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Child Care Services
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HRSA/HAB Category Definition:
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Child care services are the provision of care for the children of clients who are HIV-positive while the clients are attending medical or other appointments or attending RWHAP-related meetings, groups, or training. This does not include child care while a client is at work.
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Source: Definition provided by the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), HIV/AIDS Bureau (HAB). 2009. Ryan White HIV/AIDS Treatment Modernization Act of 2006 Definitions for Eligible Services. Rockville, Md.: HRSA HAB, August 2009.
IGS 2010: Minutes of the Planning Council November 16, 2011.
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Category Notes:
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Clarifications
The following definition clarifications are a result of a conference call involving representatives of the grantee (BCHD), Greater Baltimore HIV Health Services Planning Council (PC), PC support office (IGS) and HRSA on May 28, 2008 (IGS 2008a).
• Child-care services are not meant to be daily.
• Child-care services/activities can be a sub-activity under other categories (i.e., to help HIV positive caregiver attend other services).
• HRSA will follow up and clarify eligibility for transportation for children of infected individuals. (There has been no further clarification as of July 23, 2008.)
• Grantee must still report all child-care activities as child care.
The following clarifications were distributed from HRSA on April 8, 2010 (HRSA 2010a).
Child Care Services are an allowable Ryan White HIV/AIDS Program support service for the children of HIV-positive clients, while the clients attend medical or other appointments or Ryan White HIV/AIDS Program–related meetings, groups or training. More specifically, funds may be used to provide Child Care Services in these instances:
a. To support a licensed or registered child care provider to deliver intermittent care that will enable an HIV-positive adult or child to secure needed medical or support services, or to participate in Ryan White HIV/AIDS Program-related activities described above,
b. To support informal child care provided by a neighbor, family member, or other person (with the understanding that existing Federal restrictions prohibit giving cash to individuals to pay for these services).
In those cases where funds are allocated for Child Care Services, as described under (b) above, such allocations should be limited and carefully monitored to assure compliance with the prohibition on direct payments to eligible individuals. Such arrangements may also raise liability issues for the funding source which should be carefully weighed in the decision-making process.
Recreational and Social Activities
Funds awarded under the Ryan White HIV/AIDS Program may be used for recreational and social activities as part of a Child Care or Respite Care support service provided in a licensed or certified provider setting, including drop-in centers in primary care or satellite facilities. Funds should not be used for off-premise social/recreational activities or to pay for a client’s gym membership.
History
Standards of care for child care services were first developed by the planning council in September 1999. Child care services were formerly funded under day and respite services. In 2005, the Baltimore EMA was directed to use the child care category and definition when HRSA removed day and respite services for children from the list of fundable categories. Standards of care were revised in October 2005 to reflect these changes.
Subsequent revisions were made to the standards of care in 2008, 2009 and most recently in 2010. Standards of care as revised in 2008 and 2009 limited services to a maximum of 90-days within a program year and was based on 200 percent of the daily cost allowed by the Maryland State Department of Education's Office of Child Care. The planning council removed these restrictions in November 2010.
Current Directives
At the time of publication, there were no current directives for this service category.
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