Policy Memo 149H

DOH-CACFP: Number 149H (10/10)

TO: CACFP Sponsoring Organizations of Day Care Homes

FROM: Lynne Oudekerk, State Director, Child and Adult Care Food Program

SUBJECT: Claim for Reimbursement - Revised Form (DOH-3709)

I. Purpose and Scope

The Child and Adult Care Food Program has contracted with Colyar Consulting Group to develop an internet-based Sponsor management and payment system which will allow CACFP Sponsors to submit monthly claims via the internet. The new system is called CIPS - CACFP Information and Payment System. CIPS is in the final stages of development and we expect that Sponsors will be brought online early in 2011.

II. Background Information

CACFP has re-designed the Claim for Reimbursement for Sponsoring Organizations of Day Care Homes (DOH-3709) to speed the entry of claim data into CIPS. Beginning with your October 2010 claim, please use the enclosed form to submit your claims for reimbursement. In the future, Sponsors will be able to enter their claim data into CIPS using screens that follow this general format. The new form looks the same as the previous version with one major change:

  • Under number 3, Administrative Expenditures will now be reported monthly in addition to year-to-date (Y-T-D), and the approved budget will no longer be reported on the claim form. CIPS calculates the Sponsor's lesser of three on a monthly basis instead of calculating it at the end of the Federal Fiscal Year (FFY). This change will result in adjustments to the monthly administrative reimbursement received each month based upon the expenditures reported. Sponsors who fail to report administrative expenditures will not be issued an administrative payment.

III. Summary of Changes

The instructions for completing the claim form are printed on the back of the claim form (DOH-3709). If you have any questions about the new claim form please call 1-800-942-3858, ext. 27104 to speak to a Homes Unit Calculations Clerk.

Additional copies of the claim form may be obtained by contacting CACFP at 1-800-942-3858, ext. 27262 or by e-mail at cacfp@health.state.ny.us. The forms may also be photocopied or downloaded from www.health.ny.gov/nutrition. In order for the form to print correctly, you must download the free Adobe reader, if you do not already have it. Please dispose of existing copies of the old claim form.