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Title 13: Social Service Resources Page 108 Iowa Department of Health and Human Services Employees’ Manual Chapter G: Child Care Assistance Authorizing Services Revised June 14, 2024 Fee Schedule Nonpayment of Fees Legal reference: 441 IAC 170.4(2), 170.5(3) The provider is responsible for collecting fees and maintaining records of fees collected. Those records must be available for audit by the Department or its representative. When a parent does not pay the fee, the provider must demonstrate that a reasonable effort has been made to collect the fee. Reasonable effort means an original billing and two follow-up notices of nonpayment. Child Care Assistance may be terminated when the Department determines that no payment or partial payment of fees has been received within 30 calendar days following the issuance of the last billing. Terminate services unless the client establishes inability to pay. (See Inability to Pay Fees.) Notify the client of any adverse action using form 470-4558, Notice of Decision: Child Care. Inability to Pay Fees Legal reference: 441 IAC 170.4(2) When the family continues to need service but reports the inability to pay the fee, assess the family’s situation and verify whether it is due to the existence of one or more of the following conditions: ▪ Extensive medical bills for which there is no payment through Medicaid, Medicare, or other insurance coverage. ▪ Shelter costs in excess of 30% of the household income. ▪ Utility costs, not including the cost of a telephone, in excess of 15% of the household income. ▪ Additional expenses for food resulting from diets prescribed by a physician. If such a condition exists, continue services without a fee until the condition no longer exists and the family is able to participate in the current cost of service. Document nonpayment and the inability to pay in the case record. Assess each “inability to pay” case to determine whether the family can be charged a reduced fee. Charge the reduced fee until full participation in fees is possible.