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Child Care

Gross Income Eligibility Limits and Sliding Fee Scale

0-100% | 101%- | 116%- | 131%- | 146%- | 161%- | 176%- | 191%- | 206%- | 231% FPG 115% | 130% | 145% | 160% | 175% 190% | 205% 230% | FPG- FPG FPG FPG FPG FPG FPG FPG FPG elig. limit Family | perme, | 0% | 1% | 2% | 3% | 4% | sm | 6% | 7% | 8% | 9% Size ee family | family | family | family | family | family | family | family | family | family co-pay | co-pay | co-pay | co-pay | co-pay | co-pay | ©0-Pay | co-pay | co-pay | co-pay 1 3,632 1,198 | 1,377 _| 1,557 _| 1,737 _| 1,916 | 2,096 | 2,276 | 2,455 | 2,755 | 3,632 2 4,749 1,621 | 1,864 | 2,107 | 2,350 | 2,593 | 2,836 | 3,079 | 3,323 | 3,728 | 4,749 3 5,867 2,045 | 2,351 | 2,658 | 2,965 | 3,272 | 3,578 | 3,885 | 4,192 | 4,703 | 5,867 4 6,985 2,468 | 2,838 | 3,208 | 3,578 | 3,948 | 4,319 | 4,689 | 5,059 | 5,676 | 6,985 5 8,102 | 2,891 | 3,324 | 3,758 | 4,191 | 4,625 | 5,059 | 5,492 | 5,926 | 6,649 | 8,102 6 9,220 | 3,315 | 3,812 | 4,309 | 4,806 | 5,304 | 5,801 | 6,298 | 6,795 | 7,624 | 9,220 7 9,429 | 3,738 | 4,298 | 4,859 | 5,420 | 5,980 | 6,541 | 7,102 | 7,662 | 8,597 | 9,429 8 9,639 | 4,161 | 4,785 | 5,409 | 6,033 | 6,657 | 7,281 | 7,905 | 8,530 | 9,570 | 9,639 9 9,848 | 4,585 | 5,272 | 5,960 | 6,648 | 7,336 | 8,023 | 8,711 | 9,399 | 9,848 - 10 10,058 | 5,008 | 5,759 | 6,510 | 7,261 | 8,012 | 8,764 | 9,515 | 10,058 - : 11 10,267 | 5,431 | 6,245 | 7,060 | 7,874 | 8,689 | 9,504 | 10,267 - - - 12 10,477 | 5,855 | 6,733 | 7,611 | 8,489 | 9,368 | 10,246 | 10,477 - - - 13 10,687 6,278 | 7,219 | 8,161 | 9,103 | 10,044 | 10,687 : = : : 14 10,896 | 6,701 | 7,706 | 8,711 | 9,716 | 10,721 | 10,896 - - - - 15 11,106 | 7,125 | 8,193 | 9,262 | 10,331 | 11,106 - - - - - For each 209 423 486 549 613 209 - - - - - add’l, add Instructions: 1. Gross Income (GI) eligibility limit is at 85% of State Median Income (SMI). 2. Compare GI with Income Eligibility Limit to determine income eligibility. 3. IfGlTis less than or equal to the Income Eligibility Limit, find the largest reimbursement rate

for which the income limit is greater than or equal to GI.

Benefit,

EXHIBIT II

2

Department of Human Services

Employment and Support Services Division January 2,

2020