Stipend and Reimbursement, Support and


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Stipend & Reimbursement Forms Processed by TRI  

All forms are located in the Stipend & Reimbursement Group on the TRI website: http://triwou.org/groups/page/149/stipends-andreimbursements Mail forms to: TRI/Central Coordination of CCR&R Western Oregon University 345 Monmouth Ave N. Monmouth, OR 97361

Email forms to: [email protected]

Form

Description

DHS Provider Training Stipends

Payment to DHS Listed Providers that have taken eligible trainings through the CCR&R.

Additional details

Non-Relative Provider Regulated Subsidy (FFN)

Relative Provider Exempt LEHRC (FFN)

Pre-list requirements:  RRCAN  First Aid/CPR  Introduction to Child Care Health and Safety Eligible Stipends:  Orientation  Continued Professional Development

Pre-list requirements:  Introduction to Child Care Health and Safety Eligible stipends:  Orientation  First Aid/CPR (after becoming listed)  In-person RRCAN (after becoming listed)  Continued Professional Development

Food Handlers Card is available at no cost to provider, if working towards Enhanced Rate – ADD link

Food Handlers Card is available at no cost to provider, if working towards Enhanced Rate - ADD Link

I:\Train\CCCCR&R\LEHRC\Information Sheet\Stipend and Reimbursement, Support and Incentive Information Sheet 7-10-19.docx

Languages Form Available in English Spanish

Form

Description

Additional details

Providers will receive a stipend of $12.00 per hour for attending the following trainings:  DHS Provider Orientation  6 hours of required continued professional development

Providers will receive a stipend of $12.00 per hour for attending the following trainings:  DHS Provider Orientation



6 hours of optional continued professional development Regulated Subsidy Enhanced Rate Providers will receive a stipend of $12.00 per hour for attending the following trainings:  DHS Provider Orientation  8 hours of required continued professional development  4 hours of optional continued professional development

Exempt LEHRC Enhanced Rate Providers will receive a stipend of $12.00 per hour for attending the following trainings:  DHS Provider Orientation  8 hours of required continued professional development  4 hours of optional continued professional development

I:\Train\CCCCR&R\LEHRC\Information Sheet\Stipend and Reimbursement, Support and Incentive Information Sheet 7-10-19.docx

Languages Form Available in

Form

License Exempt Family Child Care Provider Training Reimbursement (SEIU)

Description

For License Exempt Family Child Care Providers (FFN, LEHRC, RS) participating in the subsidy program. Providers may be reimbursed for the cost of events:  community trainings  college credit classes  workshops  seminars  conferences

Licensed Family Child Care Provider Training Reimbursement

Providers will be reimbursed up to $300.00 per event. For Licensed Family Child Care Providers (Registered Family and Certified Family) for taking First Aid/CPR through a non-CCR&R agency. Providers will be reimbursed up to $55.00.

First Aid/CPR Training Reimbursement for Aide 1 and Assistant 1

For Aide 1 (Center-based care) and Assistant 1 (Family-based care) for taking First Aid/CPR. Aide 1s and Assistant 1s will be reimbursed for the cost of trainings taken on or after October 16, 2018 until present.

Additional details

Languages Form Available in

Providers are eligible for event reimbursements from April 1, 2018 through ____

English Spanish

License Exempt Family Child Care Provider Training Reimbursement Requirements:  1 form per event reimbursement  WOU Substitute W-9  Proof of cost/attendance/receipt

Providers are eligible if they are RF or CF. License Family Child Care Provider Training Reimbursement Requirements:  Completed form  WOU Substitute W-9  Receipt Aide 1s are eligible if they work in a Certified Center. Assistant 1s are eligible if they work in family child care. First Aid/CPR Training Reimbursement for Aide 1 and Assistant 1 Providers Requirements:  Completed form  WOU Substitute W-9  Receipt

I:\Train\CCCCR&R\LEHRC\Information Sheet\Stipend and Reimbursement, Support and Incentive Information Sheet 7-10-19.docx

English Spanish Russian Vietnamese Traditional Chinese

English Spanish Russian Vietnamese Traditional Chinese

Form

Safety & Quality Enhancement Dollars Form

Description

For License Exempt family providers who need assistance in meeting DHS Health & Safety requirements as indicated on the DHS Provider Listing Form.

Additional details

*If a family child care business or center-based program submits for all staff, they must complete the reimbursement form and Substitute W-9 under their Business Name and note the names of all Aide 1 or Assistant 1 eligible for this reimbursement. Safety & Quality Enhancement Dollars Form Requirements:  Completed form  WOU Substitute W-9  Receipt

Languages Form Available in

English Spanish Russian Vietnamese Traditional Chinese

The reimbursement form covers equipment, installations, and repairs to help provider meet DHS Health and Safety Requirements.

CCR&R/SDA Training Reimbursement

Providers will be reimbursed for up to $250.00. For CCR&Rs who provide no cost trainings to License Exempt providers.

CCR&R/SDA Training Reimbursement form is due within 15 days after the end of each quarter.

English

Reimbursement is covered based upon CCR&Rs cost.

Lead Testing Reimbursement

For the following providers:  License Exempt/DHS listed  Providers who are in the process of becoming listed  Registered Family  Certified Family  Certified Center

Lead Testing Reimbursement Requirements:  Completed form  WOU Substitute W-9  Receipt (if corrective action was needed) Lead Testing Reimbursement for licensed programs is available until June 30, 2019.

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English Spanish Russian Vietnamese Traditional Chinese

Form

WOU Substitute W-9 Form

W-8BEN

Description

Reimbursement covers the cost of the lead testing, shipping, and corrective action. Required along with every stipend or reimbursement.

Additional details

Processing of stipend or reimbursement will be put on hold if an incomplete or illegible WOU Substitute W-9 form is received.

Required along with the WOU Substitute W-9 Form if/when a provider checks the “Foreign Alien or Entity” box on the WOU Substitute W-9.

I:\Train\CCCCR&R\LEHRC\Information Sheet\Stipend and Reimbursement, Support and Incentive Information Sheet 7-10-19.docx

Languages Form Available in

English Spanish Russian Vietnamese Traditional Chinese English

Spark Supports and Incentive Forms Processed by TRI  

All forms are located in the Spark Portfolio Materials Group on the TRI website: http://triwou.org/materials/home/77/spark-portfoliomaterials Mail forms to: TRI/Oregon’s Spark Western Oregon University 345 Monmouth Ave N. Monmouth, OR 97361

Email forms to: [email protected]

Form

Spark Request for Support Form

Description

Eligibility: Programs designated Commitment to Quality (C2Q) and above. Exemptions: Preschool Promise and Head Start. (programs already receiving public funds for quality improvements). What is it? Spark Support Funds help offset costs of increased quality that will help programs become star rated or apply for a higher star rating. Allowed expenditures:  Curricula  Equipment  Supplies  Materials for the classroom

Additional details

Amount: Dependent on program licensed capacity. Small (1-20) = $1,000 Medium (21-49) = $1,500 Large (50+) = $2,000 Licensed capacity is independently verified by CCRIS when program applies. Accredited programs receive funds based on the accredited program schedule. Required by accompany form:  WOU Substitute W-9

I:\Train\CCCCR&R\LEHRC\Information Sheet\Stipend and Reimbursement, Support and Incentive Information Sheet 7-10-19.docx

Languages Form Available in English Spanish Russian

Form

Description  

Additional details

Languages Form Available in

Computers needed to access internet support Training

Disallowed expenditures:  Capital improvements  Sectarian materials (e.g. religious texts)  Personal use not related to program improvement  Operating cost (electric bill, water, rent, etc.) Programs are required to keep receipts for expenditures in case of an audit. Request for Enhanced Support Form for Focused Network Participants

Eligibility: Programs participating in a Focused Family Child Care Network. (eligibility determined by FCCN) Allowed expenditures:  Curricula  Equipment  Supplies  Materials for the classroom  Computers needed to access internet support  Training Disallowed expenditures:  Capital improvements  Sectarian materials (e.g. religious texts)

Amount: Dependent on program licensed capacity. Small (1-20) = $2,000 Medium (21-49) = $3000 Large (50+) = $4,000 Licensed capacity is independently verified by CCRIS when program applies. If any support funds were previously received by the program, they are deducted for the total amount eligible for. Unlicensed programs can receive $500 while they are working on licensing. Program completes a detailed budget worksheet on the form.

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English Spanish Russian

Form

Description  

Personal use not related to program improvement Operating cost (electric bill, water, rent, etc.)

Additional details

Languages Form Available in

QIS signs form approving the plan. Required by accompany form:  WOU Substitute W-9

Programs are required to keep receipts for expenditures in case of an audit. Request for Payment of Incentive Funds

Eligibility: Programs receiving a star rating. Programs that are not eligible for incentives include:  Preschool Promise  Head Start Allowed/Disallowed expenditures: There are no requirements or restrictions on Incentive Funds.

Amount of incentive funds depends on both licensed capacity and star rating. Licensed capacity verified by CCRIS. Accredited programs receive funds based on an accredited program schedule. Form completed and processed by TRI after rating WOU Substitute W-9 will be requested from the program if they have not previously received funds.

Environment Rating Scales (ERS) Training Assessment Memorandum of Understanding (MOU) and Stipend Form

Eligibility: Programs who agree to participate in an ERS Training Assessment and who commit to the following:  Coordinating a date and time for the assessment take place with a Quality Improvement Specialist and/or TRI designated staff  Permitting TRI/CCR&R staff to conduct a 3 - 4-hour on-site observation with a brief interview before the assessment begins

I:\Train\CCCCR&R\LEHRC\Information Sheet\Stipend and Reimbursement, Support and Incentive Information Sheet 7-10-19.docx

English

Form

Description 

  

Additional details

Agreeing to 2 – 4 adults (the “assessment team”) participating in the observation (1 person who is the “Spark Assessor” and the other(s) who are in training) Receiving a “Continuous Quality Improvement ERS Assessment Report” within 2 weeks of the assessment Filling out a WOU Substitute W-9 form to receive a $150.00 stipend and submit with this form Allowing TRI to use summarized data gathered during the assessment for evaluation purposes

I:\Train\CCCCR&R\LEHRC\Information Sheet\Stipend and Reimbursement, Support and Incentive Information Sheet 7-10-19.docx

Languages Form Available in