∆ Have monitors/inspectors received relevant training on the health and safety standards used by the Tribal Lead Agency?

Yes

No

4. Criminal Background Checks (658H)

1. ∆ Does the Tribal Lead Agency require criminal background checks for child care center staff; family home, group home, and in-home child care providers?

No (skip to 4.5).

Yes. Complete the table below.

Table 4.4.1 Background Checks (Check all that apply)
For each category of child care provider, check each type of background check that the Tribal Lead Agency requires:
Types of Checks	Center-based	Tribal CCDF-Operated Center	Family Home	Group Home	In-Home	Other
State Child Abuse Registry
Tribal Criminal Background Check if the Tribal Background Check includes fingerprints.
State Criminal Background Check if the State Background Check includes fingerprints.
FBI Criminal Background (including fingerprints)
National Crime Information Center
State Sex Offender Registry
Other (Such as Tribal Registries) Describe:      
None

2. ∆ Do you require background checks for others residing in a home-based child care setting?

No.

Yes. Describe:

3. ∆ Describe the process and procedures for conducting background checks, including the following:

1. How background checks are conducted in a timely manner. Describe:

2. How often individuals are required to receive a background check. Describe:

3. How the Tribal Lead Agency makes determinations about an individual’s eligibility to be a CCDF child care provider/staff member, including the criteria for disqualifying someone from eligibility to be a provider/staff member (such as conviction of certain crimes, refusing a background check, providing false information in connection with a background check, being a registered sex offender, etc.). Describe:

4. How individuals are notified about the results and the process for appealing the findings.

Describe:

4. ∆ Does the Tribal Lead Agency have a review process for individuals who have been convicted of a felony drug offense to determine if that individual is eligible to be a provider or if that adult who lives in the family child care home may have unsupervised contact with children in care?

No.

Yes. Describe:

4. Exemption of Relative Providers

Tribal Lead Agencies have the option to exempt specific relative providers (defined in CCDF regulations as grandparents, great-grandparents, siblings if living in a separate residence, aunts, and uncles) from some or all of the Tribal CCDF health and safety requirements, including applicable requirements related to background checks, health and safety training, and monitoring/inspections. Note this exception only applies if the individual cares ONLY for relative children. (98.41(A)(ii)(A))

1. Does your Tribal Lead Agency exempt some or all relative providers (as defined above) from some or all of the Tribal CCDF health and safety requirements?

Yes, all relative providers (as defined above) are exempt from all Tribal CCDF health and safety requirements, including applicable requirements related to background checks, health and safety training, and monitoring/inspections.

Yes, some or all relative providers (as defined above) are exempt from some or all Tribal CCDF health and safety requirements. Describe which relatives are exempt from which requirements (be sure to address any exemptions related to background checks, health and safety training, and monitoring/inspections):

No, none of the relative providers defined above are exempt from the Tribal CCDF health and safety requirements, including applicable requirements related to background checks, health and safety training, and monitoring/inspections.

5. Supporting Continuous Quality Improvement

Tribal CCDF funds can be used for activities designed to improve the quality of child care services and increase parental options for, and access to, high-quality child care. Throughout this section of the Plan, Tribal Lead Agencies are asked to describe their goals and activities for child care quality improvement. Tribes are encouraged, regardless of size, to take an intentional approach to quality improvement – assessing the current quality of care available and the training and technical assistance needs of providers; investing their quality funds and efforts in accordance with the needs; and reviewing the success of their activities to improve quality and making adjustments as necessary. The Tribal Lead Agency should consider its child care quality improvement goals for all Tribal children in child care, not just those receiving assistance under CCDF. (658G, 658E(c)(3)(B), 98.16(h), 98.51, 98.83(f))

Guidance: In completing this section, the Tribal Lead Agency should describe activities funded with Tribal CCDF dollars, as well as those funded through other sources. Currently, CCDF regulations require Non-Exempt Tribal Lead Agencies (those receiving $500,000 or more) to spend at least 4 percent of their CCDF funds on quality activities. Exempt Tribal Lead Agencies are strongly encouraged, but are not required, to expend CCDF funds on quality activities. If an Exempt Tribal Lead Agency has no quality activities planned, the questions in Section 5 may be completed with “N/A.” Non-Exempt Lead Agencies must complete Section 5.

Note: In completing this section, the Tribal Lead Agency should describe activities funded with Tribal CCDF dollars, as well as those funded through other sources.

1. Child Care Quality Improvement Goals

1. What are the Tribal Lead Agency’s child care quality improvement goals? Check all that apply and describe below.

Supporting the training and professional development of the child care workforce

Improving on the development or implementation of early learning and development guidelines

Developing, implementing, enhancing, or participating in a quality improvement system for child care providers and services

Improving the supply and quality of child care programs and services for infants and toddlers

Establishing a Tribal system or participating in the Statewide system of child care resource and referral services

Supporting compliance with State or Tribal requirements for licensing, inspection, monitoring, training, and health and safety

Evaluating the quality of child care programs in the Tribe, including evaluating how programs positively impact children

Supporting providers in the voluntary pursuit of accreditation

Supporting the development or adoption of high-quality program standards related to health, mental health, nutrition, physical activity, and physical development

Other activities to improve the quality of child care services:

Describe:

2. How did the Tribal Lead Agency identify the goals described in 5.1.1? For example, did the Tribal Lead Agency conduct provider surveys or assessments that identified the need for quality improvements?

3. List/describe the activities the Tribal Lead Agency intends to implement during this Plan period in an effort to meet the overall child care quality improvement goals described in 5.1.1, as well as any other planned quality improvement activities.

1. Quality Training and Professional Development Activities

Provide training on the following topics:

Prevention and control of infectious diseases (including immunizations)		Prevention of sudden infant death syndrome and use of safe sleeping practices
Administration of medication, consistent with standards for parental consent		Prevention of and response to emergencies due to food and allergic reactions
Prevention of shaken baby syndrome and abusive head trauma		Handling and storage of hazardous materials and the appropriate disposal of bio contaminants
Emergency preparedness and response planning for emergencies resulting from a natural disaster or a human-caused event (such as violence at a child care facility)		Building and physical premises safety, including identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic
Precautions in transporting children (if applicable)		First aid and cardiopulmonary resuscitation (CPR) certification
Family engagement		Access to physical activity
Nutrition		Promotion of child development
Language and literacy		Caring for children with special health or developmental needs
Fiscal management		Administration and program management
Curriculum development and instruction		Child care as a business
Other topic(s):

Supports for Career Development Pathways:

Credit towards required training hours

Certificate

Credential

Degree

Other: Describe:

Optional: Describe any of the activities checked above:

2. Assisting Providers in Meeting Licensing and Health and Safety Standards

Provide health and safety materials/equipment

Grants/mini-grants for health and safety equipment/materials

Classroom materials and resources

Financial assistance in meeting licensing requirements

Other: Describe:

Optional: Describe any of the activities checked above:

3. Consumer Education for Parents and Providers

Written materials, including newsletters, brochures, checklists, etc., on child care topics

Local/tribal media

Social media, such as Facebook, Twitter, Instagram

Counseling from Resource and Referral Agencies, including information about other early childhood and social/human services programs for which families and providers may also qualify

Internet, including electronic media, publications, and webcasts on child care topics

Postings on community bulletin boards

Other: Describe:

Optional: Describe any of the activities checked above:

4. Culturally Relevant Activities

Incorporating tribal language into child care settings

Modifying curriculum to reflect tribal culture

Serving traditional Native foods in child care programs

Culturally-based training opportunities for parents and providers

Providing information and training to non-Native providers about working with Native children and families.

Other: Describe:

Optional: Describe any of the activities checked above:

4. ∆ Does the Tribal Lead Agency evaluate progress toward meeting the overall child care quality improvement goals described in 5.1.1? (658G(d)(3))

No.

Yes. Describe:

2. Quality Improvement through Provider Training and Professional Development

1. ∆ How does the Tribal Lead Agency interact with State training and professional development systems? (658E(c)(2)(G)(ii)(IV-V))

1. Do Tribal CCDF providers participate in the State’s training and professional development system? For example, Tribal CCDF providers might participate in trainings offered by the local child care resource and referral agencies or state-funded training organizations.

Yes. Describe: No. Check all that apply:

The Tribal Lead Agency does not have sufficient information about the State’s training and professional development opportunities to share with Tribal CCDF providers.

The State’s training and professional development opportunities are not accessible to Tribal CCDF providers.

The State’s training and professional development opportunities are not affordable for Tribal CCDF providers.

Other. Describe: Unknown.

2. Has the Tribal Lead Agency been contacted by the State for input on how to make the State’s trainings and professional development opportunities more culturally relevant for Native American children?

Yes. Describe: No.

2. Other Quality Improvement Activities

1. ∆ Does the Tribal Lead Agency operate a child care resource and referral program, assisting parents with finding and choosing a child care provider; collecting and analyzing child care provider supply and demand data; and providing training and support to providers? (658E(c)(3)(B)(iii), 658G(b)(5))

No.

No, but we collaborate with the State’s child care resource and referral system. State(s):

Yes. Describe:

2. ∆ Has the Tribal Lead Agency developed early learning and developmental guidelines describing what children should know and be able to do at each stage of their development? (658E(c)(2)(T), 658G(b)(2))

No.

No, but the Tribal Lead Agency has adopted, in whole or in part, the State(s) early learning and developmental guidelines. State(s):

Yes. Describe:

3. ∆ Does your Tribe have a system for assessing and improving quality, such as a quality rating and improvement system (QRIS)? (658G(b)(3))

Guidance: A QRIS is a systemic approach to assess, improve, and communicate the level of quality in early and school-age care and education programs. Similar to rating systems for restaurants and hotels, QRIS award quality ratings to early and school-age care and education programs that meet a set of defined program standards. By participating in their State’s QRIS, early and school-age care providers embark on a path of continuous quality improvement. Even providers that have met the standards of the lowest QRIS levels have achieved a level of quality that is beyond the minimum requirements to operate.

No.

No, but the Tribal CCDF program has providers that participate in the State system of assessing and improving quality, such as QRIS. Describe:

Yes, the Tribe has a system of assessing and improving quality, such as QRIS, operating throughout the service area. Describe:

2. Funding for Quality Activities

1. ∆ Tribal Lead Agencies may leverage other funds to support their quality improvement goals and activities. Other funding sources might include tribal funds, state funds, foundation funds, public-private partnerships, etc. Are all of the activities that are checked or described in this section funded solely with Tribal CCDF dollars?

Yes.

No. List which activities are funded with other sources and indicate the source of funds used (specific funding amounts are not required):

6. Program Integrity and Accountability

The Tribal Lead Agency, as the single point of contact for the administration of the Tribal CCDF program, is responsible for ensuring that policies and procedures are in place to monitor programs and services, ensure compliance with rules of the program, and provide oversight in the expenditure of all funds, including identifying improper payments and fraud prevention and recovery. (98.11(b), 98.60(i), 98.66, 98.67)

1. Program Integrity and Accountability Measures

1. Does the Tribe or Tribal Lead Agency have written policies and procedures in place to ensure that the Tribal CCDF program is in compliance with all Federal and Tribal rules and regulations?

No.

No, but written policies and procedures are in the process of being developed. Yes.

2. ∆ How does the Tribal Lead Agency prevent and identify improper payments? Check all that apply.

Guidance: An improper payment is any payment that should not have been made or that was made in an incorrect amount under statutory, contractual, administrative, or other legally applicable requirements. Incorrect amounts are overpayments or underpayments that are made to eligible recipients (including inappropriate denials of payment or service, any payment that does not account for credit for applicable discounts, payments that are for an incorrect amount, and duplicate payments). An improper payment also includes any payment that was made to an ineligible recipient or for an ineligible good or service, or payments for goods or services not received (except for such payments authorized by law). In addition, when an agency’s review is unable to discern whether a payment was proper as a result of insufficient or lack of documentation, this payment must also be considered an improper payment. Improper payments may result from administrative error, unintentional client/provider program violations, or fraud.

Train staff on CCDF policies and regulations

Conduct supervisory staff reviews or quality assurance reviews

Share data with other programs (e.g., State CCDF, Tribal or State TANF, Head Start, Child and Adult Care Food Program (CACFP), other Tribal offices)

Run system reports that flag errors

Review enrollment documents, attendance or billing records Review provider records

Other. Describe:

3. The Tribal Lead Agency is required to recover improper payments that are the result of fraud.

How does the Tribal Lead Agency investigate and collect improper payments resulting from fraud? Check all that apply.

Coordinate with, and refer to, other Tribal, State, or federal agencies (e.g., Tribal Council, law enforcement)

Require recovery if the improper payment exceeds a specific dollar amount. Identify the minimum dollar amount:

Recover through repayment plans Reduce payments in subsequent months

Recover through payroll deductions (for CCDF clients/providers/staff employed by the Tribe)

Other. Describe:

4. ∆ The Tribal Lead Agency has the flexibility to recover improper payments that are the result of unintentional errors/program violations. Does the Tribal Lead Agency choose to investigate and collect improper payments resulting from unintentional errors/program violations?

No.

Yes. How will the Tribal Lead Agency investigate and collect improper payments resulting from unintentional errors/program violations? Check all that apply.

Coordinate with, and refer to, other Tribal, State, or federal agencies (e.g., Tribal Council, law enforcement)

Require recovery if the improper payment exceeds a specific dollar amount. Identify the minimum dollar amount:

Recover through repayment plans Reduce payments in subsequent months

Recover through payroll deductions (for CCDF clients/providers/staff employed by the Tribe)

Other. Describe:

6. Tribal CCDF Funding

1. Child Count

For the purposes of determining a Tribe/Tribal Organization’s annual CCDF funding level, the Tribal Lead Agency must conduct and submit a child count that indicates the number of Indian children under age 13 (as defined in 2.1.1a) who reside on or near the reservation or service area (as defined in 2.1.1b). The Tribal Lead Agency may not count any children who are included in the child count of another CCDF Tribal Lead Agency. The Tribal Lead Agency is required to confer with all other CCDF Tribal Lead Agencies that have overlapping or neighboring service areas. (98.61(c), 98.62(c), 98.80(b(1), 98.81 (b)(4))

1. Is the CCDF service area (as defined in 2.1.1b) adjacent to, or overlapping with, the CCDF service area(s) of any other Tribal Lead Agencies?

No.

Yes. Identify those other Tribal Lead Agencies and describe the Tribal Lead Agency’s process for ensuring unduplicated child counts:

2. Does the Tribal Lead Agency have in effect policies and procedures for conducting the CCDF child count?

Yes, the Tribal Lead Agency has comprehensive, written child count policies and procedures.

Yes, the Tribal Lead Agency has child count policies and procedures in place but only some are in writing.

Yes, the Tribal Lead Agency has child count policies and procedures in place but none are in writing.

3. Complete and attach the “Child Count Declaration” at Appendix #1.

Guidance: A tribal consortium must submit:

1. An individual Child Count Declaration for each participating Tribe signed by an individual authorized to act for the Tribe; and

2. A summary listing:

   • The name of each participating Tribe;

   • Each participating Tribe’s individual child count; and

   • The total child count for the entire consortium.

2. Estimated FY 2017 CCDF Funding Allocation

1. What is your expected level of funding for the first year of the FY 2017 – FY 2019 Plan period?

Guidance: This is a preliminary ESTIMATE for information and planning purposes; actual CCDF allocations may be larger or smaller once the final grant awards are issued. Current CCDF Tribal grantees should use their total FY 2016 allocation (mandatory and discretionary) as their estimate for FY 2017 (10/1/2016 thru 9/30/2017). Do not include any unobligated and/or unliquidated CCDF balances from previous years.

The Tribal Lead Agency estimates that the following amount will be available for child care services and related activities during the 1-year period from October 1, 2016 through September 30, 2017. (98.13(a))

$      Estimated federal Child Care and Development Fund (CCDF) FY 2017 allocation

2. Based on the Tribe’s anticipated CCDF allocation, does the Tribal Lead Agency expect to be considered an Exempt or Non-Exempt Tribal CCDF program in FY 2017? (Check only one)

Guidance: Currently, Tribal Lead Agencies are classified as either Non-Exempt or Exempt based on their annual CCDF allocations.

• Non-Exempt Tribes (CCDF allocations equal to or greater than $500,000) are required to operate a certificate program. Certificates must permit parents to choose from a variety of child care categories including center-based care, group home care, family child care and in-home care. (98.30(e))

• Exempt Tribes (CCDF allocations less than $500,000) are not required to operate a certificate program unless the Tribe chooses to include such services and the associated requirements in its program. (98.81(b)(5))

Non-Exempt (CCDF allocations equal to or greater than $500,000 for a fiscal year)

Exempt (CCDF allocations less than $500,000 for a fiscal year)

3. In FY 2017, does the Tribal Lead Agency expect to supplement the CCDF grant with dollars from other sources to help run the child care program?

No.

Yes, we expect to supplement the CCDF grant with the following: (check all that apply)

Tribal funds

Grant/foundation funds

Private donations

State funds

Other federal funds

Other. Describe:

7.3 Intent to Use CCDF Funds for Construction or Major Renovation

Tribal Lead Agencies have the option of using CCDF funds to support the construction or major renovation of a child care facility. CCDF funds cannot be spent for this purpose until a Tribal Lead Agency has completed a separate application process and received official approval from the Office of Child Care. Tribal Lead Agencies should contact the Office of Child Care for information on the separate construction/major renovation application process. Approval of this Tribal CCDF Plan does not constitute approval to spend CCDF funds on construction or major renovation. (658O(c)(6), 98.84)

7.3.1 Does the Tribal Lead Agency intend to use CCDF funds for construction or major renovation during this Plan period?

Yes.

No, not at this time.

8. Optional Abbreviated Plan for Tribes Receiving Allocations under $250,000

Tips for Completing the Abbreviated Tribal CCDF Plan Preprint

Preprint Design

The comprehensive FY 2017-2019 Tribal CCDF Plan Preprint, designed for Tribes with annual allocations of $250,000 or more, is organized into seven parts covering broad topic areas. Section 8 of the Preprint is a condensed version of the Preprint designed to reduce the paperwork burden for Tribes and Tribal consortia that receive total annual CCDF allocations of less than $250,000. Those Tribes may choose to complete and submit this optional, abbreviated version instead of the comprehensive Plan Preprint (Sections 1-7).

When a question requires a “yes” or “no” response, the order of the yes/no options changes depending on the question so that the simplest response is first and the more complex response follows. For example, if a “yes” response would require an explanation and a “no” response would not, the “no” option will appear first. Similarly, if a “no” response has additional sub-questions that need to be answered but a “yes” response does not, the “yes” option would appear first. This structure is used to simplify the Plan development process by allowing the person completing the Plan Preprint to skip over response choices that are not relevant; it is NOT designed to imply that the first answer is the correct answer or the default answer. All questions should be answered in the way that best reflects what is actually happening in the Tribal CCDF program.

Guidance boxes are provided after questions that require additional clarification. These boxes may include definitions of unfamiliar terms or phrases, suggestions for details to include in a narrative response, explanations of Office of Child Care (OCC) policy on the topic, and/or references to related questions. It is important to read the relevant Guidance box before answering each question.

Where appropriate, instructions are included that allow Tribes/Tribal Organizations to skip over certain optional questions that do not apply.

Technical Assistance

Tribes and Tribal Organizations should contact the appropriate OCC Regional Office for guidance and technical assistance support in completing the Tribal CCDF Plan Preprint. Contact information for the OCC Regional Program Managers can be found online at https://www.acf.hhs.gov/programs/occ/resource/regional-child-care-program-managers.

Tribes and Tribal Organizations having additional needs for technical assistance can report their projected needs in the annual ACF-700 report (Question #4).

Section 1 - Administration

1. Tribe (i.e., the official name of the Tribe as listed in the Federal Register) or Tribal Consortium Applicant

Name of the Tribe (or Tribal Consortium):      

Name of Tribal Chair/President/Leader:      

Title:      

Address:      

City, State, Zip Code:      

Telephone Number: (     )       -       Ext:      

Fax Number: (     )       -      

Email Address:      

Website (if available):      

Note: ACF will send official grant correspondence such as grant awards, grant adjustments, Plan approvals, and disallowance notifications to the designated contact identified here. (658D(a))

2. Tribal Consortia

   1. Are you a Tribal Consortium?

No. (skip to 8.3)

Yes. Provide a list of the participating member Tribes/Alaska Native Villages and include demonstrations from the consortium’s participating Tribes indicating that the consortium has the authority to seek funding on their behalf. Examples of demonstrations include a Tribal Resolution, a letter signed by the Tribal Leader, or another official document from the Tribal/Village government. (98.80(c)(1), 98.81(b)(8)(i))

Guidance: For Alaska Native Regional Nonprofit Corporations, the list and demonstrations are for purposes of Discretionary Funds only.

The list is provided as Attachment #:     

The demonstrations are provided as Attachment #:     

Note: If there is any change in the consortium membership, the Tribal Lead Agency must notify ACF through an amendment to the Plan.

2. A Tribal consortium must describe how it coordinates services on behalf of each of its participating member Tribes/Villages. Include a brief summary of how the consortium is coordinating services (including direct services) on behalf of each participating member. (98.81(b)(8)(ii),98.83(c)(1))

Guidance: The description should address how child care services are provided to each member Tribe/Village. The description should reference all Tribal CCDF-Operated Centers that receive CCDF funds as part of the consortium and those should be listed in Section 8.11.3.

Describe:      

3. Designated Tribal Lead Agency

   1. The Tribe or Tribal consortium will designate an agency to represent the Tribe/consortium as the Tribal CCDF Lead Agency. This designated agency agrees to administer the Tribal CCDF program in accordance with applicable Federal laws and regulations and the provisions of this Plan, including the attached assurances and certifications. (Appendix 2). (658D, 658E(c)(1))

Name of Tribal Lead Agency:      

Name of Tribal CCDF Administrator:      

Title:      

Mailing address:      

Physical address (if different than mailing address):      

Telephone Number: (     )       -       Ext:      

Fax Number: (     )       -      

Email Address:      

Website (if available):      

Note: ACF will send programmatic communications such as program announcements, Plan approvals, program instructions, and data collection instructions to the designated contact identified here.

2. Will the Tribal Lead Agency directly administer and operate the CCDF program? (98.16(c)(1)

Guidance: The Tribal Lead Agency has broad authority to administer the CCDF program through contracts or agreements with other governmental, non-governmental, or other public or private local agencies. The Tribal Lead Agency remains the single point of contact and retains overall responsibility for the administration of the CCDF programs. This question does not pertain to the demonstrations referenced in Section 8.2.1 between a consortium and its participating/constituent member Tribes/Villages. (658D(b)(1)(A), 658E(c)(3)(C), 98.11, 98.16(c)(1))

Yes, the Tribal Lead Agency will directly administer and operate all aspects of the CCDF program. (skip to Section 8.4)

No, the Tribal Lead Agency will not directly administer and implement all aspects of the CCDF program.

1. List the names of those entities that will administer/operate aspects of the CCDF program and describe which aspects of the CCDF program they will administer/operate:      

2. Describe how the Tribal Lead Agency will maintain overall control of the CCDF-funded program components administered and operated by the entities listed above:      

4. Estimated FY 2017 CCDF Funding Allocation

   1. What is your expected level of funding for the first year of the FY 2017 – FY 2019 Plan period?

Guidance: This is a preliminary ESTIMATE for information and planning purposes; actual CCDF allocations may be larger or smaller once the final grant awards are issued. Current CCDF Tribal grantees should use their total FY 2016 allocation (mandatory and discretionary) as their estimate for FY 2017 (10/1/2016 thru 9/30/2017). Do not include any unobligated and/or unliquidated CCDF balances from previous years.

The Tribal Lead Agency estimates that the following amount will be available for child care services and related activities during the 1-year period from October 1, 2016 through September 30, 2017. (98.13(a))

$      Estimated federal Child Care and Development Fund (CCDF) FY 2017 allocation

2. In FY 2017, does the Tribal Lead Agency expect to supplement the CCDF grant with dollars from other sources to help run the child care program?

No.

Yes, we expect to supplement the CCDF grant with the following: (check all that apply)

Tribal funds

Grant/foundation funds

Private donations

State funds

Other federal funds

Other. Describe:

5. Consultation in the Development of the Tribal CCDF Plan

In the development of the Tribal CCDF Plan, the Tribal Lead Agency is required to consult with representatives of general purpose local/Tribal government. (658D(b)(2), 98.14(b)) Tribal Lead Agencies are also required to conduct a public hearing to provide the public an opportunity to comment on the provision of the child care services under the CCDF Plan.

Note: For the purposes of developing this Plan, consultation involves meeting with, or obtaining input from, appropriate representatives of the Tribal community.

1. Check the boxes to describe how the Tribal Lead Agency consulted with representatives of local/Tribal government on the development of the Plan:

Regular meetings:      

Conference Calls:      

Emails:      

Working committees:      

Other: Describe:      

2. Describe the Tribal Lead Agency’s public hearing process:

Guidance: The Tribal Lead Agency must conduct at least one public hearing prior to the submission of the Tribal CCDF Plan, but no earlier than January 1, 2016. Lead Agency must provide a notice of the hearing throughout the Tribal Lead Agency’s service area. This notice must be provided no later than 20 days prior to the date of the hearing. Tribal Lead Agencies must make the contents of the Plan available to the public in advance of the hearing. (98.14(a)(c)(3))

1. Date(s) of public hearing notice(s) (at least 20 days prior to the public hearing):      

2. Date(s) of public hearing(s) (no earlier than January 1, 2016) :      

3. Location(s) of the public hearing(s):     

4. How was the public notified of the public hearing? Check all that apply.

Tribal/Parent newsletter

Tribal/local media

Internet. List website address(es)      

Social media (such as Facebook, Twitter, etc.)

Posting on community bulletin board, etc.

Other:      

5. How the content of the Plan was made available throughout the service area prior to the public hearing? Check all that apply.

Tribal offices (including CCDF offices)

Internet (provide website(s)):      

Email

Other:      

6. Describe how the input from the public hearing(s) was taken into consideration in the development of the final Plan:      

6. Consultation in the Development of the State CCDF Plan

The CCDBG Act of 2014 requires States, at the option of the Tribe or Tribal organization to collaborate and coordinate with Tribes and Tribal organizations in the development of the State CCDF Plan in a timely manner. (658D (b)(1)(E))

1. Did the Tribe provide input into the development of the State’s CCDF Plan?

No.

Yes. Describe:      

7. Coordination of Services

As part of its CCDF Plan development process, the Tribal Lead Agency is required to coordinate services with other Tribal, Federal, State, and/or local child care and early childhood development programs and with agencies responsible for public health, employment services/workforce development, public education, and Temporary Assistance for Needy Families. (658D(b)(2), 98.14(a)), 98.16(d)

1. Describe the results of the Tribal Lead Agency’s coordination of the delivery of CCDF services with the following agencies or entities:

1. Other Tribal, Federal, State and local child care and early childhood development programs, including, to the extent possible, Head Start/Early Head Start; Early Head Start – Child Care Partnerships; Maternal, Infant, and Early Childhood Home Visiting; State CCDF; Child and Adult Care Food Program (CACFP); Summer Food Service Program; and programs serving infants and toddlers, preschool-age children, children with disabilities, homeless children, and children in foster care

Describe:      

2. Employment services/workforce development

Describe:      

3. Public health (including the agency responsible for immunizations and dental care)

Describe:      

4. Public education

Describe:      

5. Temporary Assistance for Needy Families (TANF)

Describe:      

6. Public-private partnership:      

7. Other. Describe:      

8. Indian Child and Indian Reservation/Service Area

Programs and activities are to be carried out for the benefit of Indian children living on or near the Indian reservation or, for those Tribes that do not have reservations, the Tribe’s existing service area. If a Tribal Lead Agency establishes a different service area for CCDF purposes, it must be within a reasonably close geographic proximity to the borders of the Tribe’s reservation or existing service area. (658O(c)(2)(B), 98.80(e), 98.81(b)(2)(ii),

1. The Tribal Lead Agency defines an “Indian child” as:      

Guidance: While Tribes have some flexibility in defining “Indian Child, “ the definition must be limited to children from federally-recognized Indian Tribes, consistent with the Child Care and Development Block Grant Act’s definition of Indian Tribe. This could include children who are tribal members, whose membership is pending, who are eligible for membership, and/or who are children/descendants of members. This could also include adopted children, foster children, and step-children, etc.

2. Define the Tribal Lead Agency’s CCDF Service Area:      

Guidance: There is an expectation that the Tribal Lead Agency will be able to provide services to families throughout the service area. ACF will not approve an entire state as a Tribe’s service area. Tribes can limit services within the reservation boundaries or can go beyond the reservation boundaries. For example: "permanent residence is within the reservation boundaries, however the participant is temporarily attending school outside of the reservation area," or "resides within 20 miles of the reservation boundaries," etc.

9. Child Count

For the purposes of determining a Tribe/Tribal Organization’s annual CCDF funding level, the Tribal Lead Agency must conduct and submit a child count that indicates the number of Indian children under age 13 (as defined in 8.7.1) who reside on or near the reservation or service area (as defined in 8.7.2). The Tribal Lead Agency may not count any children who are included in the child count of another CCDF Tribal Lead Agency. The Tribal Lead Agency is required to confer with all other CCDF Tribal Lead Agencies that have overlapping or neighboring service areas. (98.81(a)(4), 98.81 (b)(4))

1. Is the CCDF service area (as defined in 8.7.2) adjacent to, or overlapping with, the CCDF service area(s) of any other Tribal Lead Agencies?

No.

Yes. Identify those other Tribal Lead Agencies and describe the Tribal Lead Agency’s process for ensuring unduplicated child counts:      

2. Complete and attach the “Child Count Declaration” at Appendix #1.

Guidance: A tribal consortium must submit:

1. An individual Child Count Declaration for each participating Tribe signed by an individual authorized to act for the Tribe; and

2. A summary listing:

   • The name of each participating Tribe;

   • Each participating Tribe’s individual child count; and

   • The total child count for the entire consortium.

10. Activities to Ensure the Health and Safety of Children in Child Care

This section is intended to collect information on how Tribal Lead Agencies meet the statutory and regulatory provisions related to health and safety and how these requirements are effectively enforced. In the following pages, provide the appropriate responses for each category of care offered addressing the CCDF health and safety requirements.

The CCDF health and safety requirements at 98.41 require Lead Agencies to have health and safety requirements in the following areas:

• Prevention and Control of Infectious Disease (including immunizations)

• Building and Physical Premises Safety; and

• Health and Safety training.

Table 8.10 Health and Safety Standards Used by the Tribal Lead Agency
Provider Categories	Tribal Standards	State Standards	Head Start/ Early Head Start Standards	Other Standards/ Combination of Standards
Center-Based Child Care				Describe:      
Tribal CCDF-Operated Center(s) (if different)				Describe:      
Family Home Child Care				Describe:      
Group Home Child Care				Describe:      
In-Home Child Care				Describe:      
Other				Describe:      
Provide a website to your Tribal Child Care Standards:      

1. For all categories of care (i.e., center, group home, family, in-home and other) offered by the Tribe, describe the Tribe’s health and safety requirements in the following areas:

1. Prevention and control of infectious disease (including immunizations):

Center:      

Family Home:      

Group Home:      

In-Home:      

Other:      

2. Building and physical premises safety:

Center:      

Family Home:      

Group Home:      

In-Home:      

Other:      

3. Health and safety training (including whether trainings are required during a preservice/ orientation period or on an ongoing basis; which training topics are required; and the minimum number of training hours required):

Center:      

Family Home:      

Group Home:      

In-Home:      

Other:      

2. Does the Tribal Lead Agency exempt relative providers from the health and safety requirements described in 6.4? (658)(4)(B), 98.41(e)).

Guidance: A Tribal Lead Agency has the option to exempt the following relatives from some or all of its health and safety requirements: grandparents, great-grandparents, siblings (if living in a separate residence), aunts, and uncles.

Yes, all relative providers are exempt from all health and safety requirements

Some or all relative providers are subject to different health and safety requirements from those described in Section 8.10.1 and the following describes those different requirement and which relatives they apply to:      

No, all relative providers are subject to the same requirements as described in Section 8.10.1 as appropriate; there are no exemptions for relatives or different requirements for them.

3. What methods does the Tribal Lead Agency use to monitor and enforce CCDF health and safety requirements?

Guidance: The Tribal Lead Agency is required to certify that procedures are in effect to ensure that child care providers caring for children receiving CCDF services comply with the applicable health and safety requirements. (658E(c)(2)(E), 658E(c)(2)(G), 98.40(a)(2), 98.41(d))

Describe:      

4. Describe how the Tribal Lead Agency meets the requirement to maintain a record of substantiated parental complaints.      

11. Criminal Background Checks (658H)

    1. Does the Tribal Lead Agency require criminal background checks for child care staff members and child care providers?

No.

Yes.

Describe:      

12. Supporting Continuous Quality Improvements

Tribal CCDF funds can be used for activities designed to improve the quality of child care services, provide comprehensive consumer education, and increase parental options for, and access to, high-quality child care. Tribal Lead Agencies are asked to describe their goals and activities for child care quality improvement. All Tribes, regardless of allocation size, are encouraged to take an intentional approach to quality improvement – assessing the current quality of care available and the training and technical assistance needs of providers; investing their quality funds and efforts in accordance with the needs; and reviewing the success of their activities to improve quality and making adjustments as necessary. The Tribal Lead Agency should consider its child care quality improvement goals for all Tribal children in child care, not just those receiving assistance under CCDF. (658G, 658E(c)(3)(B), 98.16(h), 98.51, 98.83(f))

Guidance: In completing this section, the Tribal Lead Agency should describe activities funded with Tribal CCDF dollars, as well as those funded through other sources. Currently, Tribal Lead Agencies completing the abbreviated Preprint are strongly encouraged, but not required, to expend CCDF funds on quality activities. If no quality activities are planned, an answer of “N/A” is appropriate.

1. What are the Tribal Lead Agency’s child care quality improvement goals? Describe:      

2. How did the Tribal Lead Agency identify these goals? For example, did the Tribal Lead Agency conduct provider surveys or assessments that identified the need for quality improvements?      

3. List/describe the activities the Tribal Lead Agency intends to implement during this Plan period in an effort to meet the overall child care quality improvement goals described in 8.11.1, as well as any other planned quality improvement activities.

a) Quality Training and Professional Development Activities

Provide training on the following topics:

Prevention and control of infectious diseases (including immunizations)		Prevention of sudden infant death syndrome and use of safe sleeping practices
Administration of medication, consistent with standards for parental consent		Prevention of and response to emergencies due to food and allergic reactions
Prevention of shaken baby syndrome and abusive head trauma		Handling and storage of hazardous materials and the appropriate disposal of bio contaminants
Emergency preparedness and response planning for emergencies resulting from a natural disaster or a human-caused event (such as violence at a child care facility)		Building and physical premises safety, including identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic
Precautions in transporting children (if applicable)		First aid and cardiopulmonary resuscitation (CPR) certification
Family engagement		Access to physical activity
Nutrition		Promotion of child development
Language and literacy		Caring for children with special health or developmental needs
Fiscal management		Administration and program management
Curriculum development and instruction		Child care as a business
Other topic(s):

Supports for Career Development Pathways:

Credit towards required training hours

Certificate

Credential

Degree

Other: Describe:

Optional: Describe any of the activities checked above:

b) Assisting Providers in Meeting Licensing and Health and Safety Standards

Provide health and safety materials/equipment

Grants/mini-grants for health and safety equipment/materials

Classroom materials and resources

Financial assistance in meeting licensing requirements

Other: Describe:

Optional: Describe any of the activities checked above:

c) Consumer Education for Parents and Providers

Written materials, including newsletters, brochures, checklists, etc., on child care topics

Local/tribal media

Social media, such as Facebook, Twitter, Instagram

Counseling from Resource and Referral Agencies, including information about other early childhood and social/human services programs for which families and providers may also qualify

Internet, including electronic media, publications, and webcasts on child care topics

Postings on community bulletin boards

Other: Describe:

Optional: Describe any of the activities checked above:

d) Culturally Relevant Activities

Incorporating tribal language into child care settings

Modifying curriculum to reflect tribal culture

Serving traditional Native foods in child care programs

Culturally-based training opportunities for parents and providers

Providing information and training to non-Native providers about working with Native children and families.

Other: Describe:

Optional: Describe any of the activities checked above:

4. Does your Tribe have a system for assessing and improving quality, such as a quality rating and improvement system (QRIS)? (658G(b)(3))

Guidance: A QRIS is a systemic approach to assess, improve, and communicate the level of quality in early and school-age care and education programs. Similar to rating systems for restaurants and hotels, QRIS award quality ratings to early and school-age care and education programs that meet a set of defined program standards. By participating in their State’s QRIS, early and school-age care providers embark on a path of continuous quality improvement. Even providers that have met the standards of the lowest QRIS levels have achieved a level of quality that is beyond the minimum requirements to operate.

No.

No, but the Tribal CCDF program has providers that participate in the State system of assessing and improving quality, such as QRIS. Describe:

Yes, the Tribe has a system of assessing and improving quality, such as QRIS, operating throughout the service area. Describe:

Section 2 - Child Care Services Offered

13. Direct Child Care Services

    1. Does the Tribal Lead Agency provide direct child services?

Guidance: Direct CCDF child care services means the care of CCDF-eligible children by CCDF-eligible child care providers. Direct child care services may be provided through a subsidy program (in which the grantee offers certificates that allow parents may choose from different categories of care), through a Tribal CCDF-Operated Center, or through grants or contracts for child care slots (i.e., agreements between the grantee and provider to provide child care services).

No. If No, stop here.

Yes. If Yes, complete the rest of the abbreviated Preprint below.

2. Does the Tribal Lead Agency operate a subsidy program offering certificates that allow parents to choose from a variety of categories of care? (658A(b)(1), 658E(c)(3)(A)&(B), 658P(5)&(6), 98.16(g)(1), 98.30, 98.50)

No (skip to 8.13.3).

Yes, parents can choose from the following categories of care (check all that apply and complete questions a-c below):

Center-based child care Family child care home

Group child care home In-home child care

1. Describe the child care certificate process:      

Guidance: Describe, for example, how the parent is issued the certificate and how he/she uses the certificate to access care.

2. If the Tribal Lead Agency allows for in-home care (i.e., care provided in the child’s own home), does the Lead Agency limit the use of in-home care in any way?

No.

Yes. What limits does the Tribal Lead Agency set? Check all that apply.

Restricted based on minimum number of children in the care of the provider (to meet minimum wage law or Fair Labor Standards Act). Describe:      

Restricted based on provider meeting a minimum age requirement. Describe:      

Restricted based on hours of care (a certain number of hours, non-traditional work hours, etc.). Describe:      

Restricted to care by relatives. Describe:      

Restricted to care for children with special needs or medical conditions. Describe:      

Other. Describe:      

3. Does the Tribe operate one or more child care centers using CCDF funds for operational costs?

Guidance: Tribal Lead Agencies that use CCDF funds to directly support the operational costs of a child care center are said to have a “Tribal CCDF-Operated Center.” The Tribe or its designee (not necessarily the Tribal Lead Agency itself) oversees operations of the child care center: paying facility costs (e.g., rent and utilities), hiring and managing staff, purchasing equipment and supplies, and screening families for eligibility.

No.

Yes. For each Tribal CCDF-Operated Center, provide the center’s name and physical address (including city & state):      

4. Does the Tribal Lead Agency provide child care services through grants or contracts for child care slots? (658A(b)(1))

Note: Do not check “yes” if every provider is simply required to sign an agreement in order to be paid in the certificate program.

No

Yes. Describe:      

5. Are all of the direct child care services described in 8.13.2-8.13.4 available throughout the entire service area? (658E(a), 98.16(g)(3))

Yes.

No. Describe where direct child care services are available within the service area:      

14. Eligible Children and Families

At the point in time when eligibility is determined, children must: (1) be under the age of 13; (2) meet the Tribal Lead Agency’s definition of “Indian Child”; (3) reside within the Tribal Lead Agency’s defined “service area”; (4) reside with a family whose income does not exceed 85 percent of the Grantee Median Income (GMI) for a family of the same size; and (5)(a) reside with a parent or parents who are working or attending a job training or educational program; or (b) receive, or need to receive, protective services and reside with a parent or parents not described in (5)(a) above. (658P(4))

1. Eligibility Criteria Related to the Child

1. The Tribal CCDF program serves children from       (weeks/months/years) to       (weeks/months/years) (Note: Maximum age is through age 12).

2. Does the Tribal Lead Agency allow CCDF-funded child care for children age 13 and above but below age 19 years who are physically and/or mentally incapable of self-care? (658E(c)(3)(B)), 658P(3))

Yes, and the upper age is       (maximum age is through age 18).

Define “physical or mental incapacity”:      

No.

3. Does the Tribal Lead Agency allow CCDF-funded child care for children age 13 and above but below age 19 years who are under court supervision? (658P(3), 658E(c)(3)(B))

Yes, and the upper age is       (maximum age is through age 18).

No.

2. How does the Tribal Lead Agency define the following terms for CCDF eligibility purposes?

1. “residing with”:      

2. “in loco parentis” (refers to an individual who assumes parental status and responsibilities for another child, such as a foster parent or other guardian):      

1. Eligibility Criteria Based on Reason for Care

1. In order to be eligible to receive CCDF services, children must reside with a parent(s) who are working, attending a job training program, or attending an educational program. Check all parent participation options below that the Tribal Lead Agency allows; for each option checked, provide a brief definition of the term as used for CCDF eligibility purposes.

Guidance: Tribal Lead Agencies have broad flexibility in defining “working,” “attending a job training program,” and “attending an educational program.” The definitions provided below should include any allowable activities, including travel time and study time. For example, a definition of “working” could include working for a salary or wages, self-employment, subsistence activities, job search, and/or volunteering, as well as the travel time to and from the activity. Definitions should also address any limitations, such as minimum hours required or maximum hours allowed.

Eligibility based on working

Define “working”:      

Eligibility based on attending a job training program

Define “attending job training program”:      

Eligibility based on attending an educational program

Define “attending educational program”:      

2. Does the Tribal Lead Agency provide child care to children who receive, or need to receive, protective services?

Guidance: Tribal Lead Agencies have the flexibility to define protective services beyond formal child welfare or foster care cases, including but not limited to, homeless children. These are families who are facing particular risks, in which child care can be a protective factor for the child. If the Tribal Lead Agency provides CCDF-funded child care to children in foster care whose foster care parents are not working, or who are not in education/training activities, for CCDF purposes, these children are considered to be in protective services and must be included in this definition.

No (skip to 8.14.4).

Yes. Complete 1-4 below.

1. Define “protective services” for the purposes of eligibility:      

2. Does the Tribal Lead Agency waive the co-payment and income eligibility requirements on a case-by-case basis for cases in which children receive, or need to receive, protective services? (658E(c)(5))

Yes.

No.

3. Does the Tribal Lead Agency provide CCDF-funded child care to children in foster care whose foster care parent(s) are not working, or who is not in education/training activities? (98.20(a)(3)(ii), 98.16(f)(7))

Yes, and foster care is included under the Tribal Lead Agency’s definition of protective services in 8.12.3(b)(1) above. (This means that, for CCDF purposes, the Tribal Lead Agency considers these children to be served under the protective services eligibility category.)

No.

4. Does the Tribal Lead Agency provide respite child care for children in protective services? (98.16(f)(7))

Guidance: CCDF allows for “respite care” only for brief, occasional periods in excess of the normal “less than 24 hr. period” allowed for CCDF child care. Respite care is available for parents in protective services cases (including foster parents, if the Tribal Lead Agency checks “yes” under 8.12.3(b)(3) above) who need relief from caretaking responsibilities. For example, CCDF could pay a provider to care for a protective services child for one weekend a month. This definition of ‘‘respite child care’’ may differ from how Tribes define it for other purposes (e.g., child welfare). Since respite care is provided to give parents time off from parenting, rather than care to allow the parent to participate in work or in education or training, CCDF cannot be used for respite care for children with disabilities unless the child also needs or is receiving protective services.

Yes, and respite care is included under the Tribal Lead Agency’s definition of protective services in 8.12.3(b)(1) above.

No.

4. Eligibility Criteria Based on Family Income

1. How does the Tribal Lead Agency define “income” for the purposes of eligibility?

Guidance: Tribal Lead Agencies have flexibility in defining “income.” This flexibility allows for the exclusion or deduction of certain types of income, as defined by the Tribe, from calculations of total family incomes for purposes of eligibility determination.

Define “income”:      

2. Tribal Lead Agencies must establish CCDF family income eligibility limits. Those limits cannot exceed 85% of the Grantee Median Income (GMI). A Tribal Lead Agency has the flexibility to use either State Median Income or Tribal Median Income as its GMI. Check the appropriate box below to indicate which option the Tribal Lead Agency has selected:

State Median Income (SMI) for a family of the same size.

Source:       Year:      

Tribal Median Income (TMI) for a family of the same size residing in the area served by the Tribal Lead Agency.

Source:       Year:      

3. Complete the CCDF income eligibility table. The effective date of the table is:      .

   1. Columns (a) and (b): Column (a) lists the current GMI for each family size. Column (b) lists 85% of the current GMI for each family size (by law, this is the maximum allowable income for CCDF eligibility). All Tribal Lead Agencies must complete columns (a) and (b).

   2. Columns (c) and (d): Tribal Lead Agencies have the option of setting income eligibility limits below 85% of the current GMI. Has the Tribal Lead Agency chosen to set income eligibility limits below 85% of the current GMI?

No (do not complete columns (c)-(d); skip to 8.14.5).

Yes. Complete columns (c) and (d) to show the Tribal Lead Agency’s maximum income eligibility level for each family size at the time a family applies for CCDF services.

Table 8.14.4(c): Tribal CCDF Income Eligibility Levels
	(a)	(b)	(c)	(d)
Family Size	100% of Grantee Median Income (GMI)	85% of GMI	(IF APPLICABLE) Maximum Income Level, if lower than 85% Current GMI
	$/month	$/month [Multiply (a) by 0.85]	$/month	% of GMI [Divide (c) by (a), multiply by 100]
1*
2
3
4
5
6
7
8

*Note: On a case-by-case basis, Tribal Lead Agencies may consider a child in foster care to be a “family of one” for purposes of determining CCDF income eligibility.

5. Does the Tribal Lead Agency establish additional eligibility criteria? (658E(a), 98.16(g)(5), 98.20(b))

Guidance: The Tribal Lead Agency has flexibility in establishing additional eligibility criteria. Additional criteria could include, for example, application to the State CCDF program first; higher income limits in one part of the tribal service area; or an asset/resource limit.

No.

Yes. Describe:      

If additional eligibility criteria include different income eligibility limits, please attach additional income eligibility tables and indicate attachment number(s):      

15. Processes with Parents

    1. Tribal Lead Agencies are required to inform parents who receive Temporary Assistance for Needy Families (TANF) benefits about the exception to the individual penalties associated with the work requirement for any single custodial parent who has a demonstrated inability to obtain needed child care for a child under 6 years of age (98.16(p) and 98.33(b)).

Guidance: The TANF agency, not the Tribal CCDF Lead Agency, is responsible for establishing the following criteria or definitions. These criteria or definitions are offered in this Plan as a matter of public record. This question is for informational purposes.

1. Identify the TANF agency that established these criteria or definitions:

State TANF Agency:      

Tribal TANF Agency:      

2. In the spaces below, provide the criteria or definitions used by the TANF agency to determine whether the parent has a demonstrated inability to obtain needed child care:

1. "appropriate child care":      

2. "reasonable distance":      

3. "unsuitability of informal child care":      

4. "affordable child care arrangements":      

3. How are parents who receive TANF benefits informed about the exception to individual penalties associated with the TANF work requirements? Briefly describe the process:      

1. Describe how the Tribal Lead Agency ensures that parents have unlimited access to their children whenever their children are in the care of a provider.      

1. Improving Access for Vulnerable Children and Families

At a minimum, CCDF requires Tribal Lead Agencies to give priority for child care assistance to “children with special needs.” Tribal Lead Agencies may also establish additional priority categories. (658E(c)(3)(B))

1. Describe how the Tribal Lead Agency will prioritize or target child care services for children with special needs. (658E(c)(3)(B))

Guidance: Tribal Lead Agencies have flexibility in how they define “children with special needs.” Tribal Lead Agencies are not limited in defining “children with special needs” to only those children with physical or mental disabilities. For example, Tribal Lead Agencies could consider children in the child welfare system, children of teen parents, or homeless children in their definition of “children with special needs.”

1. Define “children with special needs”:      

2. Describe how the Tribal Lead Agency will give priority for child care services to children with special needs (658E(c)(3)(B), 98.44(b):      

2. Does the Tribal Lead Agency have additional priority rules or categories? (658E(c)(3)(B), 98.16(g)(5), 98.20(b))

No.

Yes. Define the additional priority rules/categories and describe how priority is given:

Definition(s):      

Describe how priority is given:      

17. Market Rate Survey Requirements

Tribal Lead Agencies are required to establish payment rates for child care services that ensure eligible families equal access to child care services comparable to those services provided to families not eligible to receive CCDF services. At a minimum, Tribal Lead Agencies are required to show how payment rates are adequate based on a local Market Rate Survey (MRS) conducted no earlier than two years (07/1/2014) prior to the date of the Plan submission.

Because Market Rate Surveys might not be feasible for some Tribal Lead Agencies, Tribal Lead Agencies have three options for fulfilling the local Market Rate Survey requirements:

1. Conducting a local Market Rate Survey,

2. Using the State’s local Market Rate Survey, or

3. Providing alternative documentation in lieu of a local Market Rate Survey (if applicable criteria are met).

Which option does the Tribal Lead Agency use in fulfilling the local Market Rate Survey requirements? Please select only ONE option. (98.16(l), 98.43)

Option 1 – The Tribal Lead Agency conducts its own Market Rate Survey.

1. Date the Market Rate Survey was conducted:      /     /     

2. How did the Tribal Lead Agency use the results of this Market Rate Survey to assist in establishing payment rates for child care services? Describe:      

Option 2 – The Tribal Lead Agency uses the State’s Market Rate Survey.

1. Name of State(s):      

2. Date the State’s Market Rate Survey was conducted:      /     /     

3. How did the Tribal Lead Agency use the results of this Market Rate Survey to assist in establishing payment rates for child care services? Describe:      

Option 3 – The Tribal Lead Agency provides alternative documentation in lieu of a local Market Rate Survey. The Tribal Lead Agency must identify and meet one of the two criteria listed below. Please select only one criterion.

Criteria 1 – Check if the Tribal Lead Agency:

Provides CCDF direct services solely in a Tribal CCDF-Operated Center(s) and does not provide services through certificates, grants, or contracts; and/or

Funds CCDF direct services solely in unregulated home-based settings such as in-home care (i.e., care in the child’s own home) or unregulated family child care homes, and does not fund any CCDF services in centers, regulated family child care homes or regulated group homes.

Criteria 2 – Check if the Tribal Lead Agency:

Documents that all child care providers in the service area that would potentially be included in a market rate survey: (a) serve only children receiving CCDF subsidies and (b) serve no private-pay children.

18. Setting Payment Rates for Child Care Services

    1. Tribal Lead Agencies are required to establish payment rates for child care services that ensure eligible families equal access to child care services comparable to those services provided to families not eligible to receive CCDF services. (658E(c)(4), 98.16(l), 98.43(a), 98.43(b), 98.43 (b)(1) and 98.43(b)(2)).

Note: For Tribal Lead Agencies that only offer direct services through one or more Tribal CCDF-Operated Centers and/or grants/contracts for slots, skip to 8.18.2.

1. The Tribal Lead Agency’s payment rates are attached as Attachment #:       and the effective date of those payment rates is:      .

Guidance: The attached payment rates should reflect the variety of care offered in your program (for example, different rates based on the child’s age, the category of care, hours of care offered). Tribal Lead Agencies are reminded that payment rates cannot be based on a family’s eligibility or circumstances. This means, for example, that the Tribal Lead Agency may not establish payment rates for TANF families that differ from the payment rates for child care for the working poor, or for families in education or training.

2. Will the attached payment rates be used in all parts of the Tribal service area?

Yes.

No. Additional payment rates are attached as Attachment #:      and the effective date of those payment rates is:      . Describe or list the geographic areas where each set of rates is used:      

2. Does the Tribal Lead Agency provide child care services solely through a Tribal CCDF-Operated Center(s) and/or grants and contracts for child care slots?

No.

Yes. Complete the following:

1. Attach information on actual cost of care per child, budget information, or other documentation regarding the cost of providing child care services (Attachment #:     ).

2. How is the attached information used to determine the amount of CCDF funds used to pay for care provided in your Tribal CCDF-Operated Center(s) and/or for grant-/contract-funded slots? Describe:      

1. Family Contribution to Payment

   1. The statute requires Tribal Lead Agencies to establish a sliding fee scale that varies based on family income and the size of the family to be used in determining each family's contribution (i.e., co-payment) to the cost of child care. In addition to income and size of the family, the Tribal Lead Agency may use other factors when determining family contributions/co-payments. A grantee may waive contributions from families whose incomes are at or below the poverty level for a family of the same size, or may apply different sliding fee scales.

1. Attach a copy of the sliding fee scale (Enter Attachment #:      )

2. Will the attached sliding fee scale be used in all parts of the service area?

Yes. Effective date:      

No. Attach other sliding fee scale(s) and indicate their effective date(s).

Attachment(s) #:       Effective date(s):      

3. Does the Tribal Lead Agency use other factors in addition to income and family size to determine each family's co-payment? Examples of additional factors could include: multiple children in care; quality of care; or number of hours in care. (658E(c)(3)(B))

No.

Yes. Describe:      

2. How will the Tribal Lead Agency ensure the family’s co-payment, based on a sliding fee scale, is affordable? Examples could include limiting maximum co-payment to a specific percentage of family income or reducing co-payments for additional children in care.      

Note: A Tribe cannot use Federal CCDF dollars to pay the parental contribution (co-payment) on behalf of an Indian family who is receiving a CCDF subsidy from a State or Tribe.

3. The Tribal Lead Agency may waive co-payments from families whose incomes are at or below the poverty level for a family of the same size (98.42(c)).

1. The poverty level used by the Tribal Lead Agency for a family of 3 is $     . The source of the poverty level used by the Tribal Lead Agency is (include date of publication):      .

2. Check the option which the Tribal Lead Agency has chosen to use:

ALL families, including those with incomes at or below the poverty level for a family of the same size, ARE required to pay a co-payment.

SOME families with incomes at or below the poverty ARE NOT required to pay a co-payment. The Tribal Lead Agency waives the co-payment for families in the following circumstances:      

NO families with incomes at or below the poverty level for a family of the same size are required to pay a co-payment.

APPENDIX 1

CHILD COUNT DECLARATION

Federal Fiscal Year:      

Name of Tribe/Tribal Lead Agency:      

This certifies that the number of Indian children under age 13 (as defined in CCDF Plan) who reside on or near the reservation or service area (as defined in CCDF Plan) is:     (number).

The Tribal Lead Agency may not count any children who are included in the child count of another CCDF Tribal Lead Agency. To ensure unduplicated child counts, a Tribal Lead Agency is required to confer with all other CCDF Tribal Lead Agencies that have overlapping or neighboring service areas.

This count shows the number of Indian children under age 13 as of      (date).

Date:      /     /     

Official Signature of Individual Authorized to Act for the Tribe

Print Name

Print Title

CHILD COUNT DECLARATION (P.L. 102-477)

Federal Fiscal Year:      

Name of Tribe/Tribal Lead Agency:      

This certifies that the number of Indian children under age 13 (as defined in CCDF Plan Section of the 102-477 Plan) who reside on or near the reservation or service area (as defined in CCDF section of the 102-477 Plan) is:       (number).

The Tribal Lead Agency may not count any children who are included in the child count of another CCDF Tribal Lead Agency. To ensure unduplicated child counts, a Tribal Lead Agency is required to confer with all other CCDF Tribal Lead Agencies that have overlapping or neighboring service areas.

This count shows the number of Indian children under age 13 as of      (date).

Date:      /     /     

Official Signature of Individual Authorized to Act for the Tribe

Print Name

Print Title

REQUEST FOR REALLOTTED TRIBAL DISCRETIONARY FUNDS

The Tribe named above requests Discretionary Funds that may be available through the reallotment process.

Yes No

APPENDIX 2

CCDF PROGRAM ASSURANCES AND CERTIFICATIONS

The Tribal Lead Agency is designated by the Tribe (or Tribal consortium) to represent the Tribe (or Tribal organization).

The Tribal Lead Agency agrees to follow the Federal laws and regulations that apply to the CCDF program and to follow this Plan, when approved, including the following assurances and certifications.

The Tribal Lead Agency assures that:

1. Upon approval, it will have in effect a program that complies with the provisions of the Plan printed herein, and is administered in accordance with the Child Care and Development Block Grant Act of 1990 as amended, Section 418 of the Social Security Act, and all other applicable Federal laws and regulations. (658D(b), 658E(a), 98.15(a)(1))

2. The parent(s) of each eligible child within the Tribe or Tribal service area who receives or is offered child care services for which financial assistance is provided is given the option either to enroll such child with a child care provider that has a grant or contract for the provision of the service or to receive a child care certificate. (658E(c)(2)(A)(i), 98.2, 98.30, 98.15(a)(2)) [Exempt Tribal Lead Agencies are not required to operate certificate programs.]

3. In cases in which the parent(s) elect(s) to enroll the child with a provider that has a grant or contract with the Tribal Lead Agency, the child will be enrolled with the eligible provider selected by the parent to the maximum extent practicable. (658E(c)(2)(A)(ii), 98.15(a)(3), 98.30)

4. The child care certificate offered to parents shall be of a value commensurate with the subsidy value of child care services provided under a grant or contract. (658E(c)(2)(A)(iii), 98.15(a)(4), 98.30) [Exempt Tribal Lead Agencies are not required to operate certificate programs.]

5. The Tribe, or Tribal consortium, will coordinate, to the maximum extent feasible, with the Tribal Lead Agency(ies) in the State(s) in which the child care programs or activities will be carried out. (98.12, 98.14(a)&(b), 98.81(b)(3)(i), 98.82)

6. Tribal Child Care and Development Fund (CCDF) programs and activities will be carried out for the benefit of Indian children on an Indian reservation (except for Programs located in Alaska, California, or Oklahoma). (98.81(b)(3)(ii), 98.83(b))

7. With respect to State and local regulatory requirements (or Tribal regulatory requirements), health and safety requirements, payment rates, and registration requirements, State or local (or Tribal) rules, procedures or other requirements promulgated for the purpose of the CCDF will not significantly restrict parental choice from among categories of care or types of providers. (658E(c)(2)(A), 98.15(a)(5), 98.15(p), 98.30(e)&(f), 98.40(b)(2), 98.41(b), 98.43(d), 98.45(d))

The Tribal Lead Agency certifies that:

1. It has procedures in place to ensure that providers of child care services for which assistance is provided under the Child Care and Development Fund (CCDF) afford parents unlimited access to their children and to the providers caring for their children during the normal hours of operations and whenever such children are in the care of such providers. (658E(c)(2)(B), 98.15(b)(1), 98.31)

2. It maintains a record of substantiated parental complaints and makes information regarding such complaints available to the public on request. (658E(c)(2)(C), 98.15(b)(2), 98.32)

3. It will collect and disseminate to parents of eligible children and the general public, consumer education information that will promote informed child care choices. (658E(c)(2)(D), 98.15(b)(3), 98.33)

4. There are licensing requirements in effect that are applicable to child care services provided within the area served by the Tribal Lead Agency pursuant to 98.40. (98.15(b)(4), 98.40)

5. There are—under Tribal, local, or State law—requirements in effect designed to protect the health and safety of children; these requirements are applicable to child care providers that provide services for which assistance is made available under the CCDF. (658E(c)(2)(F), 98.15(b)(5), 98.41)

6. Procedures are in effect to ensure that child care providers that provide services for which assistance is provided under the CCDF comply with all applicable health and safety requirements. (658E(c)(2)(G), 98.15(b)(6), 98.41)

7. Payment rates under the CCDF for the provision of child care services will be sufficient to ensure equal access for eligible children to comparable child care services in the Tribe or Tribal service area that are provided to children whose parents are not eligible to receive assistance under this program or under any other Federal or State child care assistance programs. (658E(c)(4)(A), 98.15(b)(7), 98.43)

8. By the end of each three-year funding period (expenditure period for each Federal fiscal year’s grant funding), the Tribe must have expenditures that are equal to grant funds received for that fiscal year. (98.67(c))

APPENDIX 3

LIST OF CERTIFICATIONS

CCDF Regulations 45 CFR §98.13(b)(2)-(6) require the following certifications.

1. Assurance of compliance with Title VI of the Civil Rights Act of 1964

2. Certification regarding debarment

3. HHS certification regarding drug-free workplace requirements

4. Certification of Compliance with the Pro-Children Act of 1994

These certifications were obtained in the previous approved Plan and need not be collected again if there has been no change in the Tribal Lead Agency. If there has been a change in the Tribal Lead Agency, these certifications must be completed and submitted with the Plan. New Tribal Lead Agencies must submit all required Certifications.

APPENDIX 4

AMENDMENTS LOG

Child Care and Development Fund Plan For the period: 10/1/2016 – 9/30/2019

Tribal Lead Agencies are required to request approval from Administration for Children and Families (ACF) whenever a “substantial” change in the Tribal Lead Agency’s approved CCDF Plan occurs. Please refer to the ACF Program Instruction regarding CCDF Plan amendments (CCDF-ACF-PI-2009-01) for specific details and timelines specific to the Plan amendment process.

Plan amendments must be submitted to ACF within 60 days of the effective date of the change. Under the regulation, the Plan amendment must be approved no later than the 90th day following the date on which the amendment is received by ACF unless the Lead Agency and ACF mutually agree in writing to extend the period. (§98.18 (b)).

ACF encourages Tribal Lead Agencies to contact the Child Care program staff in the appropriate ACF Regional Office to discuss any proposed amendment as early as possible.

Instructions:

1. Tribal Lead Agency completes the first 3 columns and sends a photocopy of this log (showing the latest amendment sent to ACF) and the amended section(s) to the ACF Regional contact. A copy of the log, showing the latest amendment pending in ACF, is retained in the Tribal Lead Agency’s Plan.

2. ACF completes column 4 and returns a photocopy of the log to the Tribal Lead Agency.

3. The Tribal Lead Agency replaces this page in the Plan with the copy of the log received from ACF showing the approval date.

Reminder: This process depends on repeated subsequent use of the same log page over the life of the Plan. At any time the log should reflect all amendments, both approved and pending in ACF. The Tribal Lead Agency is advised to retain those “old” Plan pages that are superseded by amendments in a separate appendix to its Plan.

APPENDIX 4

Table: Amendment Log Tribal Lead Agency:      
Section Amended	Proposed Effective Date	Grantee Signature and Date Submitted to ACF	ACF Approving Official’s Signature and Date