Child Care

Service Standard

Child Care Service Standard print version

Texas Department of State Health Services, HIV Care Services Group – HIV/STD Program | Texas DSHS

Subcategories Service Units
Child Care Services Per hour

Health Resources and Services Administration (HRSA) Description

The Ryan White HIV/AIDS Program (RWHAP) supports intermittent Child Care services for the children living in the household of people living with HIV who are RWHAP-eligible clients for the purpose of enabling clients to attend medical visits, related appointments, and/or RWHAP-related meetings, groups, or training sessions.

Allowable uses of funds include: 

  • A licensed or registered childcare provider to deliver intermittent care 
  • Informal childcare provided by a neighbor, family member, or other person 

Program Guidance

Agencies should limit and carefully monitor the use of funds under this service category.

Informal childcare arrangements may raise liability issues for the funding source, which agencies should carefully weigh in the decision process.


Federal restrictions prohibit giving cash to clients or primary caregivers to pay for these services. 

These funds cannot pay for child care while the client is at work, school, or other activity unrelated to accessing medical care or other RWHAP-related meetings, groups, or training sessions. 

Universal Standards

Service providers for Child Care Services must follow HRSA and DSHS Universal Standards 1-52 and 139-142.

Service Standards and Measures

The following standards and measures are guides to improving health outcomes for people living with HIV throughout the State of Texas within the Ryan White Part B and State Services Program.

Standard Measure

Child Care Services: Intermittent childcare services are provided for the children living in the household of RWHAP-eligible clients to enable clients to attend medical visits, related appointments, or RWHAP-related meetings, groups, or training sessions. Documentation in the client’s primary record must reflect the appointment, meeting, group, or training session attended. At a minimum, documentation must include:

  • Date and duration of each unit of Child Care Services provided
  • Reason why childcare was needed (e.g., client medical or other appointment or participation in a Ryan White-related meeting, group, or training session)
  • Any recreational and social activities, including documentation that they were provided only within a certified or licensed provider setting

1. Percentage of clients that have documentation of the medical appointment, related appointment, or RWHAP-related meeting, group, or training session attended.



HRSA/HAB Division of Metropolitan HIV/AIDS Programs Program Monitoring Standards – Part A April 2013. p. 27-29. Located at:

HRSA/HAB Division of State HIV/AIDS Programs National Monitoring Standards – Program Part B April 2013. p. 26-28. Located at:

Regulation of Certain Facilities, Homes, and Agencies that Provide Child Care Services. Chapter 42 Human Resources Code as amended. Located at: and

HRSA Ryan White HIV/AIDS Program Services: Eligible Individuals & Allowable Uses of Funds Policy Clarification Notice (PCN) #16-02 (Revised 10/22/2018). Located at: